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By Hole Ousia Posted on February 25, 2018February 2, 2023

Are there now more ‘toolkits’ in healthcare than in B & Q?

As an NHS doctor I was recently sent this “development toolkit”: Healthcare has become ever more reliant on tools, toolkits, dashboards, hubs and traffic lights. All those involved in healthcare … Continue reading Are there now more ‘toolkits’ in healthcare than in B & Q?

Categories: Medical Education, Medical humanities, NHS Scotland, Omphalos films, Philosophy, Two culturesTags: #followthefellows, a most determined "one organisation" approach that starts and ends with reductionist and mechanical algorithms, a tool for every job, Antiquary, Are there now more toolkits in healthcare than in B & Q?, As an NHS doctor I was recently sent this "development toolkit", As an NHS doctor of 25 years I have become increasingly aware of the use of mechanical metaphors in healthcare, Boston, care bundles, Dashboards, development toolkit, Don Berwick, Dr Peter Gordon, Healthcare Improvement needs to consider the potential consequences of the widespread use of such mechanical language, Healthcare Improvement Scotland, HIS, Hole Ousia, How mechanical should healthcare be?, hubs, IHI, Improvement Fellows, improvement science, improvers, Institute for Healthcare Improvement, Jason Leitch, mechanical languge, NHS Scotland, Peter Gordon, QI, QI connect, rebel antiquary, Social maverick, The Antiquary, The Rebel Antiquary, the spade the chainsaw the art had gone, The spade the chainsaw the art has gone, Toolkits, Tools, tools for the trade, tools of the trade, Traffic lights, truly madly deeply

By Hole Ousia Posted on July 5, 2017January 31, 2023

How mechanical should healthcare be?

These RCPsych fliers are currently being shared by the Royal College of Psychiatrists: The following words, it seems to me, are appearing more frequently in healthcare: It is my view … Continue reading How mechanical should healthcare be?

Categories: Antidepressant prescribing, Medical Education, Medical humanities, Medical writings, Narrative medicine, NHS Scotland, Psychiatry, Two culturesTags: #followthefellows, 11 September 2017, 12 Queen Street, a tool for every job, a toolbox for psychiatrists, Advanced Interventions service, Antiquary, Dashboards, David Christmas, Depression, Dr David Christmas, Dr Peter Gordon, Dundee, Edinburgh, healthcare, Hole Ousia, How mechanical should healthcare be?, i am not a checklist, IHI Fellows, Improvement Fellows, Keith Matthews, Key Information on the use of antidepressants, mechanical languge, Mechanical metaphors, NHS Scotland, OCD, Peter Gordon, Professor Keith Matthews, Psychiatry, psychosurgery, RCPsych, RCPsych fliers, rebel antiquary, Social maverick, The Antiquary, The mechanical language of Health Improvement, the potential consequences of the widespread use of such mechanical language, The Rebel Antiquary, The Royal College of Psychiatrists, The Royal College of Psychiatrists in Scotland, toolbox, toolkit, Tools, Traffic lights, treatment refactory, treatment refactory depression, Treatment Resistant Depression, Treatment-Refractory OCD: a toolbox for psychiatrists, truly madly deeply

By Hole Ousia Posted on June 4, 2015January 22, 2023

“Costometer”

I recently noted this request: Anybody who has read my writings on Hole Ousia will be aware that I have a dislike of the current mechanical language that would seem … Continue reading “Costometer”

Categories: Delirium, Dementia, Medical Education, Medical humanities, Medical writings, NHS Hospitality Registers, NHS Scotland, Pharmaceutical industry and Medical Education, Philosophy, Scotland, Screening, Sunshine Act for ScotlandTags: #followthefellows, 2014, 29 Studios Ltd, 4AT, A letter to Professor Jason Leitch, a new instrument for rapid delirium screening: a study in 234 hospitalised older people, A person centred tool, a tool for every job, abandoning medical ethics, agitation, Alasdair MacLullich, along with staff shortages and increased demands on staff time, Alzheimer Scotland, AMT4, an apology for idlers, anti-psychotic, Antipsychotic, antipsychotic prescribing, antipsychotics, Antiquary, are making it more rather than less likely that our elders may receive antipsychotic medication that can result in significant harms, Are there now more toolkits in healthcare than in B & Q?, awareness, Behavioural and Psychological Symptoms of dementia, Bellelli, BMJ, BPSD, brief screening tools, But why am I on this anti-schizophrenic drug?, by Scottish Government figures, CAM, case-finding, Change Page: “Don’t use antipsychotics routinely to treat agitation and aggression in people with dementia, cognitive impairment, comprehensive delirium pathway, comprehensive delirium pathway as developed by SDA and HIS includes use of prescribed Haloperidol, Concerns about the over-prescribing of antipsychotic drugs in the elderly, Concerns about the over-prescribing of antipsychotic drugs in the elderly led me to consider possible explanations for this behaviour by doctors, considerations on delirium assessment, costometer, COSTOMETER - Improvement Science - NHS Scotland and the Institute for Healthcare Improvement [USA], Crabbed Age and Youth, crude reduction is always exaggeration, Cumberlege Review, Dashboards, Delirium, Delirium and Improvement work (in Scotland), delirium detection, delirium Management, Delirium management comprehensive pathway, Delirium Screening, Dementia, Deming, Derek Feeley, detection, developed from industry and in particular engineering, Director General, Do we care enough about consent?, does anyone have a person-centred-toll that I can borrow?, Doing damage in delirium, Doing damage in delirium the hazards of antipsychotic treatment in elderly people, Don Berwick, Don't use antipsychotics routinely, Don't use antipsychotics routinely to treat agitation and aggression, Dr Iona Heath, Dr Margaret McCartney, Dr Murad Moosa Khan, Dr Peter Gordon, Edinburgh, educational conferences, Edward Denning, Edward R Marcantonio, elderly, Eran D Metzger, ethics, Evidence Scan, Excel spreadsheet, Experiment, Facilit-e 46, fear, first do no harm, FOI, FOI request to all NHS Boards, follow the fellows, Forth Valley NHS Board, frailty, Freedom of Information, General Dental Council, General Medical Council, GMC, Golden lion Hotel, Haloperidol, Haloperidol in Scotland, Haloperidol prescribing in NHS Scotland, Haloperidol prescribing to Scotland's elders, harm, Hart and Mind, have been asked to try and summarise my considerations on delirium assessment, Health Foundation, Healthcare Improvement, Healthcare Improvement needs to consider the potential consequences of the widespread use of such mechanical language, Healthcare Improvement Scotland, Healthcare Improvement Scotland and a COSTOMETER - How much is HIS aka IHI COSTING NHS Scotland - June 2015 - hole ousia, Healthcare Improvement Scotland filming costs, Healthcare Improvement Scotland filming costs: £51000, Heart and Mind, HeeHaw Ltd, HIS, Hole Ousia, Hospital prescribing, Hospital prescribing of Haloperidol in your NHS Health Board area, How mechanical should healthcare be?, How much NHS Scotland money is going to 'Quality Improvement Partners'?, I also wonder if the Mental Welfare Commission may have a view of starting out with a screening test without any perceived need (as per HIS recommendations) for individual consent?, I am concerned that current approaches, I am looking for a person-centred-tool too!, If you search Healthcare Improvement Scotland for "ethics" you get zero results, IHI, IHI Fellows, improvement methodology, improvement science, Improvement Science' and the potential for harmful consequences, Improvement work, Improvement Work in Scotland, Infusion of worldwide teas, Institute for Healthcare Improvement, Institute of Healthcare Improvement, invented tool, Inverse care, ISD, ISD Scotland, It is the case, Jason Leitch, journal of Age and Ageing, Lanarkshire NHS Board, Lancet, Lancet Psychiatry, Language, Lothian NHS Board, mandatory cognitive screening introduced by NHS Scotland - as part of "improvement science" - does not meet the requirements of "the progressive test", mandatory delirium screening, Mandatory screening, Mary Midgley, mechanical, mechanical language, mechanical languge, Mechanical metaphors, Mental health prescriptions hit ten-year high, mental Welfare Commission, most patients with delirium discharged on a new antipsychotic had no instructions for discontinuation, My concerns over prescribing of antipsychotic drugs like Haloperidol in a frail elderly population led me to raise a petition for a Sunshine Act with the Scottish Government, National Clinical Director, National Health Service (Scotland) Act, NHS, NHS Ayrshire and Arran, NHS Borders, NHS Dumfries and Galloway, NHS Fife, NHS Forth Valley, NHS Grampian, NHS Greater Glasgow and Clyde, NHS Highland, NHS Lanarkshire, NHS Lothian, NHS Orkney, NHS Scotland, NHS Scotland: Improvement Science, NHS Shetland, NHS TAYSIDE, NHS Western Isles, no special training is required, off-label, off-label prescribing, Older People in Acute Care, Omphalos, Omphalos films, one organisation, OPAC, OPAC tools are working, over-medicalisation, patient centred tool, patient safety, Payments from NHS Scotland to the USA, Peter Gordon, philosophy, Plan-Do-Study-Act, powerful incentives in our health-care systems promote prescription of antipsychotics for patients with delirium, Prescribed harm, prescribing, Prescribing and Medicines, prescribing figures, prescribing figures for Haloperidol in NHS Scotland, Prescribing Statistics - Medicines used in Mental Health, primum non nocere, Principles and Practice of Screening for Disease. World Health Organisation, privatisation, Professor Alasdair MacLullich, Professor Jason Leitch, Professor Jason Leitch - letter of the 2nd June 2015 on Haloperidol prescribing ro Scotland's older generation, promotion, Psychiatric medications and potential effects on cardiac rhythm, Psychiatry, putting reduction in its place, QI, QI connect, Quality & Safety Fellows, Quality Improvement, Quality Improvement for NHS Board Members, rapid delirium screening, Realisic Medicine, Realistic Medicine, rebel antiquary, Red Road, reductionism, result in worsened clinical outcomes, Rev. I. M. Jolly, Robert K Merton, Robert Louis Stevenson, scholastic categories, Science, Scientific progress requires open-minded enquiry, Scotsman, Scottish Delirium Association, Scottish Government, Scottish Parliament, Scottish Philosophy & Psychiatry, Scottish Philosophy and Psychiatry Special Interest Group, screening, screening for cognitive impairment, SDA, Sensitive to the faltering steps of age, Sharon K Inouye, Should we not be spelling out this shortfall to Scottish Government as part of improvement recommendations, SIGN 86, Social maverick, Stirling, Studies show dramatic increase in antipsychotic treatment with mandatory delirium screening, Studio29, stupendous reductionism, takeover, technical, Temple of Decision, that antipsychotic prescribing is increasing year-on-year in NHS Scotland, The "costometer" is an invented tool, The Antiquary, The communications indicate a tone of disdain for those who may write to the Scottish Government's Department of Health with concerns about patient wellbeing and safety, The faltering unfaltering steps, the full toolset, the hazards of antipsychotic treatment in elderly people, The Health Foundation, the history of reductionism versus holistic approaches to scientific research, The mechanical language of Health Improvement, The patient paradox, the potential consequences of the widespread use of such mechanical language, the protection and the improvement of their population’s health and for the delivery of frontline healthcare services, The Rebel Antiquary, The use of antipsychotic medication for people with dementia: Time for action, THINK delirium, Too much Medicine, too much medicine campaign, TOOL library, toolkit, Toolkits, Tools, Traffic lights, Transforming Delirium Care in the Real World, truly madly deeply, unforeseen consequences, USA, Validation of the 4AT, Vested Interests, We must be wary of faltering steps into a world of inverse-care, we need to engage beyond clinicians and improvement staff, We should just design one!, We take sight at a condition in life and say that we have studied it, what is missing is the background map of the whole self, what it says on the tin, What matters to me, What matters to you, why ethics matter, why ethics matters to us all, William Edwards Deming, William Osler, Wilson and Jungner, words that appear frequently in the language of Health Improvement

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