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Re: [cp] CoP in hospitals

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  • John Parboosingh
    Hi Rosanne, Here is the reference to Jody Gittell: Gittell JH, Fairfield KM, Bierbaum B, Head W, Jackson R, Kelly M et al.: Impact of relational coordination
    Message 1 of 7 , Jun 7 9:56 PM
      Hi Rosanne,
      Here is the reference to Jody Gittell:
      Gittell JH, Fairfield KM, Bierbaum B, Head W, Jackson R, Kelly M et al.:
      Impact of
      relational coordination on quality of care, postoperative pain and
      functioning,
      and length of stay: a nine-hospital study of surgical patients. Medical Care
      2000,
      38: 807-819.
      and Colin Coles:
      Coles C. Developing professional judgement. J Contin Educ Health Prof. 2002;
      22: 55-62.
      Coles C. Developing our intuitive knowing: an alternative approach to the
      assessment of doctors. In Bashook PG, Miller SH, Parboosingh J, Horowitz SG,
      eds. Credentialing physician specialists: a world perspective. Proceedings
      of the conference held in Chicago: The Royal College of Physicians and
      Surgeons of Canada and the American Board of Medical Specialists, 93 - 108.
      2000

      You Wrote:
      I think that the "modern view" of medicine and society in general
      (especially in *some* countries) have changed the original profession (re:
      making it more individualistic).
      You are right. It started in the 20th Century when certification by
      examination of the individual and assessment of performance became focused
      on the individual. As you know, its the evaluation that determines how
      professionals behave. As long as they are rewarded in this way, learning
      from teachers, as opposed to learning from peers and using teachers as
      mentors and resources, will prevail

      John Parboosingh


      ----- Original Message -----
      From: Rosanna
      To: com-prac@yahoogroups.com
      Sent: Wednesday, June 07, 2006 9:17 PM
      Subject: RE: [cp] CoP in hospitals


      John,

      You wrote:

      "Yet there are a few fires on the go. Jim Palmer and I have an interest in
      studying Stroke Centers that claim that it is by investing in relationships
      that they have good results. Also, the work of Jody Gittell that shows the
      contribution relational coordination makes to quality of care in hospitals
      with hip replacement programs.
      Finally, I am involved in two research projects funded by Health Canada on
      the role of CoPs in teaching interdisciplinary health care to trainees"

      do you have some links to those studies? They sound sooo interesting :-)

      You wrote:

      "I have just completed workshops in a course at U of Toronto on CoPs. There
      were 28 health professionals in the course and their interest in the
      concepts was surprizingly high."

      I'm curious here. why surprising? Historically, medicine is a "group
      affaire".. In fact, the original oath of Hippocrates says:

      "I will keep this Oath and this stipulation - to reckon him who taught me
      this Art equally dear to me as my parents, to share my substance with him,
      and relieve his necessities if required; to look upon his offspring in the
      same footing as my own brothers, and to teach them this art, if they shall
      wish to learn it, without fee or stipulation; and that by precept, lecture,
      and every other mode of instruction,

      I will impart a knowledge of the Art to my own sons, and those of my
      teachers, and to disciples bound by a stipulation and oath according to the
      law of medicine, but to none others."

      I think that the "modern view" of medicine and society in general
      (especially in *some* countries) have changed the original profession (re:
      making it more individualistic).

      Rosanna

      "Real knowledge is to know the extent of one's ignorance."

      -Confucius

      <https://www.linkedin.com/in/gionnetto>
      https://www.linkedin.com/in/gionnetto

      -----Original Message-----
      From: com-prac@yahoogroups.com [mailto:com-prac@yahoogroups.com] On Behalf
      Of John Parboosingh
      Sent: Thursday, June 08, 2006 4:11 AM
      To: com-prac@yahoogroups.com
      Subject: Re: [cp] CoP in hospitals

      I have just completed workshops in a course at U of Toronto on CoPs. There
      were 28 health professionals in the course and their interest in the
      concepts was surprizingly high.

      Enough for now

      John Parboosingh

      ----- Original Message -----
      From: Rosanna
      To: com-prac@yahoogroup <mailto:com-prac%40yahoogroups.com> s.com
      Sent: Wednesday, June 07, 2006 4:02 PM
      Subject: RE: [cp] CoP in hospitals

      Hello Roger,

      You wrote:

      "I am also concerned about the impact of process engineering initiatives
      in health care, if left unbalanced with relationship-based initiatives,
      Knowledge Engineering, or management of intangible values. My medical
      center is 5 years into using Toyota Global Production System methods in
      healthcare, which has done much for patient safety, but less for robust
      relationships, IMHO."

      Awesome perspective! In my spare time, I'm a medical student *grin* I have
      passed 52 of the 59 exams required to graduate in Italy, and have done most
      of the training (needs 2 more months only, both of them in Internal
      Medicine, because I've already passed Pediatrics, Gynecology and 2 months of
      General Surgery).

      Medicine has increasingly been looked at from a process management approach
      (see the several diagnostic algorithms for almost anything under the sun..
      here I could get polemical, they almost always come from *surgeons*, the
      most technical branch I guess!). I am slightly more comfortable with the
      medication "tiers" (like first-choice, second-choice and third-choice drugs
      for given pathologies).

      However, the part that has been neglected is the human part, ie: coaching,
      mentoring and - especially - apprenticeship!

      This being said, I have some questions for you:

      1. have you tried mentoring programs (formal or informal)?
      2. have you some peer-review stuff in place (like, "newbies" writing up
      an assignment and old timers reviewing it)?
      3. have you tried some "case of the day" discussion, through listserv
      and wikis?

      After all, isn't the training period a part of the life of a doctor in which
      a doctor gets acquainted with informal learning?

      ;;)

      Rosanna

      "Real knowledge is to know the extent of one's ignorance."

      -Confucius

      <https://www. <https://www.linkedin.com/in/gionnetto>
      linkedin.com/in/gionnetto>
      https://www. <https://www.linkedin.com/in/gionnetto>
      linkedin.com/in/gionnetto

      I am also concerned about the impact of process engineering initiatives
      in health care, if left unbalanced with relationship-based initiatives,
      Knowledge Engineering, or management of intangible values. My medical
      center is 5 years into using Toyota Global Production System methods in
      healthcare, which has done much for patient safety, but less for robust
      relationships, IMHO.
      Roger

      Roger W. Bush, MD, FACP
      Director, Internal Medicine Residency Program
      Virginia Mason Medical Center H8GME
      925 Seneca Street
      Seattle, WA 98101
      206 583-6079
      FAX 206 583-2307
      https://www.
      <https://www.
      <https://www.virginiamason.org/body.cfm?id=838&CFID=481719&CFTOKEN=63107863&
      > virginiamason.org/body.cfm?id=838&CFID=481719&CFTOKEN=63107863&
      jsessionid=3230472b6e2e60426c72>
      virginiamason.org/body.cfm?id=838&CFID=481719&CFTOKEN=63107863&jsessionid=32
      30472b6e2e60426c72

      >>> parboo@telusplanet. <mailto:parboo%40telusplanet.net> net 06/07/06 8:08
      AM >>>
      Hello Bob,
      Most of my work is developing pilots and mentoring health care groups
      on how to "invest in relationships" , using the principles and practices
      behind CoPs. But most care delivery units in Canada dont have the same
      resources as I see in industry to experiment. Feel free to contact me if
      you think I could help.

      There is also a large push to develop research projects that use
      interventions at the leadership level to create a learning organization
      culture in clinical departments, and develop basic knowledge management
      systems, if only to collect and manage lessons learned around patient
      safety.

      Hope this helps

      John Parboosingh MB FRCSC
      Professor Emeritus, University of Calgary
      Consultant, Community Learning

      Mailing address: 146 Rundle Crescent, Canmore,
      Alberta, Canada T1W 2L6
      Phone (403) 609-3321
      Fax: (403) 609-3371
      Email address: parboo@telusplanet. <mailto:parboo%40telusplanet.net> net

      ----- Original Message -----
      From: bob van limburg
      To: com-prac@yahoogroup <mailto:com-prac%40yahoogroups.com> s.com
      Sent: Wednesday, June 07, 2006 6:45 AM
      Subject: [cp] CoP in hospitals

      Hi,

      I am looking for CoP in hospitals or related
      industries.

      Who can help?

      Sincerely,

      Bob

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