Sue Payne 18/04/11 - SHINe

Sue Payne 18/04/11 - SHINe

E E EEmergingevidence ofbenefit, risk,harm variationEfficacyClinicaleffectivenessCosteffectivenessGenerate consensusEPolicy ChangeImplementation PlanActions “Non discretionary”Accepted by a groupof stakeholdersInitiates ReviewStocktake ofcurrent practiceOutcomeEvaluationOptions forchangeRecommendationE E E

Reality: Process is chaotic, messy,opportunisticDrivers for Change: Multiple factors,may not be obvious, requiremomentum

LobbyingMSPs, Press, Patient(s),Complaints, Clinicians, VoluntarySector, Charities, AuditLeadsClinical and Nonclinical“do the work”Financial ImperativesEfficiency savings,minimising expenditure,avoiding costsIdentifying ‘real’ stakeholdersIndividuals or groups. Influence(positive/negative). Power todecide (basis for authority)Political Imperatives“Must do actions” / ManifestopromisesPlanning guidance, MELS,strategies, targets, AnnualReviewLeadsClinical and Non-clinical“build momentum forchange”Evidence (internal / external)Benefit, Harm, Variations

RealityNot really messy, chaotic or opportunisticPlanned and informedLeads, obvious and hiddenNeed a plan or set of behaviours• Present a solution focussing on process (notoutcome)• Consider scenarios (ultimate goal win-win)• Use drivers in right order and correct time tobuild momentum• Work the system (retain freedom but appearaccountable)• Effort and endurance required over months• Allow others to take credit

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