{"id":744,"date":"2013-12-16T16:45:52","date_gmt":"2013-12-16T05:45:52","guid":{"rendered":"http:\/\/blog.panicola.com\/?p=744"},"modified":"2013-12-16T17:04:35","modified_gmt":"2013-12-16T06:04:35","slug":"sir-muir-gray-acsqhc-presentation","status":"publish","type":"post","link":"https:\/\/blog.panicola.com\/?p=744","title":{"rendered":"Sir Muir Gray &#8211; ACSQHC Presentation"},"content":{"rendered":"<ul>\n<li>We&#8217;re entering a new era in the NHS where there is &#8220;<span style=\"text-decoration: underline;\"><strong>NO MORE MONEY<\/strong><\/span>&#8220;<\/li>\n<\/ul>\n<p>@19min: describes &#8220;three big businesses in respiratory disease &#8211; asthma, COPD, apnoea&#8221;<\/p>\n<ul>\n<li>Value = Outcomes \/ Costs<\/li>\n<li>Outcome = Effectiveness (EBM+Quality) &#8211; Harm (Safety)<\/li>\n<li>Costs = Money + Time + Carbon<\/li>\n<\/ul>\n<p><span style=\"line-height: 1.714285714; font-size: 1rem;\">@2<\/span><span style=\"line-height: 1.714285714; font-size: 1rem;\">2mins: moving from guideline care to personalised care<\/span><\/p>\n<p>@26mins: Bureaucracy is important and necessary, but should stick to what it&#8217;s good at doing:<\/p>\n<ol>\n<li>The fair and open employment and promotion of people<\/li>\n<li>The un-corrupt management of money<\/li>\n<li><span style=\"line-height: 1.714285714; font-size: 1rem;\">!! Not the curing of disease or delivery of health care &#8211; populations defined by need, <span style=\"text-decoration: underline;\"><strong>not jurisdiction<\/strong><\/span><\/span><\/li>\n<\/ol>\n<p>@32mins: law of diminishing returns &#8211; benefits plateau as invested resources rise<\/p>\n<p>@33mins: Harmful effects of healthcare increase in direct proportion to the resources invested<\/p>\n<p>@34mins: combine the 2 curves &#8211; get a j-shaped curve with a <span style=\"text-decoration: underline;\"><strong>point of optimality<\/strong><\/span> &#8211; the point of investment after which, the health gain may start to decline<\/p>\n<p>@35mins: as the rate of intervention in the population increases, the balance of benefit and harm also changes for the individual patient<\/p>\n<p>@37mins: value spectrum<\/p>\n<p><span style=\"line-height: 1.714285714; font-size: 1rem;\"><strong>[HIGH VALUE]<\/strong><br \/>\n&#8211; necessary<br \/>\n<\/span>&#8211; appropriate<br \/>\n<strong>[LOW VALUE]<\/strong><br \/>\n&#8211; inappropriate<br \/>\n&#8211; futile<br \/>\n<strong>[NEGATIVE VALUE]<\/strong><\/p>\n<p>@39mins: The Payers&#8217; Archipelago<\/p>\n<p>20th Century Care &gt;&gt; 21st Century Care<br \/>\nDoctor &gt;&gt; Patient<br \/>\nBureaucracy &gt;&gt; Network<br \/>\nInstitutions &gt;&gt; Systems<\/p>\n<p>@42mins: clinicians responsible for whole populations, not just the patients in front of them<\/p>\n<p>@45mins: How to start a revolution<br \/>\n&#8211; change the culture &#8211; destabilise and constrain; control language<br \/>\n&#8211; engage patients and citizens, and the future leaders of 2033<br \/>\n&#8211; structure doesn&#8217;t matter (5%)<br \/>\n&#8211; systems (40%)<br \/>\n&#8211; culture or mindset (50%)<\/p>\n<p>@46mins: Culture &#8211; the shared tacit assumptions of a group that it has learned in coping with external threats and dealing with internal relationships&#8221; Schein (1999) The Corporate Culture Survival Guide<\/p>\n<p>@47mins50s: data doesn&#8217;t change the world, emotion changes the world<br \/>\n&#8211; atlases written for OMG effect<br \/>\n&#8211; programme budgeting<\/p>\n<p><strong>destabilise<\/strong> then <strong>constrain<\/strong> then change the <strong>language<\/strong><\/p>\n<p>@49mins: MUDA means waste &#8212; resource consumption that doesn&#8217;t contribute to the outcome.\u00a0motonai &#8211; the feeling of regret that resources are being wasted. ban old language.<\/p>\n<p>@51mins: mandatory training in new thinking<\/p>\n<p>The Third Healthcare Revolution is already underway<br \/>\n1. PHONE<br \/>\n2. CITIZENS<br \/>\n3. KNOWLEDGE<\/p>\n<p>The third healthcare revolution will come out of the barrel of a smartphone<\/p>\n<p>@56mins: Healthcare is too complex to be run by bureaucracies or markets. Work like an ant colony &#8211; neither markets nor bureaucracies can solve the challenges of complexity.<\/p>\n<p>&nbsp;<\/p>\n<p><span style=\"line-height: 1.714285714; font-size: 1rem;\">PDF:\u00a0<\/span><a style=\"line-height: 1.714285714; font-size: 1rem;\" href=\"http:\/\/blog.panicola.com\/wp-content\/uploads\/2013\/12\/Sir-Muir-Gray-Masterclass-presentation-1-Oct-2013.pdf\">Sir-Muir-Gray-Masterclass-presentation-1-Oct-2013<\/a><\/p>\n<p>ASQHC Presentation link:\u00a0<a href=\"http:\/\/www.safetyandquality.gov.au\/our-work\/medical-practice-variation\/presentations\/\">http:\/\/www.safetyandquality.gov.au\/our-work\/medical-practice-variation\/presentations\/<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>We&#8217;re entering a new era in the NHS where there is &#8220;NO MORE MONEY&#8220; @19min: describes &#8220;three big businesses in respiratory disease &#8211; asthma, COPD, apnoea&#8221; Value = Outcomes \/ Costs Outcome = Effectiveness (EBM+Quality) &#8211; Harm (Safety) Costs = Money + Time + Carbon @22mins: moving from guideline care to personalised care @26mins: Bureaucracy &hellip; <a href=\"https:\/\/blog.panicola.com\/?p=744\" class=\"more-link\">Continue reading <span class=\"screen-reader-text\">Sir Muir Gray &#8211; ACSQHC Presentation<\/span> <span class=\"meta-nav\">&rarr;<\/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":[14,9,17,22,6,27],"tags":[],"class_list":["post-744","post","type-post","status-publish","format-standard","hentry","category-complex-adaptive-systems","category-healthcare","category-musings","category-policy","category-politics","category-storytelling"],"_links":{"self":[{"href":"https:\/\/blog.panicola.com\/index.php?rest_route=\/wp\/v2\/posts\/744","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blog.panicola.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blog.panicola.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blog.panicola.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/blog.panicola.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=744"}],"version-history":[{"count":3,"href":"https:\/\/blog.panicola.com\/index.php?rest_route=\/wp\/v2\/posts\/744\/revisions"}],"predecessor-version":[{"id":748,"href":"https:\/\/blog.panicola.com\/index.php?rest_route=\/wp\/v2\/posts\/744\/revisions\/748"}],"wp:attachment":[{"href":"https:\/\/blog.panicola.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=744"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blog.panicola.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=744"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blog.panicola.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=744"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}