Here’s another reflection arising from this week’s King’s Fund discussion about innovation in healthcare – they must have had good coffee.
Whenever we talk about innovation, ther e is a tendency for us to be talking about innovative interventions and projects – shiny new ways of doing a task, or shiny new bits of kit. Another way of thinking about innovation is to think of innovation in systems – in the way that those tasks and bits of kit work together. A system can be innovative without any new tools. A system which is has all the new tools, but hasn’t worked out how to use them together, can be chaotic rather than innovative. Sometimes getting rid of bits of kit which didn’t really turn out to add much value, actually improves things. One way I heard this put recently was that we should be thinking about systems design in terms of developing a healthier eco-system, rather than thinking up a more impressive machine.
Escaping the invisible asylum 
I couldn’t agree more! In my work as a trainer/facilitator in person-centred care in dementia (and also aged care generally) and researcher in barriers to person-centred approaches, I very much emphasis the notion of culture change throughout facilities/organisations. It is not enough to bring in the latest popular activity, nor to train individual staff, nor to set up a snoezelin room – It has to be about changing the whole, in particular through relationships throughout the organisation and negotiation of values and beliefs (professional, personal and organisational). It is about an ecological system.