{"id":510,"date":"2010-10-23T13:27:36","date_gmt":"2010-10-23T13:27:36","guid":{"rendered":"http:\/\/www.saasoft.com\/blog\/?p=510"},"modified":"2010-10-23T13:27:36","modified_gmt":"2010-10-23T13:27:36","slug":"kill-or-cure","status":"publish","type":"post","link":"https:\/\/hcse.blog\/?p=510","title":{"rendered":"Will the Cuts Cure the Problem or Kill the Patient?"},"content":{"rendered":"

\"\"<\/a>Times are hard. Severe austerity measures are being imposed to\u00a0plug the hole in the\u00a0national finances. Cuts are being made.\u00a0 But will these cuts\u00a0cure\u00a0the\u00a0problem or kill the patient?\u00a0 How would we know before it is too late? Is there an alternative to sticking the fiscal knife in and hoping we don’t damage\u00a0a vital part of the system? Is\u00a0a single\u00a0bold slash or a series of planned\u00a0incisions a\u00a0better strategy?\u00a0 How deep, how far and how fast is it safe to cut? The answer to these questions is “we don’t know” – or rather that we\u00a0find it very hard to\u00a0predict with confidence what will happen.\u00a0 The reason for this is that we are dealing with a complex system of interdependent parts that connect to each other through causal links; some links are accelerators, some are brakes, some\u00a0work faster and some slower.\u00a0\u00a0Our caveman brains were not designed to solve this sort of predicting-the-future-behaviour-of-a-complex-system problem: our brains evolved to spot potential danger quickly and to manage a network of social relationships.\u00a0 So to\u00a0our caveman way of thinking\u00a0complex systems behave\u00a0in counter-intuitive ways.\u00a0 However, all physical systems are constrained by\u00a0the Laws of Nature – so if we don’t understand how they behave\u00a0then the limitation is with the\u00a0caveman wetware between our ears.<\/p>\n

We do have an amazing skill\u00a0though – we have the ability to develop tools that extend our limited biological capabilites.\u00a0We have mastered technology – in particular the technology of data and information. We have\u00a0 learned how to recode and record our expereince and our understanding\u00a0so that each generation can build on the knowledge of the previous ones.\u00a0 The tricky\u00a0problems we are facing are ones that we have never encountered before so we have to learn as we go.<\/p>\n

So our current problem of understanding the dynamics of\u00a0our economic and social\u00a0system is this:\u00a0we cannot do this unconsciously and intuitively\u00a0in our heads.\u00a0Instead we\u00a0have developed tools that can extend our predictive capability.\u00a0Our challenge is to learn how to use these tools – how to wield the fiscal scalpel so that it is quick,\u00a0safe and effective. We\u00a0need to excise the\u00a0cancer of waste while preserving\u00a0our vital social and economic structures\u00a0and processes.\u00a0\u00a0We need the\u00a0best tools available\u00a0– diagnostic tools, decision tools, treatment planning tools, and progress monitoring tools.\u00a0 These tools exist – we just need to learn to\u00a0use them.<\/p>\n

A perfect example\u00a0of this is the\u00a0reining in of public spending and the impact of cutting\u00a0social service\u00a0budgets.\u00a0 One thing that these\u00a0budgets provide are services\u00a0that some people need to\u00a0maintain independent living in the community.\u00a0\u00a0Very often elderly people are only just coping and even a minor illness can be enough to tip them over the edge and into hospital – where they can get stuck because to discharge them safely requires extra social support – support that if provided earlier might have prevented a hospital admission. So\u00a0boldly slashing the social care budget will not magically\u00a0excise the waste – it\u00a0means\u00a0that there will be\u00a0less social support capacity and patients will get stuck in the hospital part of the health and social care system. This is not good for them – or anyone else. Hospitals are not hotels and getting stuck in one is not a holiday! Hospitals are for people\u00a0who are very ill – and if the hospital is full of not-so-ill people\u00a0who are stuck then we have an even bigger problem – because the very\u00a0ill people get even more ill – and then they need even more resources to get them well again. Some do not make it. A bold\u00a0slash\u00a0in just one part of the\u00a0health and\u00a0 social care system can, unintentionally,\u00a0bring the whole health and social care system\u00a0crashing down.<\/p>\n

Fortunately there is a way to avoid\u00a0this – and it is counter-intuitive – otherwise we would have done it already. And because it is counter-intuitive I cannot just explain it – the\u00a0only way to understand\u00a0it is to\u00a0discover and demonstrate\u00a0\u00a0it to\u00a0ourselves.\u00a0 And in the process of learning to master the tools we need we will make a lot of errors.\u00a0Clearly, we do not want to impose\u00a0those errors on the real system – so we need something to practice with that is not the real system yet\u00a0behaves realistically enough to allow us to develop our skills. That something is a system simulation.\u00a0To experience\u00a0an example of\u00a0a healthcare system simulation and to play the game\u00a0please follow the link: click here to play the game<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

Times are hard. Severe austerity measures are being imposed to\u00a0plug the hole in the\u00a0national finances. Cuts are being made.\u00a0 But will these cuts\u00a0cure\u00a0the\u00a0problem or kill the patient?\u00a0 How would we know before it is too late? Is there an alternative to sticking the fiscal knife in and hoping we don’t damage\u00a0a vital part of the … <\/p>\n

Continue reading “Will the Cuts Cure the Problem or Kill the Patient?”<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[22,34,41,43,45,46],"tags":[],"class_list":["post-510","post","type-post","status-publish","format-standard","hentry","category-healthcare","category-questions","category-stories","category-why","category-what","category-teach"],"_links":{"self":[{"href":"https:\/\/hcse.blog\/index.php?rest_route=\/wp\/v2\/posts\/510","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=510"}],"version-history":[{"count":0,"href":"https:\/\/hcse.blog\/index.php?rest_route=\/wp\/v2\/posts\/510\/revisions"}],"wp:attachment":[{"href":"https:\/\/hcse.blog\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=510"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/hcse.blog\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=510"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/hcse.blog\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=510"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}