The Q health framework

Developed to support leaders in planning and delivering large-scale improvements across health systems, this framework (image accompanying this post; Q, 2024) was a collaboration with a broad range of British medical sector leaders.

The framework falls into two halves: the first half is focused on sustainable development and creating the conditions for a sound health/wellness system; the second half is on how that service should be delivered, via service and outcome transformation. Within each half are thee sets of activities: collective vision and leadership; an aligned operating model; capability, connections and culture in the sustainable development half. In the service and outcome transformation half there is: system and pathway redesign; continuous quality improvement; and targeted innovation. Around these six activities are 18 key considerations which all stakeholders must address for this type of system change to work and to stick (Q, 2024). They are:

• Co-creating a vision and narrative for change
• Building leadership support
• Understanding together the nature of the system
• Engaging with all partners and communities
• Redesigning management systems to enable improvement 
• Aligning resources and incentives
• Agreeing priorities and mediating expectations
• Developing goals and the ability to measure progress
• Enabling productive cross-silo connections and reflections
• Creating collaborative learning habits and structures
• Building skills and space for everyone involved in the change

And in the second half:

• Understanding the context, needs and assets of those served
• Diagnosing and redesigning end to end pathways and service models
• Delivering multi-strand 'transformation' programmes
• Incrementally improving hundreds of processes with service users
• Adapting roles, ways of working, metrics and linked systems
• Ongoing monitoring, adaptation and control of service performance
• Testing, experimenting, scaling and embedding innovations
• identifying priority gaps and/or innovations
• Understanding the current situation and desired futures

In order to create the right conditions, the framework emphasises building a collective vision, prioritising transformation efforts, and developing sustainable change through culture and capabilities. These elements rely heavily on engagement with partners and communities, shared understanding, and strong leadership support across organisations (Q, 2024). The delivery aspects focus on three key areas: system redesign, continuous improvement, and targeted innovation. These require deep understanding of local context and population needs, iterative testing with real-time data, and identifying promising innovations that can be scaled effectively across systems. This will need programmes combining pathway redesign with changes to funding, IT, and infrastructure. Tools for reviewing and planning large-scale change is built into the system. This is not easy work, but will require investment over multiple years, and a government committed to making change. I am not sure than any government on the planet is realistically in that space right now... and as for making cross-party long term funding commitments... well. I think that too is a wait and see thing.

The framework is a partnership between the Health Foundation, the Q community, and NHS Confederation. It will be nice if it works, and if the UK government actually fund it and back it. 

Sam

References:

Q. (2024, August 29). Improving across health and care systems: a framework. Q, The Health Foundation. https://q.health.org.uk/resources/improving-across-health-and-care-systems-a-framework

read more "The Q health framework"

The innovation index

The European Union (EU) nations are a collection of highly innovative societies, with, according to the Global Innovation Index 2022, Switzerland ranked at #1 with another 5 member states in the top 10: Sweden, the Netherlands, Germany, Finland and Denmark (Dutta et al., 2022, p. 19).

However, I recently read a US book (Stolzoff, 2023) proposing that that the EU was not very innovative, and that the US was. While the rankings do show that US is very innovative, sitting at #2 on the list, that nation is surrounded - bracketed - by equally innovative European nations (Dutta et al., 2022). 

We do need to be careful of our claims. Particularly when they are easily checked.

New Zealand too sits in the top 20 of innovative nations (only just) alongside Australia. We are in the elite company of those high-income nations who - for our development level - outperform expectations. Our R&D pushed on into Covid-19 times despite the turbulence being experienced on a global scale.

We are in good company, for the time-being at least. Let us see what the next update to these rankings brings for all nations.

Sam

References:

Dutta, S., Lanvin, B., León, L. R., & Wunsch-Vincent, S. (2022). Global Innovation Index 2022: What is the future of innovation-driven growth?. World Intellectual Property Organization (WIPO). https://doi.org/10.34667/tind.46596

Stolzoff, S. (2023). The Good Enough Job: Reclaiming Life from Work [e-book]. Penguin.

read more "The innovation index"

Some Pros & Cons of Amazon Go

I will be interested in hearing updates on how the new Amazon Go grocery shop is going in Seattle.

While I like the idea of no lines, I am not so fond of check out staff possibly losing their jobs. However, it looks instead as if it will be retraining time for them: in customer service. Amazon needs staff to answer people's queries. They probably - excuse the pun - won't be hitting the breadline. I have had heard that Amazon allows all their staff to do any study they want to, at the company's expense, so those who work for Amazon and don't want to make the shift to customer service should be well-looked after.

However, Amazon is not everyone. What about other staff who may well find their supermarkets taken over by Amazon, or retooling to automation, in the relatively near future? I suspect that the Amazon model will be the way which many retail stores will go fairly quickly: with seamless self-check out technology app, supported by on-hand customer service staff. As the kinks are ironed out, and economies of scale kick in with the technology, the automated format will apply to almost every type of retail there is. Some may rely on a store card rather than an app: it may simply work with your visa card.

On the first few days, the Amazon go store was choked, but things are now evening out. It seems to be running smoothly, but I am sure there will be plenty of opportunity for things to go wrong, for code to need tweaking, for fraud, and for all the things we humans like to complain about!

One customer asked "I know it was always coming but I'm not ready...I don’t even like the self checkouts, I like humans and having a chat? Give me the good news?"

I think the good news is that you won't have to stand around waiting for someone to change the receipt roll in there till, or behind someone else who is just rushed back to pick something else up while you wait and wait and wait, or in a line behind four people with huge trolley-loads. You can still talk to the staff who stock the shelves and staff the Deli: you just don't have to wait for the someone to find their wallet, drop their wallet, try to find their customer card, dither about whether to buy the item which turns out to not be on special, replace the can of beans because it has a ding in it...

And I, for one, am looking forward to that!


Sam

References:

• NewsTalkZB (23 January 2017). Amazon opening first checkout-free supermarket. Retrieved 24 January 2018 from http://www.newstalkzb.co.nz/on-air/early-edition/audio/chris-wilkinson-amazon-opens-first-checkout-free-supermarket/?lipi=urn%3Ali%3Apage%3Ad_flagship3_profile_view_base_recent_activity_details_all%3BPq499NSsSE6P%2BfZb2U22vw%3D%3D
• King 5 (22 January 2017). Amazon opening first checkout-free supermarket. Retrieved 24 January 2018 from https://www.youtube.com/watch?v=JmURnEOIen0

read more "Some Pros & Cons of Amazon Go"

Concrete and washing machines

There is something that you may not expect about the modern washing machine. Apparently many of them contain a concrete block or several concrete blocks. We may ask why: to hold the machine still during spin cycles. I had no idea this was so. I do know that washing machines are often surprisingly heavy. I assumed it was all the steel used in construction. And boy, how wrong was I.

A bright young engineer from Trent University wondered just why we put concrete in washing machines and then shipped them around the world. So he designed a replacement that almost any housewife could have told a designer about a hundred years ago: replace the concrete block with a container of water that you fill once you have put the machine into position. We ship empty, we fill once ready to use. Hardly rocket science, is it. So why has it taken us a hundred years to think of it?

Well, actually, it hasn't taken that long. The first patent for water filled ballast was filed 50 years ago (here). It is just that washing machine manufacturers were a little slow in getting around to doing anything with the idea. And, if we stop to think about it, this is just like one of those water-filled bases we regularly use for an outdoor sunshade or umbrella.

And, like those fillable bases, we could, if we need it to be heavier, fill it with sand and then add another couple of kilos by topping the container up with water.

My washing machine does not contain a concrete block under the hood. It is an Asko, which, like Meile, uses a cast iron surround and four stabilisers to balance it. However, using the water idea, those companies could build out of lighter steel or aluminium, then use a fillable plastic container instead. Or we could bracket the machine to the floor, or have a safety belt on the wall locking the machine in place while it does its thing. Then we wouldn't need additional weight at all.

The silly thing is that worldwide we have gobbled up hundreds of thousands of litres of fuel, damaged moving people's backs, and created lots of household frustration in moving washing machines that could have all weighed at least twenty five kilos less. As a race, this shows me that we humans are surprisingly thick.

I am very glad that the Trent Uni engineer got to apply the nous that any at-home parent could have applied, had they known what was under the washing machine hood.

Maybe we should all ask more questions?!

Sam

• Reference: Jones, R. (4 August 2017). No more heavy loads: experts develop greener, lighter washing machine. 5 August 2017 from https://www.theguardian.com/technology/2017/aug/04/washing-machines-lighter-carbon-emissions-nottingham-trent-university

read more "Concrete and washing machines"

Moving from hierarchies to devolved decision-making

We tend to consider the military in terms of hierarchies.

However, in modern warfare, it is probably more useful to consider devolved decision-making, where those who are doing the job are well prepared to make decisions that fit with the broader strategic goals of the organisation.

On the fly. As it happens. For that, you need a different approach to strategic planning, thinking and training.

University of Queensland School of Business lecturer in innovation, Tim Kastelle, talks about why that is.

Sam

• Reference: Kastelle, Tim (n.d.). Can business learn from the military. Retrieved 30 September 2016 from https://player.vimeo.com/video/104063132

read more "Moving from hierarchies to devolved decision-making"

Newsletter Issue 181, April 2010

Sam Young Newsletter

Issue 181, April 2010

Hi guys,

Are you an innovator? Then New Zealand needs you desperately. Check out Kiwi Innovation - RIP below.

IOD might be about to throw out the baby with the bathwater - read about it in IOD Provisional Accreditation. 

Hot Key for Excel's AutoSum   TLAs for SMEs        Tips, Short & Hot Keys        Hot Linx

Don't forget, if you want to be taken off my mailing list, click here to send me a reply e-mail and I will remove your name.

Kiwi Innovation - RIP

Apparently it is official; Kiwi innovation is dead.

IBM announced in late February (at http://www-03.ibm.com/press/nz/en/pressrelease/29432.wss) the results of the JV between themselves and Auckland Uni, the "Innovation Index of New Zealand". The index examines patents, R&D, trademarks, design, plant variety rights, productivity and organisational and managerial innovation, to assesses innovation within the NZ economy. The team has analysed data from 1998 onwards over 16 industry sectors (including commercial and non-commercial entities).

The industry sectors are constructed and measured as per the ANZSIC industrial classifications (viewable at www.stats.govt.nz), and are: Agriculture, Forestry & Fishing; Manufacturing; Electricity, Gas, Water and Waste Services; Construction; Wholesale Trade; Retail Trade; Accommodation and Food Services; Transport, Postal and Warehousing; Information Media and Telecommunications; Financial and Insurance Services; Rental, Hiring and Real Estate Services (called "Property & Business Services"); Professional, Scientific and Technical Services; Administrative and Support Services; Public Administration and Safety (called "Government Administration & Defence"); Education and Training; Health Care and Social Assistance (called "Health & Community Services"); Arts and Recreation Services; and Other Services - obviously for all those little things that just don't fit anywhere else :-).

The worst hit industries were the construction sector (down 15%), the accommodation, cafes and restaurants sector (down 12%), and the property and business services sector (down 11%). From 2000 to 2007 we were entirely static on innovation, then we took a dive well into the negative in 2008. Excellent. Our results were only partly saved by the Ag, forestry and fish sector who romped home well ahead in the past decade, doubling in their innovation output.

What is reassuring about this research is that the methodology underlying the NZ Innovation Index is based on a similar JV project with IBM Australia and Melbourne University. For we Kiwis, this then means that have a relevant trans-Tasman comparative measure on an 'apples to apples' basis.

So what does this lack of innovation mean for we Kiwis as a whole? Well, if we want to stick to our knitting in ag, forestry and fish; nothing much, except monitor results and ensure that this area continues to have adequate resources put into it. And perhaps we do just let the other areas slide.

However, this seems to me to be a rather defeatist attitude. If anything, I think it means we need to look at little more closely at how we foster, develop and positively encourage entrepreneurship, innovation and creativity throughout our business community. Without intellectual property being generated here, we are missing the knowledge wave, and we will lag even further behind on the OCED scale.

Backing this Auckland Uni and IBM work up are some 2009 stats on national rankings from Insead and CII. According to their Global Innovation Index Report at http://www.insead.edu/facultyresearch/centres/elab/documents/GIIFinal0809.pdf, New Zealand is currently rated at 27th of 130 countries - above us are UAE, Qatar, Malaysia, Israel, pretty much all of Europe, Australia, South Korea, Japan, Hong Kong, Taiwan, Canada, and the US.

There are a number of nations out there who are heading for, if not at the head of the knowledge wave. Perhaps we could try taking a longer term view, getting our two party system to agree on a longer-term innovation strategy, and apply some of the lessons learned by Sweden, Singapore, Switzerland and Ireland.

Something to dream about, anyway.

IOD Provisional Accreditation

For those of you who are currently Provisionally Accredited with the Institute of Directors (IOD), from the first of June this year, your accreditation will disappear.

IOD have decided to streamline and simplify their accreditation process, and the provisional accreditation category is being done away with. Personally, I think this is a pity - this is the 'cadet' level of directors who are serious about developing a career, but have usually had experience in Not-For-Profits, but not yet gained experience as listed company directors in organisations of substance (ie, over $10m).

I hope IOD get a lot of feedback from their members with regard to this; I think they are about to cut away a valuable resource that could be tapped into locally by Not-For-Profit organisations and small private companies who are seeking a diverse mix of independent directors.

IOD currently list directorship positions on their website which has been growing very slowly. It takes quite a while for word to get out there that people can contact IOD directly if they are needing directors, and the board shouldn't expect a massive uptake at the instigation of a new idea - you need to give it five years or so to run.

However, if IOD cut away the large chunk of provisionally registered directors from their potential directors, 'poorer' organisations will not bother to list; the director remuneration requirement will be too high for them to even bother.

Food for thought, IOD.

Hot Key for Excel's AutoSum

There is a very easy hot key way to sum values in Excel if you are finding the ribbons in Office 2007 rather hard to find things in:

• Highlight the row or column, plus one blank cell for the result, and press [Alt]++. Voila! Your selection is summed.

For example, if you want to sum the values in cells B2:B5, you select the cells B2:B6, and then press [Alt]++, with Excel displaying the sum in cell B6. It works with multiple columns and rows and non-contiguous blocks of values too.

Thanks to TechRepublic for this tip at http://blogs.techrepublic.com.com/msoffice/?p=2249&tag=nl.e056 - and remember that in Office 2010 you will be able to customise your ribbons at last, so finally able to work with your Office applications efficiently once more.

TLAs for SMEs

Here are this newsletter's TLAs (Three Letter Acronyms) for you:

• YACC, Yet Another Compiler Compiler. This is real techno-speak - a standard 'parser generator' for Unix operating systems, generating code for the parser in 'C' (programming language). Unix is an open source operating system - ie unlike Microsoft Windows, open source OS's and apps are largely free and developed by users to suit their needs, and is either freeware or shareware... such as Linux or Ubuntu.

Please feel free to email me with any TLAs that you want to get the bottom (meaning!) of.

Tips, Short+Hot Keys

In this newsletter, carrying on the Excel tip theme, we look at what you can do with those 'odd' characters in Excel:

• Excel "Apply the Currency format with two decimal places (negative numbers appear in parentheses)" Ctrl & Shift & $ (dollar)
• Excel "Apply the Date format with the day, month, and year" Ctrl & Shift & # (hash)
• Excel "Apply the Exponential number format with two decimal places" Ctrl & Shift & ^ (Caret)
• Excel "Apply the General number format" Ctrl & Shift & ~ (Tilde)
• Excel "Apply the Number format with two decimal places, thousands separator, and – (minus) for negative values" Ctrl & Shift & ! (Exclamation Mark)
• Excel "Apply the outline border" Ctrl & Shift & & (ampersand)
• Excel "Apply the Percentage format with no decimal places" Ctrl & Shift & % (percentage)
• Excel "Apply the Time format with the hour and minute, and indicate AM or PM" Ctrl & Shift & @ (Commercial At)
• Excel "Copy the value from the cell above the active cell into the active cell or the formula bar" Ctrl & Shift & " (Quotation Mark)
• Excel "Copy a formula from the cell above the active cell into the cell or the formula bar" Ctrl & ' (Apostrophe)
• Excel "Alternate between displaying cell values and displaying cell formulas" Ctrl & ` (Single Left Quotation Mark) 

Hot Linx

Each quarter Hays produces a Quarterly Report to target candidate hotspots and present market commentary. Check out Hay's website at http://www.hays.net.nz/forecast/

Unhappy Hipster has taken photography from Dwell Magazine and re-captioned them at http://unhappyhipsters.com/, entitled "Unhappy Hipsters - it's lonely in the modern world"

And "Every time you think there is nothing left to scare you, there is" guide to live dot com; keeping you alive from danger since 2008. Read all about the dangers of onions on their site at http://www.yourguidetolive.com/article.php?a=dangersofonions

If you are looking for some real international marketing nous, you probably can't do better than Trendwatching. They offer their premium service for small operators seeking market information and trends at http://www.trendwatching.com/premium/

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                                Catch you again soon!! E-mail your suggestions to me here

read more "Newsletter Issue 181, April 2010"