Ohio. Famous for picking US presidents (28 out of the last 30), and the birthplace of aviation (the Wright brothers grew up here in 1870s). Less famous for being home of a number of the most advanced healthcare networks in the world. With collaboration currently flavour of the month, what can the US teach us about working together?
A decade ago I swapped north London for the American Midwest, the NHS for Cincinnati Children's Medical Centre, and management consultancy for supporting an emerging learning network for children with inflammatory bowel disease.
During the nine years I called Ohio home, ImproveCareNow grew from nine care centres in the US to 109 centres all over the world, working with tens of thousands of children and their families collaborating to improve outcomes.
Kaleidoscope has just reached its second birthday. Throw confetti, chow down on some cake or create a cotton masterpiece – any and all forms of celebration welcome.
Now that we’re the wise old age of two, we’ve started to ask ourselves the serious questions. Can we still call ourselves a start-up? When do we become just an ‘up’? As a former (or possibly still present) start-up, have we really drunk enough hipster coffee or tried our hardest to work a man bun?
Are you the same person at work as you are at home? Some? A bit perhaps? This might matter to you immensely, or not at all, but almost all of us would see there being some difference between how we think personally and professionally.
Sometimes this is helpful (not everyone needs to know about your Panini sticker fascination), but sometimes it’s not. The annual NHS Providers conference is an extravaganza of the complexity of healthcare policy. Critiques of control totals, tinkerings with tariffs, and processes to produce plans abound. This is peak-profession conversation (I don’t know how your household runs, but it probably doesn’t have much room for marginal rate emergency rules).
Language is a crucial marker of tribal identity. Both ethnic and professional tribes use language to recognise members of their own tribe and to exclude members of other tribes. Two ethnically related tribes may be distinguished by their use of different languages, but in other cases the linguistic differences may be subtle.
Small but significant linguistic markers of identity are known as shibboleths, after the Old Testament story in which the pronunciation of this word was used to identify members of an 'out-group.'
Where two tribes share a genuinely common language, tribal politics may encourage the creation of artificial shibboleths. Serbs and Croatians share what used to be a common language, but Serbs chose to write it using the Cyrillic (Russian) alphabet while Croatians adopted the Latin script. Over time, small differences in usage have evolved.
I'm excited about this month's upcoming events to discuss the lessons of the changes to stroke services in London and Greater Manchester.
The events will draw on the findings of the study led by Professor Naomi Fulop of UCL, which brought together a team of researchers, clinicians and service users from London and Manchester to examine the effectiveness of stroke reconfiguration. I am delighted to have been a member of this team.
But why are we talking about stroke reconfiguration in London and Greater Manchester? And why are we talking about it right now? We believe that, by using a mixed method approach to study a number of cases of major system change in stroke services, our research has identified several lessons for people who want to carry out changes of this kind in other settings.
There’s a lot of us out there, in different industries and sectors, trying to build collaborations, develop new ways of working and change systems that are no longer fit for purpose.
Whether referred to as innovators, system changers, collaborators, community builders, navigators, knitters or something else, we are all usually glass-half-full, 'we can do this better' type people. Which is important because, let’s face it, getting diverse groups of people and organisations to work together for the greater good is not always easy, despite best intentions.
In my previous blog, I argued that, while successful collaboration certainly requires a 'common language', there are in fact several kinds of common language, requiring different degrees of effort to develop, and supporting collaborations of varying kinds and levels of complexity.
In this blog, I will discuss the most basic forms of collaboration. These pay no attention at all to their own cultural and behavioural aspects and deliberately restrict the flow of information between partners.
"We need to find a common language." This is often said when two or more organisations or disciplines are working together. At first sight it appears everyone is working to a common goal: improving outcomes, reduced costs, better experience. Not much to argue with there.
Then the misunderstandings and tensions begin to build up. To try to resolve them, you go back to first principles: "It’s all about the patient!"
But by this stage, even the most basic assumptions about the partnership start to seem questionable. What, exactly, is all about the patient? What about the patient is it all about? What is a patient anyway?
I know you’re in the middle of something – thanks for even stopping by – but could I borrow you for two quick thought experiments? Only be a minute.
First, you’re a government minister. Or a chief executive of a national statutory body. You’re announcing a nationwide change programme to help safeguard the future of the NHS, our most beloved institution.
You want it to sound suitably impressive, capable of making headlines and winning plaudits. What do you say? A pot of money? A new ‘thing’ – an institute perhaps? Probably a number (containing many zeros) of new clinicians to spearhead your charge. The creation of a new acronym certainly.