Using evidence in healthcare systems
IHDP’s Guiding Principles reflect many key factors which are central to understanding and implementing change in complex healthcare systems, as outlined in our evidence review.
Using evidence in healthcare systemsHave a clear vision of what you want to achieve
- Build your team around the vision to ensure you bring in the right people, with the right expertise and contacts, at the right time.
- Develop a delivery framework which allows different stakeholders to do their jobs effectively and fosters creative thinking, rather than being prescriptive.
- Make sure you identify the “right” problem for the desired outcome, rather than trying to fix the ‘visible problems’ and reaching for ‘ready solutions’.
- Monitor national issues and sense check whether current plans are still the best option - knowing when to change tack can be important, while still keeping focused on the overall vision.
- Has the right problem been identified and clearly defined?
- Are the outcomes clearly defined and linked to the vision?
- What programmes of work are needed for delivery? How will they be facilitated?
- How can you build agility into your plans and processes to ensure you can flex without being derailed?
Be willing to learn from others
- Actively look to understand where stakeholders are coming from, and what their drivers and priorities are - don’t assume you already have the necessary knowledge.
- Start with the approach of ‘what can we do to help?’ to understand any barriers and identify practical solutions. Seek input from multiple sources.
- Think about which people, roles and organisations you need to involve and why, when, and how.
- How are you going about identifying your stakeholders and how will you reach them?
- Are you engaging widely enough? How well do you know their views and experiences? How will you find out about their contexts, challenges and enablers?
- Will your planned actions address the problem(s)? How will you know you’ve been successful?
Be curious
Be open to different ways of working and new ideas, and foster a ‘test and learn’ approach.
Innovation is not necessarily inventing something new or finding a technical solution, it can simply mean different ways of doing things or repurposing existing tools for a different environment.
- Take an exploratory approach to allow emerging ideas, opportunities, and possible barriers to delivery to be captured, explored, and acted upon.
- Think creatively about the range of sectors you could learn from.
- Balance allowing time for exploration with the need to “get on with it” and move at pace.
- Actively seek opportunities for innovative thinking and action.
- Look out for opportunities to innovate and catalyse action and change.
- Encourage an iterative and agile approach.
- Support exploration and learning from ‘failure’.
- Is there similar work underway or completed in other areas that could be built on?
- Are you looking beyond the ‘obvious’ stakeholders? What insight could other sectors offer over reaching solutions to address similar issues? What different ways could your vision and delivery plans be approached?
- Have you created the conditions for exploration and creativity?
Pursue engagement and trust at all levels
Transparency and visibility at all levels are important to gain support for the change process, from the most senior levels to those ‘on the ground’ delivering services.
Building credibility and trust can take time, energy and persistence. It requires a measured and constructive use of effort and influence, and the ability to cascade that influence across organisations and sectors.
- Invest time and effort in relationships - at all levels - to engender trust and credibility, and provide strong foundations for collaborative working.
- Shared motivation is a powerful driver - bring together the right partners for a common purpose and a shared vision.
- Demonstrate ‘skin in the game’ to show commitment and generate credibility.
- Identify clear routes and mechanisms for engagement and influence.
- How does your work align with policy, practice and people (professionals and patients)?
- Do you have the authority to lead the work to the proposed solution? Who else might you need to involve/ influence?
- How can you identify champions amongst leaders within your networks for the vision?
- Which sectors do you need to involve, how can you reach them?
- How are you ensuring that you are really engaging, and not just communicating?
Balance pace and progress
- Allow time to forge meaningful relationships and positive engagement.
- Move at pace, tolerating imperfection rather than always aiming for perfection, balancing timely progress with adequately meeting needs.
- How will you know when you have adequately met needs? Who do you need to involve to understand this?
- How will you know when good is good enough, and resources can be directed to other efforts?
- How will you prioritise needs while ensuring sufficient action for progress to be made?
Apply the right resource in the right place
- Investigate the nature of the resource gap, which may well not be financial - freeing up expertise, and supplying in-kind support such as administrative resource, can keep work moving at pace.
- Identify what is needed to ‘get things out of the starting blocks’, and to act as a lever to unlock progress in other areas.
- Consider what is needed to create the conditions for creative thinking, at the outset.
- Think carefully about how to get best value for money.
- Identify your resource needs -for example do you need to bring in specific expertise to help define issues, direct work, or consider different approaches?
- What are the resource needs of the stakeholders - funding, expertise, time, systems?
- Are there any areas that could be ‘pump primed’ to swiftly investigate or kick-start options?
- Are there any practical barriers that could be removed which would make it difficult for stakeholders to not be involved?
- What can you do, or provide, to enable others to experiment and explore?
Further details about the types of resources used in the IHDP approach can be found at Resources for innovation.
Impact Stories
The ways in which IHDP’s approach and activities contributed to improved outcomes and impact are shown through impact stories.