The Dynamics of Care Understanding People Flows in Health and Social

This book describes numerous projects which shed light on some of the most persistent issues of the day in health and social care. The work demonstrates the importance of embedding the concept of flow into everyday health and social care thinking and crea

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e Dynamics of Care Understanding People Flows in Health and Social Care Foreword by: Jack Homer

The Dynamics of Care “Wolstenholme and McKelvie bring two lifetimes of award-winning experience in applying system dynamics to health and care dynamics to the creation of this new book. In spite of amazing advances in all areas of medical science with associated increases in our ability to diagnose and treat complex medical problems, our medical system as a whole is facing multiple crises. These problems arise not from how we diagnose and treat patients on a one-on-one basis, rather from how components of care are organised (or more often not organised) into a coherent overall system of care. Our current dysfunctional system of care is the target of Wolstenholme and McKelvie’s insightful analysis. Focused on flows and throughput as key analytic concepts, this new book condenses and focuses insights from over 80 empirical studies within a coherent analytical frame. All of us interested in and concerned about the cost and quality of maintaining a health population need to read and come to grips with the points that they are making in this important new book.” —David F. Andersen, O’Leary Distinguished Service Professor, Emeritus, Nelson A. Rockefeller College of Public Affairs and Policy, University at Albany, State University of New York, Albany, New York “This very welcome book offers the hope of sound and sustainable solutions to persistent and serious problems that not only cause untold misery to millions but also impose considerable costs in many societies. The exceptional work it reports on illustrates that a fundamental new capability has been reached—it is now both technically and practically feasible to simulate most management and policy challenges we face. This is as true for small, local issues as it is for large problems of wide scope. These working, quantified simulations are powerful because they mimic the observable behaviour of the systems we want to better manage, not just the performance outcomes of concern, but everything else of significance. They therefore allow us to experiment, boldly and at trivial cost, with software facsimiles of the real world, rather than (as we have always done until now) on the real world itself. This potential is now recognised in the UK government report ‘Computational modelling: Blackett review’, which makes clear that every executive, advisor and policy-maker, in every field of endeavour, should understand what such simulations can do and know how to implement and exploit them.” —Kim Warren, Managing Director Strategy Dynamics, London, UK

Since its inception more than seven decades ago, the NHS has become one of the great unchanging features of the British landscape. The flip side of such permanence is its inability to move with the times in the way that has revolutionised other industries. In this timely book, Eric and Douglas peel back the mystique around care delivery. They introduce two key concepts, feedback and flow, and show why any attempt to modernise delivery will