{"id":4888,"date":"2016-10-01T07:55:52","date_gmt":"2016-10-01T06:55:52","guid":{"rendered":"http:\/\/www.saasoft.com\/blog\/?p=4888"},"modified":"2016-10-01T07:55:52","modified_gmt":"2016-10-01T06:55:52","slug":"the-cream-of-the-crap-trap","status":"publish","type":"post","link":"https:\/\/hcse.blog\/?p=4888","title":{"rendered":"The Cream of the Crap Trap"},"content":{"rendered":"

\"database_transferring_data_150_wht_10400\"<\/a>It has been a busy week.<\/p>\n

And a common theme has cropped up which I have attempted to capture in the diagram below.<\/p>\n

It relates to how the NHS measures itself and how it “drives” improvement.<\/p>\n

The measures are called “failure metrics” – mortality, infections, pressure sores, waiting time breaches, falls, complaints, budget overspends. \u00a0The list is long.<\/p>\n

The data for a specific trust are compared with an arbitrary minimum acceptable standard to decide where the organisation is on the Red-Amber-Green scale.<\/p>\n

If we are in the red zone on the RAG chart … we get a kick. \u00a0If not we don’t.<\/p>\n

The fear of being bullied and beaten raises the emotional temperature and the internal pressure … which drives movement to get away from the pain. \u00a0A nematode worm will behave this way. They are not stupid either.<\/p>\n

As as we approach the target line our RAG indicator turns “amber” … this is the “not statistically significant zone” … and now the stick is being waggled, ready in case the light goes red again.<\/p>\n

So we muster our reserves of emotional energy and we PUSH until our RAG chart light goes green … but then we have to hold it there … which is exhausting. \u00a0One pain is replaced by another.<\/p>\n

<\/a><\/p>\n

The next step is for the population of NHS nematodes to be compared with each other … they must be “bench-marked”, and some are doing better than others … as we might expect. We have done our “sadistics” training courses.<\/p>\n

The bottom 5% or 10% line is used to set the “arbitrary minimum standard target” … and the top 10% are feted at national award ceremonies … and feast on the envy of the other 90 or 95% of “losers”.<\/p>\n

The Cream of the Crop now have a big tick in their mission statement objectives box “To be in the Top 10% of Trusts in the UK<\/em>“. \u00a0Hip hip huzzah.<\/p>\n

And what has this system design actually achieved?\u00a0The\u00a0Cream of the Crap.<\/strong><\/em><\/p>\n

Oops!<\/p>\n

\n

It is said that every system is perfectly designed to deliver what it delivers<\/em>.<\/p>\n

And a system that has been designed to only use failure and fear to push improvement can only ever achieve chronic mediocrity – either chaotic mediocrity or complacent mediocrity.<\/p>\n

So, if we want to tap into the vast zone of unfulfilled potential, and if we want to escape the perpetual pain of the Cream of the Crap Trap … we need a better system design.<\/p>\n

And maybe we might need a splash of humility and some system engineers<\/em> to help us do that.<\/p>\n

This week I met some at the Royal Academy of Engineering in London, and it felt like finding a candle of hope amidst the darkness of despair.<\/p>\n

I said it had been a busy week!<\/p>\n","protected":false},"excerpt":{"rendered":"

It has been a busy week. And a common theme has cropped up which I have attempted to capture in the diagram below. It relates to how the NHS measures itself and how it “drives” improvement. The measures are called “failure metrics” – mortality, infections, pressure sores, waiting time breaches, falls, complaints, budget overspends. \u00a0The … <\/p>\n

Continue reading “The Cream of the Crap Trap”<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5,15,22,24,41,48],"tags":[],"class_list":["post-4888","post","type-post","status-publish","format-standard","hentry","category-4n-chart","category-design","category-healthcare","category-improvementology","category-stories","category-trust"],"_links":{"self":[{"href":"https:\/\/hcse.blog\/index.php?rest_route=\/wp\/v2\/posts\/4888","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/hcse.blog\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/hcse.blog\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/hcse.blog\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/hcse.blog\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=4888"}],"version-history":[{"count":0,"href":"https:\/\/hcse.blog\/index.php?rest_route=\/wp\/v2\/posts\/4888\/revisions"}],"wp:attachment":[{"href":"https:\/\/hcse.blog\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=4888"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/hcse.blog\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=4888"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/hcse.blog\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=4888"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}