Organising for performance

A recent incident gave me cause to reflect on how we deliver performance. A lot of what people do is focused around KPIs and targets, but sometimes it is just so much simpler to organise ourselves to perform.

The incident was a friend’s knee replacement. He had his first knee replacement a couple of years ago, but getting the follow up appointments and physio was a real problem. There were delays, cancellation and a whole set of unnecessary administration which contributed to a longer recovery period, because this was not planned when the operation was done.

As the NHS was endeavouring to catch up after Covid, his second knee replacement was outsourced to a private provider. But interestingly, the NHS procured not only the operation, but also the pre-medical checks, follow up consultation and the physio – all in one package. As a result, it all happened like clockwork and the recovery time was considerably reduced.

Now this blog isn’t about the merits of the NHS v private medicine; it is just a reflection on how we organise ourselves to deliver the desired outcome. In this case, the outcome isn’t a knee replacement, it is returning a patient to the fullest mobility possible as quickly as possible. This means that the operation is only one part and the rest of the activities have to be managed and coordinated to deliver the desired result.

In the French health system this packaged approach is widely used, people have their whole treatment package diarised in one go removing a whole raft of additional administration.

So, it is useful to have KPIs on how long it takes to do x and y, but if the system organises things, then much of this will happen automatically eliminating waste and delivering the real outcome.