Knowing where and when an intervention can be made will determine the outcomes of people\'s lives for decades to come. This ppt attempts to show the range and scope of such interventions
1. Developing Capable Health and Social Care Organisations: Commissioning and Procurement in Context A Systems Approach to Commissioning Change in a Problematic world
5. The Continuum between Hard & Soft Systems Approaches (What is the balance point?) Hard Approaches Things dominate the problems and its setting Soft Approaches People dominate the problems and its setting A continuum exists between these poles A critical question is. What is the balance point from which to Commission AND what is the level of system or subsystem Maturity, Culture, Learning AND Which Procurement Procedure and Model of Competition will work?
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9. Closed – Deterministic System Closed systems models involve recursive patterns of feedback Viability depends on maintaining identity and stability Self-construction limits feedback and stifles feedforward In the “closed” systems perspective, a system is analysed in terms of its own information and perspective Boundary is regarded as closed Organisational meaning: Emphasising stability, group loyalty, security, clear boundaries and tight controls Sources: Bateson, Beer, Maturana, Varela
10. An Open Commissioned System Open systems models shows dynamic relationships between the organization and the environment Viability depends on maintaining critical interchanges between system and the Environment Sources: Emery, Miller, Rice, Trist The open systems perspective emphasizes exchanges of information and energy with the environment. The Boundary is regarded as porous and may be diffuse. Organisational meaning: Emphasising flexibility, collaboration, consensus building and authentic communication.
11. Multiple Perspectives A viable Systems View – How does optimising processes at an operational level help development of capability?
12. What are the Issues we are addressing? A Messy Unbounded Problem? Is Procurement the answer? It is not a simple cause and effect problem it is about the relationship between Decision Making Cycles
14. “ Messy/Wicked Problems” Diagnosis Analysis Tame problems may be quite complex, but the lend themselves to analysis and solution by known techniques, for example: Six Sigma, Lean Sigma, TPS, TQM and TPM methods
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17. Commissioning Perspectives Whose System of Interest? what's in, what's out? The Procurement view Operations View Finance View
18. February 19, 2010 Start with Systems maps and rich pictures Complexity and multiple Relationships and scenarios (story boards) Can be added later If required, schematics and one line diagrams can be produced at a detailed level Overall System Architecture Initial Capability Model System of Interest 1 st Resolution Model Process Logic
19. Likeliest Intervention for Performance Improvement Tame Problems are suited to low level procurement procedures “ Messy/Wicked Problems” Including “special causes” Note; innovation often falls into this area and requires high end permissions and procurement procedures Clarifying the Problem? What is the systems of interest? Tame problems may be quite complex, but the lend themselves to analysis and solution by known techniques. Complex behaviour can be based on simple rules Rule Set Complex Many Value Analysis to understand sources of value, cost and performance Diagnosis to understand relationship between sources of value (context) and value chain; determine and set boundaries. Rule Set: Simple /Few Simple Analysis to understand cost and performance, e.g. Six and Lean Sigma, BPR More complex end-to-end Process Analysis needed to construct value chain and understand, cost, value and performance Process Complexity Simple Process Complexity Complex
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24. What are we Commissioning: Innovation and Continuous Improvement? Customer focus – long term market growth – customer retention Initial payback and long term social dividend Performance Criteria People, process, culture Usually technology Orientation Usually spread Can be high Risks Conventional know-how's and state of art Conventional know-how's and state of art Stimulus Collective Select few with know how Approach Everybody Select few with know how Involvement Incremental Intermittent Change Slow small steps Fast – big steps Pace/time frame Long term – long lasting Short term - dramatic Effect Continuous Improvement Innovation (Breakthrough)