I have been interested in health policy, public health and medical leadership since the start of medical school and this interest deepened after reading books by Atul Gawande (www.gawande.com), a surgeon and public health researcher. I felt that discussion of population-level approaches to healthcare delivery was lacking during my undergraduate degree. This is understandable in the context of an intensive course where producing safe junior doctors who can interact effectively with individual patients is the priority. With this in mind, when presented with the blank canvas that is the elective period it represented a golden opportunity to find out more about public health.
Harvard School of Public Health is one of the world-leading centres for public health. Therefore I set about emailing doctors there and eventually, with the help of Diagnosis' Dr. Emma Stanton, arranged a placement. This was a fantastic experience. I worked as part of a multidisciplinary team whose focus was to analyse health services and provision of care which exposed me to core disciplines of public health such as epidemiology and biostatistics. My role was to collect data on recent US health policy changes and to work with statisticians and physicians on analysis and interpretation. Additionally, I spent time with a cardiologist which provided front line context for my experience of public health. The facilities in Boston are hugely impressive but exist in a system which, like many others, faces challenges of equity of access to health services.
A particular personal highlight was the opportunity to attend seminars and conferences dealing with public health, policy, leadership and management. Speakers included Elliot Fisher, a key thinker behind the concept of Accountable Care Organisations which are an important feature of the Affordable Care Act. I also heard Gary Gottlieb speak, President and CEO of Partners which is one of the leading non-profit healthcare systems in the USA, as well as Lucian Leape, a pioneer and international leader of the patient safety movement and Joseph Newhouse, a distinguished health economist. I was able to visit the Institute for Healthcare Improvement (www.ihi.org) in Cambridge to learn about Quality Improvement (QI) and the IHI Open School which offers online courses in QI including a practicum element which walks learners through their own QI project.
There were many learning points which I took back to the UK. It was particularly interesting to observe the strong culture of medically-qualified leadership in the US, in contrast to the UK where many managers and CEOs don't have a clinical background. This led me to consider how I might develop my own management skills. I also noted a strong "can-do" attitude in the US, where no challenge is too large. I intend to retain this sentiment as I begin life as a doctor. My interests in public health, policy and medical leadership are still coalescing but I left HSPH feeling inspired, motivated and determined to learn more. I would highly recommend visiting HSPH to anyone that has the opportunity.
Saturday, June 30, 2012
Sunday, June 17, 2012
Leadership for Improvement: The Kings Fund Seminar 22nd May 2012 – by Rebecca Minton, Clinical Leadership Fellow & Psychological Therapist
I had the privilege of attending a fantastic seminar hosted by The Kings Fund on ‘Leadership for Improvement.’ The event brought together 80 key names in the field of healthcare leadership and we heard talks from four experienced and inspiring leaders.
Maureen Bisognano, President and CEO for IHI presented three inspiring case studies where applying ‘improvement science’ led to better patient care and improved outcomes at a lower cost. One example: Southcentral Foundation’s Nuka model of care – designed with the Alaskan population at the heart – listening to their views, designing a system around their values and preferences, providing integrated health and social care, and focusing on wellbeing rather than disease. Can the NHS do more of this? And should ‘improvement science’ be included in clinical training? – the majority of the roundtable believed so. Maureen Bisognano said clinicians have two roles: clinical work and improving care. Would all clinicians agree? I do! The IHI holds R&D days where staff are given problems to solve in order to learn new ways to use improvement science – could the NHS adopt this too?
David Fillingham, CEO of AQuA, stated that successful leaders need technical know-how, improvement know-how, and personal effectiveness to achieve results, not hierarchical power. He also stressed the importance of having the time and headroom to develop these skills, and career opportunities structured for breadth, not just depth, gaining learning from elsewhere (the Diagnosis Intern Network perhaps!?)
Bettina Fitt, General Manager at GE Healthcare, talked about the open, collaborative, ‘we’ culture where staff engagement is key, leaders inspire and listen to their staff, and results from staff opinion surveys are used to drive performance.
Professor Richard Bohmer promoted the need for clinical leadership and emphasised that clinical leadership is: a) respectable and b) work - so needs to be valued (yeh!).
So key points to take away:
- Communicate purpose and model leadership behaviours
- Talk about tomorrow not today
- Focus on how problems can be prevented rather than solved
- Learn from the voices of patients
- Step outside the walls of the hospital
- Look outside and understand the real needs of the population
- Engage and listen to others
- Use improvement science (or learn it first!)
>br>
It was very exciting to be in a room with so many great people and hear everyone speak so passionately about leadership. I feel very privileged to have had this opportunity to hear the knowledge and wisdom of respected healthcare leaders from across the world (thanks for the invite Emma!). It was great to hear that they want to encourage and learn from young emerging leaders and I’m now even more inspired in my role as a new clinical leader. Now I can’t wait to tell my cohort of clinical leadership fellows all about it!...
Maureen Bisognano, President and CEO for IHI presented three inspiring case studies where applying ‘improvement science’ led to better patient care and improved outcomes at a lower cost. One example: Southcentral Foundation’s Nuka model of care – designed with the Alaskan population at the heart – listening to their views, designing a system around their values and preferences, providing integrated health and social care, and focusing on wellbeing rather than disease. Can the NHS do more of this? And should ‘improvement science’ be included in clinical training? – the majority of the roundtable believed so. Maureen Bisognano said clinicians have two roles: clinical work and improving care. Would all clinicians agree? I do! The IHI holds R&D days where staff are given problems to solve in order to learn new ways to use improvement science – could the NHS adopt this too?
David Fillingham, CEO of AQuA, stated that successful leaders need technical know-how, improvement know-how, and personal effectiveness to achieve results, not hierarchical power. He also stressed the importance of having the time and headroom to develop these skills, and career opportunities structured for breadth, not just depth, gaining learning from elsewhere (the Diagnosis Intern Network perhaps!?)
Bettina Fitt, General Manager at GE Healthcare, talked about the open, collaborative, ‘we’ culture where staff engagement is key, leaders inspire and listen to their staff, and results from staff opinion surveys are used to drive performance.
Professor Richard Bohmer promoted the need for clinical leadership and emphasised that clinical leadership is: a) respectable and b) work - so needs to be valued (yeh!).
So key points to take away:
- Communicate purpose and model leadership behaviours
- Talk about tomorrow not today
- Focus on how problems can be prevented rather than solved
- Learn from the voices of patients
- Step outside the walls of the hospital
- Look outside and understand the real needs of the population
- Engage and listen to others
- Use improvement science (or learn it first!)
>br>
It was very exciting to be in a room with so many great people and hear everyone speak so passionately about leadership. I feel very privileged to have had this opportunity to hear the knowledge and wisdom of respected healthcare leaders from across the world (thanks for the invite Emma!). It was great to hear that they want to encourage and learn from young emerging leaders and I’m now even more inspired in my role as a new clinical leader. Now I can’t wait to tell my cohort of clinical leadership fellows all about it!...
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