KNOWING IS NOT ENOUGH Jonathon Gray Director of Improvement & Innovation Ko Awatea, Counties Manukau DHB Chair Innovation and Improvement Victoria University, Wellington @Graymattrs
Personal Story 1 Personal Story 2 What could we do The Challenge we Face Together What will we do Challenge & Opportunity
Personal Story 1 “… knowledge is continuing to grow. But having discovered so much, we have hit a new problem — how to actually deliver on all that has been learned.” Atul
Personal Story 1 “There was a time when what was known, you could know we built it around a culture and set of values that said what you were good at was being daring, at being courageous , at being independent and self-sufficient . Autonomy was our highest value .” Atul
Personal Story 1 “We have trained, hired and rewarded people to be cowboys . But it's pit crews that we need, pit crews for patients.” Atul
Personal Story 1 1. Recognize Success 2. Devise Solutions 3. Humility, Discipline, Teamwork
Personal Story 1 Pit Crews not Cowboys
Personal Story 1 Personal Story 2 Systems & Group Success
Personal Story 2 “We can’t know it all, we can’t do it all by ourselves.” Atul
Personal Story 2 Knowledge & our Values around it
Personal Story 2 Systems & group success We can’t do it all by ourselves The Challenge we Face Together
The Challenge we Face Together The last 60 years have been fantastic, particularly the investment, science and good management of the last 40
The Challenge we Face Together
“Where to start …” The story of now Different IT systems Different levels of investment in different areas Variation in our system Different management and organisational systems in 20 regions Capability is limited “I almost think there is no area where there is not variation !” The Challenge we Face Together Smaller DHBs not have infrastructure Need to improve faster than we can alone
“Toxicity of some traditional leadership approaches” “We remain victims of myths that poison our progress” “Intellectual impoverished theories” Old theory- that somehow out of competition and fragments will come the perfect and reliable patient centred simple system The Challenge we Face Together “Leadership that needs to get out of the way”
Incentives will save us • “In most places myths are in charge Measurement will save us. • and stalling progress” Accountability will save us. • Markets will save us • Technology will save us • “To have winners need losers” The Challenge we Face Together “That collaboration is naïve” “That competition builds better bridges” Cooperation works but is more difficult • Truths in market based environments Competition builds waste •
The Challenge we Face Together Forces of destruction – People & Organisations Incentive pay Numerical goals without method Competition instead of collaboration
We can’t do it all by ourselves Systems & group success What could we do The Challenge we Face Together Archipelagos and half bridges
5 solutions 1. Use global brains 2. Speak to the truth, inspire What could we do action 3. Seek to collaborate – connect people to execute change 4. Seek for/encourage sensemaking. Share resilience 5. Build capability, in improvement and leadership.
By joining up the bright spots By connecting What could we do By being brave By importing ideas from afar
We can’t do it all by ourselves Systems & group success What could we do Connect up the bright spots Archipelagos and half bridges What will we do
An Agenda for New Zealand? The best health system in the world at improving! Knowing is not enough, we must apply. Willing is not enough, we must do.” ― Bruce Lee What will we do
We can’t do it all by ourselves Systems & group success Connect up the bright spots Archipelagos and half bridges Network to improve as a system What will we do Challenge & Opportunity
An Agenda for New Zealand? The best health system in the world at improving! 1. Establish knowledge exchange, and increase peer-to-peer learning. 2. Cease competition. Get past the tall poppy syndrome and share 3. Stop competing - Substitute science - Create and join collaboratives to pursue shared aims. 4. Convene regularly like this to share, reflect, review, learn and celebrate – appreciative enquiry 5. Awards ceremony and a repository of great practice 6. Build and support a national system to remove the variation in delivery of best practice. 7. National Learning, national improvement Impact network for NZ Invite interested DHBs: Common dashboard; Leadership sharing & learning; Improvement visits; Collaboratives each year • Continue conversations beyond traditional meetings • Learn faster together • By the front line for the frontline
Ignorance is like cholera; it cannot be controlled by the individual alone it requires the organised efforts of society ― Professor Sir Muir Gray Challenge & Opportunity
KNOWING IS NOT ENOUGH Jonathon Gray Director of Improvement & Innovation Ko Awatea, Counties Manukau DHB Chair Innovation and Improvement Victoria University, Wellington @Graymattrs
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