Report: Practical Guidance for scaling up healthcare innovations

There's a FAB report from WHO and Expandnet with clear and concise guidance for the scaling up of healthcare innovations.

There's no excuse now to write more how to guides (yes, that includes me!0 - let's get using the guidance we have to make a difference.

The report covers:


Scaling up: definition and underlying principles 
Why successfully tested innovations? 
A guided process from the outset 
Who should use this guide? 
Content and structure of this guide 

2. An applied framework for scaling up 
The innovation 
The user organization 
The environment 
The resource team or organization 
Strategic choice areas 

3. The innovation 
Attributes of innovations that enhance the potential for scaling up 
How to enhance the attributes of success and the potential for sustainable scaling up

4. The user organization(s) 
Attributes of user organization(s) that facilitate successful scaling up 
How to enhance the capacity of the user organization(s) to ensure successful scaling up 

5. The environment 
How to maximize the opportunities for sustainable scaling up inherent in the environment 

6. The resource team or organization 
Attributes of a successful resource team or organization 
How to ensure that the resource team or organization can maximize the potential for sustainable scaling up


7. Strategic choices for scaling up 
Type(s) of scaling up 
Dissemination and advocacy 
Organizing the scaling-up process 
Costs of scaling up and resource mobilization 
Monitoring and evaluation of scaling up 

8. Strategic planning and management of scaling up are a balancing act 
How to create and maintain balance in scaling up 

9. Conclusion 
References 

Mostly free Pages Numbers Keynote templates for the IPad

Trying to use your IPad instead of your laptop or desktop? I find it's ok as long as I don't want to create anything of length or complexity. Many of the templates designed for Windows, tend to get reformatted strangely when on the iPad.  Here are a few of my favourite places to get templates for my iPad Pages, Keynote and Numbers:

1. There are 156 templates available from Jaxworks. I've not checked them all. They do have a US bias but that's not an issue. They cover the entire gamut of business planning and management.
2. You can find templates for Pages, and Keynote here.
3. There are templates in iTunes which cost around £0.69 for a bundle - not a bad price to save time and to cheer up what might be a dull report or presentation.

Resources and Links about Positive Deviance

image from plexisinstitute.org

Positive deviance is an asset based method of change - find what works well and do more of it. I've been harping on about this for year but now it seems it has its time.  I've curated a list of resources and links in case you want to learn more about this concept.

1. Wikipedia has a decent overview of what PD is about.
2. The PD initiative is a key resource centre which includes an comprehensive set of resources including presentations, videos, books etc. Most importantly is has many case studies of PD in action. 
3. The 7 characteristics of positive deviants I'm not entirely certain about the who of PD being the same as the what, but nonetheless, there are lessons to be learnt from both aspects.
4. Here is a YouTube list of various videos covering different aspects of PD
5. The BMJ had a paper on the topic in 2009 - useful for those who need a bit of theory and credibility to back up what may seem a little "woolly"

Redundant? Starting up on your own? Free Business Planning Templates

The redundancies notices have been issued. CV's are being spruced up and the calculators are out as many NHS staff figure out whether they can work under their own steam, on contract, as consultants  by starting up their own business...

The one most important fact of a business, for which there are no exceptions, is "Cash is King".

Even if you think your new organisation you're starting up will be subbed by the Department of Health or some other contract - the same statement holds. You can't pay staff, your telephone bill, you rail-fare etc, unless you have cash in the bank.

Cash is not a promise of work - there are plenty of those that don't deliver/
Cash is not an invoice - though if you're desperate, you can ask the bank to give you a loan against it.

Cash is when the money is in the bank account.

Business planning is essential if you're planning to go on your own. You'll find that the plans have more meaning than any plan you've done for an organisation  You need an in year plan and at least a 3 - 5 year plan that sets out your strategies and goes down to the level of cash - in the bank.

To help you, I've complied a list of free templates you can use for your business planning processes:

1. There are 5 excellent plans, check-lists, budget summaries etc available from Invoiceberry.  As with all plans you'll need to edit and customise to make them your own, but the details are covered in these.
2. Microsoft Office has a number of templates for download.. They have a SWOT, 5 yr plan, business plan, balanced scorecard and an excellent waterfall forecasting model which analyse profit and loss, and balance statement each month (remember, cash is king).
3. Bplans has templates for different types of businesses - in case you are feeling like opening up a restaurant or a bicycle repair shop.
4. Teneric has a comprehensive suite of tmeplates, including a free course on how to write a business plan

Paper: Realist randomised controlled trials: A new approach to evaluating complex public health interventions

Realist reviews of complex healthcare interventions are all the rage - and justifiably so. The realist process is far better as discovering and questioning the complex interactions within health and social care than more linear methods. Specifically, it investigates the how and why of interventions, rather than a singular focus on the what.  It's the way forward.

Realist randomised controlled trials: A new approach to evaluating complex public health interventions.
Bonnel, Fletcher, MOrton, Lorenc, Moore.

Soc Sci Med. 2012 Dec;75(12):2299-306. 

The words innovation and improvement can be misleading

If you want an idea or activity to be judged as good, then label it as an innovation or an improvement. Correct?  Well, I'm not sure it should be, but it seems that's what happens. I've been wondering why it is that the words "innovation" and "improvement" are assumed to represent "the good".

At a high level, there is an ethics issue; to whom does the "good" belong? New ideas often stem from crises, and crises are often either sourced from or produced by competition. When one side creates an innovation, the other side loses.

At a more detailed level, what worries me is that by labelling an idea or activity using words that come with the assumption of good, is that we:

• fail to evaluate whether the idea does what it intends (fidelity; more about fidelity here)
• fail to check whether there are unintended consequences in applying it
• fail to understand the drive of the person or organisation behind it
• urge the spread of a "good" practice, without assessing its value
• just accept; and the more we just accept, the more we open the floodgates to ideas and activities which may no longer be what we need

There's a lot of talk in the NHS about the need for "innovation". It will be good when this is grounded into discussion about the problems that need to be solved and then the ideas and activities being introduced to solve them. Solutions need to stand on their own right, not be labelled to give them credibility.