Quality assurance issues at Addenbrooke’s Hospital and systems thinking
27/01/2017

Last year the quality care commission put Addenbrooke’s Hospital into special measures after their inspection. The good news is that the hospital is out of special measures and in January this year the overall rating was good.
At the time of the initial report and the placement into special measures there was an outcry as some considered the rating unfair. Death rates were comparable to most well run hospitals, patient care was good and cancer treatment outcomes were amongst the best in Europe. So what was the problem? The issue was that although clinically the performance was good, there were operational issues that meant routine operations were often being cancelled, there was a backlog in follow up clinics and resourcing was not always adequate.
The point I would make is that it isn’t good enough to be “clinically excellent”; the organisation needs to be “operationally excellent” as well.
Clinical excellence comes from having well trained and motivated staff working in their areas of expertise and delivering to high standards. By and large, doctors and medical staff can attain this on their own, but operational excellence requires wider involvement of all the staff in an organisation. It requires the systems to work. It requires coordination between different clinical groups and between administrative staff and clinical staff. It requires plans so that the demand is understood and the resources are planned for and provided. This is a different skill set and if anyone thinks hospitals don’t need hospital management they are wrong.
A lot of managers can deal with their own versions of “clinical excellence”. They can create teams of well qualified, motivated and experienced people that deliver on local goals. But the wider coordination and planning activities requires wider skills. It is not just about managing people it is about understanding operations and processes. It requires wider skills in systems thinking.
Finally, what is the role of leadership? The role of leaders is to create and manage the overall system in which everybody needs to work. They need to understand the dynamics of that system and how each part of the system interacts. They need to know how to guide that system through setting goals, measures and targets. They need to understand how the rules of the game that are created by doing this impacts on the performance of the organisation as a whole. And too often I don’t see people at the senior level who fully understand this.
Mike Bourne
Categories & Tags:
Leave a comment on this post:
You might also like…
New students can book a tour of Kings Norton Library
To help new students find their way around Kings Norton Library, staff will be offering lunchtime tours at 12.15pm every weekday, 2-6 October. Tours will also be offered every Tuesday and Thursday throughout the rest ...
What opportunities are offered by vehicle connectivity and automation on highway?
Over the past decade, the number of road vehicles connected with the outside world has been growing rapidly, in response to the need for real-time navigation data, the introduction of eCall requirements, the practicality ...
Download the Library app!
You can use it to: Check what we have in our print collection (and a selection of our eBooks too!) Borrow items directly with the app instead of using a self-service machine* Reserve and renew ...
Why I chose Cranfield
After completing an undergraduate degree in Internet of Things Engineering, Zhen Sun was working with Siemens and looking for an area to give his focus to. He seized the opportunity to upgrade his skillset ...
Bloomberg basics
Accessible in SOM Library from 12 dedicated terminals, Bloomberg provides access to the real world of finance through the same platform as used by the world’s leading banks, corporations and government agencies. Bloomberg provides real-time ...
Five tips to help you start your Cranfield journey
Starting your postgraduate study journey can be a roller coaster of emotions; as exciting as it is nerve wracking. While there’s lots to look forward to, it’s also normal to be apprehensive of what ...
Mike, Gosh – lots of points I’d like to make on this one. I’ll just pop one on here around leadership in the National Health and Public Sector overall, as well as the Private Sector, and we kind of discussed this topic in several Cranfield Round-tables. Leaders are generally poor at defining the organisation’s “Purpose”. They them come up with a Strategic Plan with weak/no links to Purpose, and Strategy Execution is then flawed which means no links to what shape of System they should be designing and operating, or what should be measured and therefore managed! It would be so much easier if they would just start with Purpose -> Design System -> Operate System -> Measure System -> Manage (i.e. Improve) System with Purpose in mind. So they all go off managing (i.e. bullying and blaming) people instead!