Yokoso Japan - health and healthcare

15/05/2010 by Patrick Keady.

Statistics (from www.nationmaster.com)

 

Population density in Japan is 37% higher than here in the UK. Their Life expectancy at birth is 4% higher and Healthy life expectancy is 6% higher.

 

The birth rate per 1,000 people is 30% less and the proportion of the population that is obese in the Japan is one seventh that in the UK.  The percentage of daily smokers in Japan is higher - 30.3%, compared with 26% in the UK.

 

The percentage of people dying from circulatory disease per 100,000 people in Japan, is 75% less and the proportion of deaths from heart disease per 100,000 is four times less than in the UK. Infant mortality per 1,000 live births is 2.8 in Japan and 4.93 in the UK.

 

Total Expenditure on health services as % of GDP in Japan is less than in the UK - 7.8% versus 8.1%. They have almost three times as many Hospital beds per 1,000 people.

 

While the numbers of Physicians per 1,000 people are similar in Japan and the UK, people in Japan have three times as many consultations with Doctors.

 

The number of Nurses per 1,000 people in Japan is less than in the UK - 7.8, compared with 8.8 in the UK.

 

About Patrick Keady

 

Patrick helps NHS organisations make better decisions. A former NHS Director of Governance and Strategy, he received awards from the BMA and IOSH. Patrick is a Company Director, a Trustee at a Chartered professional body and Editorial Board member at a peer-reviewed Journal. For more information, click www.betteroutcomes.org

 

Posted in Darzi, Patrick Keady, Public Health, Safety, NHS, Health and, Patient, Uncategorized | Print | No Comments »

Yokoso Japan - sights, sakura, food and more

01/05/2010 by Patrick Keady.

   

Just returned from a wonderful holiday in Japan, extended by 14 days.  This is my list of favourites from Japan. Together with comparisons of health in Japan and the UK.

 

 

Favourite City/Town: Nara

 

Other Cities and towns visited: Tokyo, Hakata, Kagoshima, Nara, Kyoto, Koyasan, Nagoya, Hakone-Yumoto, Hakodate and Sapporo

 

 

Favourite Historic Sight: Senganen

 

Other historic sights visited:

Nara - Todaiji Daibutsuden, Tempura Asuka, Ninjatsudo Hall, Sangatsudo Hall, Tamukeyama-Hachimangu, Kasuga Taisha, Gangoji, Kofukuji, Kaneiji and Toshogu

Koyasan - Daito, Kondo, Saito, Fukuchiin, Ichijin, Tokugawa, Kongobu-Ji, Treasure Museum, Reihokan Museum, Fudoudo, Kompan Daito, Daimon and Daighi Kyokai
Kyoto - Higashi Honganji, Nishi Honganji, Kinkakuji, Ninnaji and Ryoanji.
Kagoshima – Reimeikan and Tenmonkan

Tokyo - Imperial Palace, Sensoji and Asakusajinja

 

 

Favourite Sights: Sakura and Shinjuku Gyoen

 

Other sights visited:

Kagoshima - Sakurajima volcano
Tokyo - Sony Building, Nissan Building, Toyota Auto-Salon, Tokyo Tower, Rappongi Hills, Asahi TV, Marunouchi Building, Imperial Theater, International Forum, Metropolitian Art Space, Sunshine City Observatory, Metropolitian Government Building Observatory, Midtown, Meijijingu, Nihombashi bridge, Electric City, Ueno Onshi and Nakanise

Nagoya - Toyota Plant

Sapporo - TV Tower, Morning Market and Clock Tower
Hakodate - Mount Ropeway and Red Brick Warehouses

 

 

Favourite Food: Shojin-ryori

 

Other memorable food - Crab, Kagoshima Ramen, Mochi, Tontsuka, Ekiban Bentobox, Sukiya

 

 

Favourite accommodation: Rengejoin

Other accommodation:

Ryokan Matsumae - Nara

Ryokan Kyoraku - Kyoto
Tokyo House, Ikebukuru

Ichinoyu Honkan, Hakone

Cassiopeia, Tokyo to Sapporo

Toyoko-Inn - Hakata-guchi ekimae 2, Kagoshima Chuoeki Higashi-guchi, Nagoya-eki Sakura-guchi Honkan, Sapporo-eki Kitaguchi, Hakodate Ekimae Asaichi, Akabane Iwabuchi Ekimae and Tozai-Sen Nishi-kasai

 

Favourite train: Shinkansen Tsubame – between Kagoshima and Shinyatsushiro

 

Other trains travelled: Cassiopeia, Narita Express, Shinkansen Yatsushiro, Relay Tsubame, Shinkansen Tsubame, Shinkansen Hikari Railstar, Shinkansen Kodama, JR Nara Line, JR Yamatoji Line, Nankai Koya, JR Osaka-Loop Line, JR Special, Rapid Service, Hakonetozan Railroad, Odakayu Hakone, JR Saikyo Line, Super-Hokuto, Hakucho, Hayate, Spacia Nikko and Shinkansen Hikari

 

 

 

Helpful Websites:

Spring in Japan

Toyota Plant tour

 

Hyperdia

The Japan Times

NHK World

Japan International Broadcasting Inc

 

 

About Patrick Keady

 

Patrick helps NHS organisations make better decisions. A former NHS Director of Governance and Strategy, he received awards from the BMA and IOSH. Patrick is a Company Director, a Trustee at a Chartered professional body and Editorial Board member at a peer-reviewed Journal. For more information, click www.betteroutcomes.org

 

 

Posted in Innovation, Patrick Keady, NHS | Print | No Comments »

Fundamentals of Governance

19/01/2010 by Patrick Keady.

HSJs Fundamentals of Governance took place in London, late last year.

Click here to see my review of the Conference. For a .pdf, contact me via www.betteroutcomes.org

 

About Patrick Keady

Patrick helps NHS organisations make better decisions. A former NHS Director of Governance and Strategy, he received awards from the BMA and IOSH. Patrick is a Company Director, a Trustee at a Chartered professional body and Editorial Board member at a peer-reviewed Journal. For more information, click www.betteroutcomes.org

Posted in Patrick Keady, Risk Management, NHS, Governance, Legislation, Uncategorized | Print | No Comments »

Does the NHS need management consultants?

21/12/2009 by Patrick Keady.

 

Every week, I receive two or three phonecalls about assignments in NHS risk management, governance and safety. However, many of the proposed assignments would be a waste of NHS time and NHS money.

 

Earlier this year, a PCT asked me to lead on corporate governance, health & safety, risk management, information management, health records, complaints, claims, moving and handling and commissioning strategy.

 

I challenged the potential client to describe in a few short sentences, what they wanted me to achieve, and by when. They were unable to see or tell me what success might look like.

 

So, I offered them telephone coaching, free-of-charge. The PCT soon saw that my input would be very worthwhile in one discreet project, where my independent insight and skill-set was just right.

 

The project is mission-critical to the PCT. They were happy with my daily rates too ! And during the course of the phone conversations, the potential client identified in-house people that could lead on many of the other pieces of work.

 

NHS organisations need to clearly think about what they want to achieve, before contacting independent consultants.

 

 

About Patrick Keady

Patrick helps NHS organisations make better decisions. A former NHS Director of Governance and Strategy, he received awards from the BMA and IOSH. Patrick is a Company Director, a Trustee at a Chartered professional body and Editorial Board member at a peer-reviewed Journal. For more information, click www.betteroutcomes.org

Posted in Patrick Keady, Risk Management, Innovation, Safety, NHS, Patient, Governance, Health and | Print | No Comments »

Mike O’Brien to “name and shame”

12/11/2009 by Patrick Keady.

One of the headlines on www.hsj.co.uk today, caught my eye. Managers anger at O’Brien’s name and shame threat.  And then it began to make sense. Mike O’Brien and David Nicholson seem to be speaking the same language!

In each year since 2000, Mike O’Brien and his colleagues in the Blair/Brown Governments, increased their funding of the NHS in England by almost 7% (on average).

And now we are preparing for annual funding increases that will be much closer to 0%. David Nicholson told us earlier this year that the NHS needs to find £15bn-£20bn of savings by 2014. The NHS has two options.

The first is to hit the target and miss the point.

By reducing inputs - cutting staff, closing buildings and increasing waiting lists. Its refreshing that Mike O’Brien does not want to see budgets and services slashed in response to the public sector funding squeeze.

Hitting the target and missing the point would be costly. Patients would not be interested in why NHS services were being cut. They would not want explanations as to why there were less staff on-duty.

Patients expect a return on their investment - for the National Insurance Contributions that they have and/or are making. And my guess is that patients will continue to expect better healthcare.

The second option is to hit the target …. and to hit the point.

By reducing waste in core processes, such as diagnosing, treating, and communicating with patients. By getting the care of patients right first time. By reducing unnecessary readmissions.

By ensuring that clinicians and managers feel empowered to achieve results, to make changes, to take decisions, to drive service improvement, to actively deal with risk.

The NHS is likely to reduce waste in core processes, when Directors of Finance and their colleagues become even more actively involved in process improvement and removing waste. When they continue allocating serious investment in the development of improvement capability. By continuing to focus on cost per unit, and not expecting increased funding from the Government or elsewhere.

My guess is that Mike O’Brien will not ‘name and shame’. Because the NHS will actively work to reduce waste in its core processes. And that the NHS will find the £15-£20bn of savings by 2014. And because Mike O’Brien and David Nicholson will continue to speak the same language.

Posted in Innovation, Creativity, Risk Management, Patrick Keady, NHS, David Nicholson, Strategy | Print | No Comments »

Innovation and Creativity

17/07/2009 by Patrick Keady.

Listening to Evan Davis on BBC Radio 4, I was particularly interested in the language of his guests.

James Dyson introduced himself as the founder of vacuum cleaners that work better.

Marta Lane Fox, recently appointed Champion of Digital Inclusion, is working to make life better for the six million economically and socially disadvantaged people in the UK that have no access to technology.

And Adrian Ringrose  the chief executive of a company that enables public sector organisations do what they do, by doing all the bits that these organisations don’t want to think about.

When introducing ourselves in the NHS, we tend to use different language. And this episode of BBC Radio 4’s The Bottom Line promised a lot. It was a discussion about creativity and innovation.

To be good at innovation and creativity, Martha Lane Fox said that boldness and self-confidence works for her. James Dyson added that innovation for him is caring about solving problems and taking little incremental steps to get there.

And Adrian Ringrose gave his insight into the public sector. He suggested that it is more important to do what we do in the public sector - by the rules, rather than focusing on the end game.

A generalisation perhaps, he reminded us that it is the end point that matters and we are more likely to get there by building on our mistakes.

And my guess is that this point resonates with you and many leaders in NHS risk management, governance and safety. I enjoyed this edition of BBC Radio 4’s The Bottom Line and I know that you will too.

Posted in Risk Management, Innovation, Creativity, Patrick Keady, NHS, Personal Development, Governance, Strategy | Print | No Comments »

NHS Institute

31/03/2009 by Patrick Keady.

The NHS Institute has been an exciting place to work. During my 18 months with them, I led the development of their intranet-based risk register and board assurance framework, standing orders, standing financial instructions and scheme of delegation.

As well as being a key link between the Institute and the Department of Health, I was actively involved in developing their balanced scorecard; sustainable development; reviewing the security of their people, buildings and information; the procurement of health and safety training and risk assessment services and lots more besides.

Working with the NHS Institute meant a lot me. Over the 18 months, it has transformed into an outward looking, customer-focussed organisation. Whenever I hear about NHS Live, Knowledge Management, World Class Commissioning, the Management Training Schemes, the Productives, Safer Care series … I’ll think of them.

And I’m looking forward to my next assignment at NHS Stoke on Trent.

Posted in Safety, Patrick Keady, NHS, Governance, Health and, Legislation, Uncategorized | Print | No Comments »

twitter

01/03/2009 by Patrick Keady.

Joined twitter today and I’m delighted with the amount of information on there. About celebrities, the M5, Universities, BMJ, newspapers and three NHS Trusts - buckinghamshire hospitals, oxford radcliffe, and southampton university hospitals.

With twitter, I can follow other twitter’ers and be followed. Already being followed by two sites and I’m following 42 twitter sites.

And best of all, I can see all of their tweets chronogically. My profile is http://twitter.com/patrickkeady

Posted in Patrick Keady, NHS, Recommended, Uncategorized | Print | No Comments »

certified NLP master practitioner

28/02/2009 by Patrick Keady.

This morning I received an INLPTA Certificate from David Smallwood, for completing the NLP Master Practitioner course.

David is a certified trainer of business-focused NLP, a certified NLP health practitioner and a certified INLPTA trainer. And he was my principal trainer throughout all of my NLP training at diploma, practitioner and master practitioner levels. David is a wonderful inspiration, an excellent trainer and unbeatable value for money too.

Having completed the NLP practitioner course last year, David commented that it was during the master practitioner training that I really demonstrated the integration of my Practitioner training.

A number of people have asked what the NLP master practitioner training is all about and how it differs from NLP practitioner training.

While I had the skills and understanding of an NLP practitioner, the master practitioner training leveraged my learning from there to go to levels of competency that to an untrained observer might appear amazing. See what Richard Bandler has to say about master practitioner training.

While the focus in practitioner training was on learning the fundamentals, the master practitioner training was about Mastery. This brought with it new levels of understanding and skills development so that I am now able to run the NLP patterns as well as able to tailor, re-organise, and even make new patterns on my own that are appropriate to the situation in hand.

I learned new distinctions and developed new skills and David trained us with his eye on precision and elegance. The epistemology of the master practitioner training was very different too from that of the practitioner - in terms of outcomes, behaviours, ways of being, and ways of relating to the world.

The master practitioner training was about me and the many routes open to me to achieve my outcomes, my better outcomes. It was about my ability to facilitate behavioural change and to do so elegantly, generatively, and with precision.

Posted in NLP, Patrick Keady, Recommended, Personal Development | Print | No Comments »

patient safety research portfolio (psrp)

12/02/2009 by Patrick Keady.

‘Without a national study, politicians and health professionals go into denial ….. we don’t have a problem’. This was one of the comments for Sir Liam Donaldson when he opened the Patient Safety Research Portfolio Conference this morning at the Royal College of Physicians

Speaking to a selection of the researchers that participated in the 36 patient safety research projects undertaken over seven years, at a cost of about 70p per NHS England employee per annum. He outlined his vision of the ten contributions that patient safety research offers to improving healthcare, as follows:

•    increasing awareness of patient safety - with clinicians, provider organisations and commissioners
•    understanding the causes of patient (un)safe-ty – and in relation to sleep deprivation, Sir Liam reminded us of the importance of the 48 hour week - clinicians are more likely to kill patients when they are tired.
•    more research in the young discipline of patient safety will enhance safety and improve productivity
•    establishing conceptual concepts - to enhance the ‘poverty of concepts in patient safety’
•    developing solutions – including improved design in healthcare, a recurring theme throughout the day
•    setting standards for information – before and after studies, randomised control trials etc
•    informing evidence based care
•    evaluating progress including checklists - twice as effective as education
•    nurturing researchers
•    and promoting leaders in patient safety

Professor Richard Lilford oversaw the Patient Safety Research Portfolio from its inception and this morning, he highlighted some of the successes of the programme. These included Professor Nick Barber’s discovery that nursing homes openly welcomed the prospect of his team observing medication errors and recommending improvements – their willingness could be related to the significant amount of time that care home staff spend in medication-related activities.

The day was chaired by Professor Paul Barach, one of the best Chairs that I’ve seen at a healthcare seminar/conference. He has has a very rare ability. He keeps the audience interested, even during the ‘graveyard shift’.  And he ensured that all 17 leaders in patient safety research, delivered their presentations in less than 4 hours. Now that is a rare achievement.

Citing an (unnamed) study elsewhere in the world, we heard that 9% of clinicians wash their hands before they touch a patient in the operating room and 17% do so after they touch the patient. Enter Professor Sheldon Stone summarising the successes of the Clean Your Hands campaign – and reminding us of the rationale for the campaign - 8% of patients acquire healthcare associated infections and their mortality is six times higher. Direct contact by hand is the main route of infection and Sheldon delivered this very serious message, in an entertaining way.

Chris Fuller described HHOT – the hand hygiene observation tool and Professor George Hanna told us about the checking procedures developed by his team for naso-gastric tubes. Dr Rebecca Lawton highlighted the success and lessons learned in evaluating non-luer spinal connectors.

While risk metrices represent risk and are almost universal in healthcare, Professor John Clarkson highlighted their limitations - they lack a systematic approach. And this is why he and his team are developing a toolbox for healthcare, that will include risk assessment models and tools and a process for escalating the higher risks.

Dr Karin Lowson’s insight into single hospital rooms, was topical and revealing. Patients in single rooms are more satisfied. They are less likely to acquire infection experience medication errors during their hospital stay. That said, some patient in single rooms are more likely to die and experience depression. And the risk of an adverse event and length of stay are about the same for patients in wards and in single rooms.

Much has been said about enhancing the patient safety agenda on the curricula of healthcare professionals. And recommendations as to this an be achieved, were provided by Dr Pauline Pearson and Professor Amanda Howe.

Professor Ian Watt gave an overview of how patients can ensire that clinicians deliver safe patient care – by making sure that the treatment is appropriate for them, that the treatment is as planned and in accordance with the appropriate protocol, and identifying how the health system can be made safer.

Dr Ken Catchpole shared his line of enquiry in operating theatres and elsewhere in healthcare. And he has four key questions. Is the healthcare team’s approach consistent with achieving high standards of care. Is what they are doing acceptable for Ken and his family. Does what the team are doing have to be like this. Is this the best it can be? Simple questions, revealing answers.

And Professor Mary Dixon-Woods outlined six rules for governance in operating theatres. The organisation is geared to promote patient safety. Protocols are deployed appropriately and everyone serves their spirit. Optimum communication. Minimal distraction and interruption. Effective authority and accountability. Reporting patient safety incidents.

Professor Justin Waring is in the process of summarising the outputs from the PSRP under the broad headings of the nature of patient safety, sources of risk and safety, and identifying the future direction for research.

And Martin Fletcher was the final speaker, talking about the science of safety. The NPSA Chief Executive sees the patient safety research agenda developing by networking the researchers, funding more PhD students and running another UK patient safety research conference.
Some of the many highlights for me were hearing about the science of safety, Ken Catchpole’s approach to enquiry in patient safety, how patients can be more assertive, updating the curricula, design of hospitals and non-luer spinal connectors, prospective analysis, competency based training in naso-gastric tubes and handwashing, observing hand hygiene, the benefits and weaknesses of focusing on improving culture and CHUMS.

With many thanks to Sir Liam Donaldson, Professor Lilford, the PSRP team and all of the researchers for making this fantastic conference a reality.

Posted in NHS, Safety, Patrick Keady, Public Health, Governance, Recommended, Personal Development, Health and, Patient, Legislation, Strategy | Print | No Comments »