Posted by: ayrshirehealth | May 4, 2016

I’ve been hack’ed by @maidenturret

Healthcare hackathon

I’ve had 24hrs to reflect on my experience of the first healthcare ‘hackathon’ to take place in Scotland. Care Hackathon

So was it another tick in the box of the latest workshop methodology or was it a meaningful, purposeful exercise to explore the complex issue of unscheduled care, shape ideas and build commitment for change?

Building the conditions for creativity

The hackathon was held in the Mclellan Art Galleries (Glasgow), which is currently being used as studio space for the Glasgow School of Art. McLellan GalleryI was originally concerned about participants having to travel from Ayrshire, but this was an inspired choice.

The location created a real sense of a working space for the creative expression against a backdrop of the grand (Even the toilets added to the sensory experience – flashback to my school days!). Participants commented on a real sense of getting away from the daily pressures and the casual dress code added to the feel of something different! McLellan Day 1

There was a real buzz in the room as the 150 participants (public sector, third sector, patients, private sector, art & design students) took their seats to hear the introduction from Dr Hans Hartung (project lead for hack).

Hans emphasised the importance of carving out even a small amount of time to ‘day-dream’ and think about the future state and he reminded us that all great inventors achieved through failure – testing their ideas through prototyping.

Trust the Process

As a new experience it was clear that the hackathon methodology was taking many in the room out of their usual ‘comfort zone’. Steps in processWorking in the public sector we tend to stick to linear, structured planning processes and a hackathon is more iterative, with a focus on discovery of ideas to refine through prototyping. So we were told to trust the process (the approach is rooted in the double diamond design model developed by the Design Council).

The first phase on day 1 involved the process of discovery. Snook had undertaken a considerable amount of pre-hack research, talking to a wide rnge of people about their experiences of unscheduled care.

Stepped processA number of case studies of an individual’s lived experience of various elements of unscheduled care were mapped out on story boards round the room. Participants were asked to consider the case studies and uncover challenges relating to unscheduled care.

Listening and talking to participants, I was blown away by the insightfulness and powerful reflections on considering each case study.

There was a real cacophony of debate, with many participants commenting positively about the opportunity to reflect on people’s end to end journey and not just thinking about their bit of the process. The feedback powerfully relayed the challenges of committed staff working with broken systems and processes.

‘Why do we do it this way? – it looks and feels like a production line’

‘Why was the patient not asked what they wanted at the beginning of their journey?’

‘Can we not shape our services round our citizens?’

‘Do we have to see a doctor? Do you have to come into hospital?’

‘There should be more ‘love’ in our systems and processes’

‘We make simple things complex and complex things simple’

‘Carers and families could be much better supported’

Defining Challenges and forming Teams

The passion for a more person centred approach was palpable in the room and it was humbling to hear feedback from participants that was rooted in a desire for collective change. TeamsThe next phase of the ‘hack’ involved participants defining challenges that could be addressed and then forming teams around a mutual area of interest.

This was a fluid process that allowed people to self select and changes teams as they wished.

The last activity of the day involved the generation of ideas (as many and as ‘whacky’ as they liked), ‘chewing the fat’ over solutions to the unscheduled care challenge.

I have been to very few events on a Friday where almost all participants stayed to 5pm on a Friday!

Prototyping, Testing and Defining Ideas

It was great to see more than one hundred and twenty people return on the Saturday for day two of the ‘hack’. Day 2 readinessDay two focused on refining their ideas and prototyping how the ideas would work in practice. Day 2 working

Teams greatly benefited from the art & design students facilitation (they are used to testing the ‘how’) and the support of expert mentors in the room (including product design, data management and quality improvement). This made me reflect on our historical practice in the NHS, where we plan in infinite detail to get it right first time, rather than prototype using an iterative process.

We were furnished with loads of props and ‘arty’ materials to support us in our testing.

Show and Not Tell

Design aidsThe final stage in the process was for teams to present their proposals from the perspective of what it would feel like to experience their idea (in 4 minutes or less). So no death by powerpoint!

The teams rose to the challenge – we had drama, role play, audience participation, 3d models amongst the approaches used to get their ‘idea’ across.

I never realised Ayrshire had so many talented actors! The change ideas for unscheduled care were big and small including:

  • Self-referral for psychological distress
  • Volunteers to support end of life care
  • Development of community hubs and integrated health and social care teams to deliver the right care in the right place
  • Using existing technology to support the sharing of anticipatory care plans
  • Enhancing homecare to prevent hospital admission

Next steps and date for the diary

As well as the enthusiasm, passion and commitment generated by participants (I wish I could bottle this for use!), copious amounts of valuable data, change ideas and projects were generated during the two day process. It is important that the synthesis and outputs from the event link with other conversations and change plans that are already in train (lots of good work already happening in partnership between the Health and Social Care Partnerships, Acute Services and other service providers).Co-created

This was reinforced by Mr John Burns our Chief Executive in his closing remarks. The focus must now be on delivery, using the outputs from the hackathon to deliver the required change to sustainable person centred models of care. The outputs from the hackathon will be shared widely with stakeholders and there will be a follow up event on Friday 3rd of June at University Ayr and University Crosshouse Hospitals.

So back to my original question – was the Hackathon a tick in the box or a meaningful exercise?  I think it was really worthwhile for a number of reasons, but the ‘proof of the pudding’ will be in the delivery of change.

This week’s blog was by @maidenturret (Andrew Moore), Lead Nurse, South Ayrshire Health & Social Care Partnership; Assistant Nurse Director, Quality Improvement and Governance, NHS Ayrshire & Arran

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