Collective impact: Improving healthcare through collaboration and shared values

Richard Hamilton
09th September 2024
Imagine a healthcare system where every minute of patient time is valued, or a system where clinical resources have an hour a day freed up via integrated technology tools, where collaboration across sectors leads to innovative solutions, and technology acts as a powerful enabler rather than a daunting hurdle.

All this is achieved through the power of collective impact – where complex sector problems can be solved through shared purpose, using great data, supported by appropriate technology, where shared insights enable disruptive thinking, harnessing the collective wisdom of workforce and consumers to create greater value for all. Shared values, system thinking constructs, group language, and outcome objectives, are formed through this way of working, which in turn shape how we serve our communities.

Central to this approach is the concept of valuing people’s time – both patient time and workforce time, deliberately expressed in this order.

Valuing time: The real currency empowering healthcare

The true currency of our health system is not money but time – both patients’ and workforce time.

Patient time, defined as the period from clinical need to when that need is met, is a precious commodity that health systems too often waste. Delays in care, whether waiting for specialists or diagnostics, being over-tested, or not seeing the right person early on, negatively affect quality of life, livelihoods, and social interactions.

Our health system is often configured to manage the patient around our scheduling needs and ways of working, prioritising staff and system time over patient time. This leads to missed opportunities to improve the patient journey and experience between various parts of the health and social systems, particularly between community and tertiary level care.

Worldwide social movements like Professor Brian Dolan’s End PJ Paralysis and Last Thousand Days campaigns challenge people’s mindsets around the value of time, and the negative impacts that can occur. They urge the sector to reconsider how to manage patient care and stop eroding a person’s quality of life when they are under the system’s care, especially in their final days of life. For many, especially those in their last 1000 days, time spent in clinical settings rather than with family has a significant loss of quality and meaning.

To invest in improving patient time, the system needs to value staff time. The system can give back “an hour a day” through better processes and technology application. Clinical burnout is occurring; driven by excessive work and cognitive loads through meeting increased demand and administrative burden. Clinical time is a precious and constrained resource worldwide – anything that gives time back to the workforce, enhances the work experience and improves cooperation, coordination, safety, and patient outcomes, leads to better staff retention.

Clinical teams are driven to make a difference for their communities; they want to contribute to health and social systems that improve the outcomes for all parts of the population. They willingly give their personal time if they believe their knowledge and time will be respected by the system, and will make a difference to patient and population experiences. The inverse is equally true; disrespect and distrust increases when this personal time investment leads to no tangible impact for their time investment.

Empowering healthcare professionals to work collaboratively with communities is key to designing and delivering services that keep people well at home, respect their time, and enable quick access to critical services when needed.

Approximately 70% of health funding is used to pay for workforce time. Works studies conducted over the last twenty years show that 20% to 40% of this time is wasted through inefficient process, inadequate tools, poor communication and information flow, hunting and gathering equipment and supplies, and work not being sequenced effectively to the patient needs. Much of this waste is hidden, we don’t see it as it impacts on someone else. If we follow the patient’s journey, we see the wastes and delays. If you are a patient or a worker in the health system, you see these wastes every day. The Lean Production movement can teach us a lot about how to create a culture that empowers system improvement through valuing staff and patient time and the causes of waste. The culture of collective impact is built through effective leadership. When we create a permissive environment, staff feel empowered to innovate and improve the system. Frontline staff are not empowered or driven by financials. They are driven by seeing better outcomes and quality of care. They understand and are frustrated by the waste of patient and staff time, and see opportunities to make it better for both. At Spark Health, our approach involves encouraging staff to bring their energy and ideas to the table. By promoting a culture of permission-giving and proactive problem-solving, we support a movement where everyone feels they have the power to make a difference. This cultural shift is essential for driving meaningful change across the health and social care sectors.

Technology as an enabler

Technology is a powerful tool in our quest for collective impact. It has the potential to free up staff time, improve patient flow, and enhance overall system efficiency. Addressing constraints in areas like radiology, for example, can significantly reduce patient wait times and improve outcomes. Technology enables us to work smarter, not harder, and to deliver better care without increasing the burden on our workforce.

At Spark Health we understand the importance of choosing wisely the technology solutions to streamline processes and support our healthcare professionals. From AI-driven diagnostic tools to integrated data systems, we are using technology to enhance the efficiency and effectiveness of all aspects of the health system.

Shifting focus from illness to wellness

Our vision extends beyond treating illness to promoting wellness. When we focus on keeping people well in their communities, we reduce the need for hospital care. This shift from an illness-oriented system to a wellness-oriented one is necessary for the future of healthcare.

This involves supporting initiatives that promote healthy lifestyles, preventive care, and community-based health services. By prioritising wellness, we can prevent many health issues before they require acute intervention.

The path of collective impact and shared values

Looking to the future, the challenges of a shrinking workforce and growing demand for healthcare can only be addressed through collaboration. By working together, we can create an environment that values time and waste reduction, and delivers high-quality care.

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Richard Hamilton
Richard Hamilton brings over two decades of innovation and operational experience to enhance New Zealand’s health systems. Richard’s expertise, honed through his pivotal role in the globally recognised Canterbury Health System, drives his contributions to Spark Health's initiatives. Previously, Richard served as Regional Improvement Lead on the Te Waipounamu Integration Team, advancing South Island health sector integration. His innovative approach, rooted in the Theory of Constraints, Lean Thinking, and Design Thinking, has significantly impacted leadership programmes and HealthLearn, reaching over 7,000 professionals nationally. Richard’s career began with reshaping postal sectors around the world, before transitioning to healthcare, where he has been a consistent advocate of the power of collective impact. At Spark Health, his commitment to empowering people through data-driven insights and collaborative problem-solving ensures New Zealand’s health organisations receive the highest level of expertise and leadership.
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