According to David Carnevale, author of Trustworthy Government, one of the key differences between learning organizations and traditional controlling organizations “is that deeply ingrained defensiveness so characteristic of low-trust, traditional bureaucratic organizations undermines necessary learning. Trust expedites learning.”
Carnevale says that “Healthy learning organizations are managed with the objective of liberating and using employee know-how to improve work processes. The emancipation of employee know-how is enabled through a different philosophy of organization and job design, communication patterns, labor-management relations, participatory methods, and other processes that reduce the climate of fear and allow staff the necessary psychological peace of mind to fully engage their work”.
Tomorrow I am going to the DH to discuss progress with the paradigm shift from compliance to compassion (fear to trust) which is at the heart of the thinking of a small but growing number of leaders in local authorities, care providers and the NHS.
I am not sure how relevant the consultation is but welcome its emphasis on compassion - what we long for when vulnerable and what takes many health and social care professionals into the caring space.
Our next step is to create 'The Compassionate Leaders Network' to enable the courageous to stay strong and resilient and to build influence from a place of grounded action and impact.
The people I work with and the impacts made on patient and staff well being fills me with optimism that a deep change of culture is possible.
Finally, and perhaps most importantly, improving the patient experience requires a change in culture. This change must be embraced by and reflected in the actions of everyone within the system. Furthermore, everyone must understand the fundamental truth that change is an ongoing and healthy process. All organizations undergo constant change, but healthcare organizations that embrace the patient voice, encourage shared leadership, and seek to build trust rather than apportioning blame, are bound to evolve in a patient-centric direction.
The art of healthcare involves much more than consideration of bedside manner and clinical judgment. It involves the relationships between people: doctors with nurses, patients with their families and communities, and healthcare providers with patients and families. It is the nature and extent of these relationships that make healthcare as an enterprise unlike any other business. Yet these relationships are currently out of balance. Restoring the art of medical practice requires re-visioning these relationships as true, functional partnerships.
Suzie Daggett interviews Dr. Daniel Allen, DO an Osteopathic Physician whose specialty is Craniosacral osteopathy.
What sparked your interest in medicine?
I was raised on a farm, with horses, calves and life all around. Getting hurt and healing is a normal, natural process. In my pre-kindergarten years, I would follow behind the plow and see the earth worms surface. I wondered what made earth worms wiggle after you cut them in half, how can they still be moving? Then, I fell out of the barn when I was 6 and broke my leg. Watching the process of fixing my leg by the country doctor was fascinating and it stayed with me. In college, I was not good with reading or writing my areas of interest were math and science - I was a very good problem solver. One of my teachers knew I had an interest in medicine and introduced me to the idea of osteopathy, which he felt was a fit for me. It took some time because I was afraid of the intense studies demanded by the medical profession, but finally after procrastinating for a few years, I became an Osteopath.
What is osteopathy about?
Osteopathy a sub-specialty of medicine. It was started 100 years ago by A.T. Still, a core man in the Civil War, who learned medicine in the frontier of Missouri and Kansas. A frontier doctor needs to be resourceful, use his mind and use the tools around him. Dr. Still was traumatized by his life experience in the war, the loss of life of many of his children and his first wife due to disease. He thought deeply about the medicine being practiced, and found that the body is built to heal on it's own. His philosophy was that a human being is a living thing instead of a disease manifesting entity. He believed that the body is built for life, and by nature, it is built to heal. Instead of fighting disease, he suggested promoting health. He believed that the body can manufacture any inherent internal chemical that it needs for healing. We are now just beginning to find that there are receptors in the body for all sorts of chemicals that modern science had no idea existed, but exist in nature. The factory of health is in your body. Doctor Still taught his students to think, feel, listen and pay attention to the patient and the body. He stressed that we as doctors would teach our hands how to feel in the body. We learn to feel the difference between a diabetic body, a soft body, how the bones fit together, how the joints move, how the organs move, how the muscles interact – all by the feeling and paying attention process. We feel physical tissue, layer upon layer and instead of using instruments, we use our hands.
When someone comes to you, what do they experience?
It is all very individualized and many times, we start with a conversation. For some people, that may be all they need for the moment. I work with my patients to introduce positive language, moving from language like "I have bad knees that keep me from doing what I want" to "I have knees that are a pathway to going where I am going". The knees, like all parts of the body are a living element in the body, so we work with them to examine limited beliefs. Working with the patient's belief systems can create a positive life style and wellness. Since Osteopaths see the body as a fluid living model, not a static two-dimensional cut and paste model, we use many different tools to treat the whole body, such as Craniosacral work.
What is Craniosacral work?
Craniosacral is a simple yet very complex practice. It is also called the primary respiration mechanism. In a healthy person, the cells expand and contract in an organized manner. Through the cranio fluid, the components of oxygen and the movement of waste products are moved out across the cell membrane. When someone is healthy, the movement is free flowing. In patients who have suffered a trauma like a car accident or a fall (even from years before), the cranio fluids become static. I work to gently move the sutures of the head which helps relieve pain and discomfort and allows the fluids to move in their natural flow again.
How do people stay well?
The biggest factor against wellness is the misuse of time. That is the single most important medicine. Time, food and water are the basic components of health. We can do a lot of medicine with these three elements. If you have a healthy garden you do not have much of a pest problem. If you pay attention to the problems early on you can assist with your own health and wellness in a natural way.
What's the best part of your practice for you?
Being part of the sacred dance of life is so precious. All around us is the garden of Eden and it is so beautiful, it is something we can all tap into if we believe in the possibilities of health. It is so amazing to help people get life back in their eyes as the body is offered a natural chance to feel better.
An example of communication in healthcare is between clinical professionals and staff, patients and their relatives or carers, professionals doctors, occupational therapists, social workers, midwives, physiotherapists and administration staff (Darley, 2002).