Patient centric organisations and caregiver central innovation, same process!

During the period I developed and subsequently managed zorgbeheer.com (a portal for managers of care homes for the elderly), I posted an organigram which I used at my own care home since somewhere around the year 2000.
In stead of a hierarchical structure it represents a flat circular structure, with the patient in the middle. Each inner layer initiates requests towards outer layers. Each outer layer tries to cater the requests coming from inner layers.
The organigram was the most downloaded file on the platform, by far.
We still work this way, almost 20 years, so you can hardly call it an experiment.
2 basic concepts are crucial:
1) the patient has the opportunity to co-steer his treatment
2) employees are given the right means (and responsibilities) to do their job optimally, resulting in increased staff satisfaction and a great service towards the patient

Patient centric organisation

Recently I read an excellent blog post by Ingrid Willems https://twitter.com/immwillems from Datascouts on reinventing organisations https://datascouts.eu/2017/06/11/reinventing-organizations/ Partly the post is about Frederic Laloux’s book (recommended!), the other part describes collaborations with distributed leadership, where people from different backgrounds come together and contribute for a better future.

Together with the insights I gained working at Healthstartup and doing several innovation initiatives in healthcare, this is exactly the reason why I started with Hyperadvancer http://hyperadvancer.com, an intense event-format, where people from different industries and different layers within the organisation are brought together to come up with concepts that make their organisations more future proof. Due to the setup of the event the foundations are laid out for post-event (distributed) collaboration between partners.

Coming up with concepts is so much more meaningful if they originate from real problems. And -in healthcare- one of the best sources of real problems are nurses. Nurses have tough and high stress jobs and -to make it worse- lot’s of times they have to work with sub-optimal tools. If you take some time to hear them out, they will bury you with opportunities healthcare delivery can be improved. I was happy my friend Lucien Engelen https://twitter.com/lucienengelen recently made a plea to include nurses during innovation (#NursesIncluded Dutch only: https://www.patreon.com/posts/insight-zijn-in-11800627).

I then realised innovation in healthcare should have exactly the same process as the organigram we’ve been using at the care home for over 20 years.
In stead of having the patient in the middle, the caregiver is given a central role. Same principles apply: each inner layer initiates requests towards outer layers and each outer layer tries to cater the requests coming from inner layers.
2 basic concepts are crucial:
1) the caregiver has the opportunity to co-steer his treatment
2) caregivers are given the right means (and responsibilities) to do their jobs optimally, resulting in an increased staff satisfaction and a great service towards the patient

Caregiver central innovation

While I’m fortunate to be in a situation where innovation is happing in such way (nurses and care-aids tell me how an application should be build and what digital items/processes/forms/… should be improved), this is absolutely not the way innovation happens in lots of healthcare organisations.

But I feel this is rapidly changing and I’m happy to see caregivers are finding ways to exchange information and collaborate. Like ‘BE Nurse’ https://twitter.com/benurse_BE for example (hashtag #benurse https://twitter.com/hashtag/benurse?src=hash ). I’m sure this is THE way forward and it will soon give them a voice during development of new (digital) tools. 
Very similar to organisations the biggest obstacle is the layer at the outer circle, this time not the management but policy and government. This nut is very hard to crack but I’m sure one day they will really listen and try to cater increasing demand from inner layers. Keep pushing them!

Wishing you lots of energy improving healthcare delivery.

PS1: If you think I can help with this evolution, let me know!
PS2: I’m still looking for examples of Maker Nurse communities. Thank you for sending stuff my way :)