From designing for patients to coproducing with people

The last month has been pretty busy for me as the ISQua conference took place in Cape Town. This affords me the opportunity to reflect on the key lessons that came out of the conference that may apply to the Irish Healthcare system. There is more than enough for more than one article so I probably will use the concepts over a few, writes Dr. Pater Lachman.

The last month has been pretty busy for me as the ISQua conference took place in Cape Town. This affords me the opportunity to reflect on the key lessons that came out of the conference that may apply to the Irish Healthcare system. There is more than enough for more than one article so I probably will use the concepts over a few, writes Dr. Pater Lachman.

Throughout the programme, we had a theme of Coproduction. This was highlighted by the leading thinker in the field, Dr Paul Batalden. Paul is well known for the introduction of microsystem theory while he led the way in Dartmouth and many of us use this theory as we come to recognise the importance of systems theory – pure extrapolation from Deming. In Ireland, we teach Microsystem theory and I think it is the foundation of the improvement work we undertake.

Every Hospital Manager needs to understand how systems work and interact.  An understanding of Microsystem theory can help in achieving better results as we navigate the complex adaptive system that is healthcare. There are examples from Dartmouth http://clinicalmicrosystem.org/  and the successful transference of the theory to Sheffield where there have been great results in the application of the theory. https://www.sheffieldmca.org.uk/

However, Batalden has progressed to the next level of understanding what it takes to improve healthcare. He is now the key advocate of Coproduction of Health  This is a new way of looking at healthcare from the eyes of the user and really acknowledging that we do not have the answers to solving the challenges we have.  It is about thinking differently and undergoing a true transformation rather than making token improvements.

THE BAR IS NOW SET FOR THE NEXT QUALITY JOURNEY- FROM IMPROVING WHAT IS NOT WORKING TO CODESIGNING WHAT WILL WORK.

In this paper and at the conference he makes the point that unless we really share our decision making at the system level and clinical level with people whom we call patients, we will not achieve the outcomes we want to achieve.  “Clinicians need to learn in ways that encompass all of the forms of knowledge …. including eliciting a patient’s immediate and long term aims. On an individual level, this can be described as shared decision making. On a system level, this way of thinking and practising may enable us to transform healthcare to improve health for our patients and populations”

People are the missing ingredients in all our planning. We consult focus groups, patient groups and the wider population. But is this real consultation and does it lead to the co-production of Health and the delivery of Healthcare. Every member of the HMI needs to ask this question when they plan healthcare provision – who has is the real expert and have we taken their view into account? An examination of what it takes to coproduce means that we share power and design appropriate healthcare.

The real challenge is to meet the need for coordinated integrated care that is infused with dignity and compassion. The bar is now set for the next quality journey- from improving what is not working to codesigning what will work.

Originally published https://www.healthmanager.ie/2019/11/from-designing-for-patients-to-coproducing-with-people/

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Nourhan Kawtharani

Nourhan, a quality and safety coordinator with eight years of experience in ambulatory healthcare in Lebanon, aims to deepen her understanding of the systemic and holistic approach to healthcare through this fellowship.

She aims to identify gaps and develop tailored interventions that address specific contexts rather than applying general solutions. Engaging with diverse professionals and perspectives during this educational journey will expand the application of these concepts across different cultural settings.

Nourhan emphasizes the importance of promoting a culture of continuous learning and improvement within healthcare institutions, considering it a vital leadership responsibility to integrate quality and safety initiatives into the organizational culture.

Nourhan's commitment to patient safety and quality management includes sourcing practical resources and transforming insights into actionable knowledge to drive continued progress in healthcare practices and outcomes.

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Elom Otchi

Elom is passionate about improving quality of care and patient safety outcomes.

In view of this, he has had the opportunity to work in various capacities with various organisations including AfIHQSA, WHO, UNICEF and others undertaking research, supporting the development of national quality policies and strategies, facilitating the establishment of quality governance systems across all the levels of the health sector and building capacity of national and sub-national quality leads/teams to institutionalize the practice of quality and patient safety across the continent.

He has also worked extensively across all levels of care in the health sector of Ghana, including leading the Quality & Patient Safety program in its largest teaching hospital.

I would like to use this Fellowship as a learning platform and an opportunity to acquire the requisite knowledge, skills and competencies to complement ongoing efforts by like-minded individuals and organizations to continuously advance improve the quality and patient safety in Ghana and the continent.

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Stephen Taiye Balogun

Stephen is a Senior Programme Officer at the Institute of Human Virology in Nigeria as well as Country Representative for Health Information for All (HIFA).

Stephen plans to use this opportunity to maximise his impact by championing the cause of patient safety and quality in Nigeria and across Africa.

Stephen says "Quality and safety is a major wheel through which universal healthcare coverage can be achieved. The goal is to be a bridge in the gap between the International Quality Improvement and Patient Safety community and my country to ensure rapid spread, adoption, implementation and practice."

We are looking forward to working with both Stephen and our 2020 winner Rhoda Kalondu over the next year.

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Dr Rhoda Kalondu

Rhoda is the Head of the Patient Safety Unit at Kenyatta Hospital in Nairobi and wants to use this Fellowship to learn how to establish a culture of safety and develop systems for assessment and analysis at her institution, and more widely. As well as this, Rhoda intends to develop and execute an intervention to improve patient safety in Kenyatta National Hospital.

It is one thing to institute measures and processes for improvement, but quite another to change the culture of an environment. Rhoda's ambition to lead others in this change inspired the panel.

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Dr Subhrojyoti Bhowmick

I am an MBBS graduate from Calcutta University with a Gold Medal in Gynecology & Obstetrics.

I have completed M.D in Pharmacology from IPGME& R, Kolkata and have over 12 years of experience in the field of Clinical Research, Pharmacovigilance and Medication management in Hospitals.

I have completed certification in Clinical Research Administration & Project Management from Stanford University, USA and in Patient Safety from Johns Hopkins University, USA.

I am an Assessor for National Accreditation Board for Hospitals & Health care providers (NABH), India assessing hospitals for medication safety and clinical quality standards and NABH Assessor for Ethics Committee Accreditation program in India as well.

I serve as the Chairperson, Institutional Ethics Committee of Health Point Hospital, Kolkata and am associated with 2 other Hospital ethics committees as a member.

I finished my Fellowship in Healthcare Quality from the International Society of Quality in Healthcare (ISQua) from Ireland in 2017.

I have published several research articles and have also authored a chapter on “Regulations governing Clinical Trial” in the book “Fundamentals of Clinical Trial & Research”.

I am a peer reviewer for prestigious international journals like the British Journal of Clinical Pharmacology, CNS Drugs and Drug Safety case reports.

I am the recipient of the UK Seth Oration Award for Best Clinical Pharmacology paper by the Indian Pharmacological Society in 2009 and the “Most promising Healthcare professional in Patient Safety in India” award by the Asian African Chamber of Commerce and Industry in October 2018.

Recently in April 2019, I received the Young Quality Achiever award by Consortium of Accredited Healthcare Organizations (CAHO), India for 2019 for my work in the field of medication safety and clinical research.

I have a keen interest in teaching and am visiting adjunct faculty of Pharmacology at KMC, Mangalore, India and for Healthcare technology at MAKAUT, Kolkata, India.

I was associated with Stanford University School of Medicine, in the USA as a Senior Clinical Research Associate from 2015 to 2017 and have certification in Biostatistics, Evidence-based Medicine and Medical Writing from Stanford University.

Currently, I am working as the Clinical Director of Academics, Medical Quality and Clinical Research at Peerless Hospital and B K Roy Research Centre, Kolkata.

I am very happy and thrilled to receive the prestigious ISQua Lucian Leape Patient safety Fellowship Award for 2019 and I look forward to honing my skills further in the field of healthcare quality and patient safety through my experiences during this fellowship.

I sincerely believe that successful completion of this fellowship will help me evolve as a more confident Patient safety leader in India who in turn can provide significant inputs on policy changes through NABH for the Indian healthcare system.

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