{"id":788,"date":"2011-05-07T09:42:09","date_gmt":"2011-05-07T09:42:09","guid":{"rendered":"http:\/\/www.saasoft.com\/blog\/?p=788"},"modified":"2011-05-07T09:42:09","modified_gmt":"2011-05-07T09:42:09","slug":"focus-on-flow","status":"publish","type":"post","link":"https:\/\/hcse.blog\/?p=788","title":{"rendered":"The Seven Flows"},"content":{"rendered":"

\"\"<\/a>Improvement Science is the knowledge and experience required to improve … but to improve what?<\/p>\n

Improve safety, delivery, quality, and\u00a0productivity?<\/p>\n

Yes –\u00a0ultimately – but they are the outputs. What has to be improved\u00a0to achieve these improved outputs? That is a much more interesting question.<\/p>\n

The simple answer is “flow”.\u00a0But flow of what? That is an even better question!<\/p>\n

Let us\u00a0consider a real example. Suppose we want to improve the safety, quality, delivery and productivity of\u00a0our healthcare system – which we do\u00a0– what “flows” do we need to consider?<\/p>\n

The flow of patients is\u00a0the obvious one – the observable, tangible flow of people with health issues who\u00a0arrive and leave healthcare facilities such as\u00a0GP practices, outpatient departments, wards, theatres, accident units, nursing homes, chemists, etc.<\/p>\n

What other flows?<\/p>\n

Healthcare is a service with an intangible product that is produced and consumed at the same time – and in\u00a0for those reasons it is very different from manufacturing.\u00a0The interaction between the patients\u00a0and the carers is\u00a0where the\u00a0value is added and this implies that “flow of carers”\u00a0is\u00a0critical\u00a0too. Carers are people – no one had yet\u00a0invented a\u00a0machine that cares.<\/p>\n

As soon as we have two flows that interact we have a new\u00a0consideration – how do we ensure that they are coordinated so that they are able to interact at the\u00a0same place,\u00a0same time, in the right way and is the right amount?<\/p>\n

The flows are\u00a0linked – they are interdependent – we have a system of flows and we cannot just focus on one flow or ignore the inter-dependencies. OK, so far so good. What other flows do we need to consider?<\/p>\n

Healthcare is a problem-solving\u00a0process and it is\u00a0reliant on data\u00a0– so\u00a0the flow of data is essential\u00a0–\u00a0some of this is clinical data and related to the practice of care, and some of it is operational data\u00a0and related to the process of care. Data flow\u00a0supports the patient and carer flows.<\/p>\n

What else?<\/p>\n

Solving problems\u00a0has two stages – making decisions and taking actions – in healthcare the\u00a0decision is called diagnosis and the action is called\u00a0treatment. Both may\u00a0involve the use of materials (e.g. consumables, paper, sheets, drugs,\u00a0dressings,\u00a0food, etc) and equipment (e.g. beds, CT scanners, instruments, waste bins etc). The\u00a0provision of\u00a0materials and equipment\u00a0are flows that require data and people to support and coordinate as well.<\/p>\n

So far we have flows of patients, people, data, materials and equipment and all the flows are interconnected. This is getting complicated!<\/p>\n

Anything\u00a0else?<\/p>\n

The\u00a0work has to be done in a suitable environment\u00a0so the buildings\u00a0and estate need to be provided. This may not seem like a flow but it is – it just has a longer time scale and is more\u00a0jerky than the other flows – planning-building-using\u00a0a new hospital has a time span of decades.<\/p>\n

Are we finished yet? Is anything\u00a0needed to support the these flows?<\/p>\n

Yes – the flow that links\u00a0them all is money. Money\u00a0flowing in is called revenue and investment and money flowing out is called costs\u00a0and dividends and so long as revenue equals or exceeds costs over the long term the system can function. Money is like energy – work only happens when it is flowing – and\u00a0if the money doesn’t flow to the right part at\u00a0the right time and in the right amount then the performance of the whole system can suffer – because\u00a0all the parts and flows are interdependent.<\/p>\n

So, we have Seven Flows<\/strong> – Patients, People, Data, Materials, Equipment, Estate and Money – and when considering any process or system improvement we must remain mindful of all Seven because they are interdependent.<\/p>\n

And that is a challenge\u00a0for us because our caveman brains are not\u00a0designed to solve\u00a0seven-dimensional time-dependent problems! We are OK with one dimension,\u00a0struggle with two, really struggle with three and that is about it. We\u00a0have to face the reality that we cannot do this in our heads – we need\u00a0assistance – we need tools to help us handle\u00a0the Seven Flows simultaneously.<\/p>\n

Fortunately these tools exist – so we just need to learn how to use them – and that is what Improvement Science<\/a> is all about.<\/p>\n","protected":false},"excerpt":{"rendered":"

Improvement Science is the knowledge and experience required to improve … but to improve what? Improve safety, delivery, quality, and\u00a0productivity? Yes –\u00a0ultimately – but they are the outputs. What has to be improved\u00a0to achieve these improved outputs? That is a much more interesting question. The simple answer is “flow”.\u00a0But flow of what? That is an … <\/p>\n

Continue reading “The Seven Flows”<\/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":[13,18,20,22,32,34,35,39,40,42,43,45,46],"tags":[101,115,146,273,292,299],"class_list":["post-788","post","type-post","status-publish","format-standard","hentry","category-chimpware","category-finance","category-flow","category-healthcare","category-productivity","category-questions","category-reflections","category-seven-flows","category-sfqp","category-how","category-why","category-what","category-teach","tag-dynamics","tag-flow","tag-interdependence","tag-systems","tag-what","tag-understanding"],"_links":{"self":[{"href":"https:\/\/hcse.blog\/index.php?rest_route=\/wp\/v2\/posts\/788","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=788"}],"version-history":[{"count":0,"href":"https:\/\/hcse.blog\/index.php?rest_route=\/wp\/v2\/posts\/788\/revisions"}],"wp:attachment":[{"href":"https:\/\/hcse.blog\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=788"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/hcse.blog\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=788"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/hcse.blog\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=788"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}