The Conceptual Age needs tools to catch, match and patch ...

I have finally read some of Dan Pink's book A Whole New Mind: Moving from the Information Age to the Conceptual Age.

The graphic copied here from the book is interesting for this blog and its readers by both what is included - the conceptual age and what is omitted.

Pink's graphic supports and reinforces what I have felt for many years. Namely, that in Hodges' model we have a conceptual framework fit for our time and purposes. Looking at the figure developmentally then of course we think conceptually from a very early age in order to make sense of self, other, world and future.

Pink's graphic is interesting in that as depicted here we have not reached the knowledge age as yet. While these ages are discrete when conducting health and social care and other activities the boundaries are of course unclear and fuzzy.

Being in the conceptual age we need tools that can catch our care and related concepts. A stage that makes them accessible for reflection and association.

Moving further towards the knowledge age we then need tools that can recognise patterns in our concepts and begin to match them.

For safety's sake we then need to recognise the important concepts missed in our assessments, problem solving, project management and service improvement processes ... These tools will be able to suggest and patch the gaps in our framework and hence our understanding.

Image original source: http://elearningtech.pbworks.com/f/daniel-pink-conceptual-age.png

Additional links:

Dan Pink - A Whole New Mind

'conceptual spaces' on W2tQ

'concepts' on W2tQ

Reflecting on this it is a shame that there is no Innocent Age any longer or what there is often cut short.
The least we can do is to try to preserve it for as long as possible ...

Relationships matter: Society Guardian & The WSJ

Re. Charles Leadbeater's State of Loneliness, The Guardian, Society, 01.07.09

The cover of this weeks Society Guardian immediately caught my eye with its picture (I wonder which corner of which care domain this lady is sat in?):

The text initially passed me by; then yesterday I caught up, it seems the business model quest in one sector is having a domino effect with new models needed elsewhere including health and social care.

Leadbeater's piece reminded me of Lean thinking the improvement process with its drive to identify value, reduce waste and repetition. ... His text points out that:

More efficient services quickly move in and out of people's lives, but they don't really change how people live. That is one reason why we have not made deep inroads into the most deprived communities, the most troubled families, the most intractable social problems. Services manage and process people and problems, but only rarely allow people to change their lives. Service solutions are ill-suited to the emerging challenges of the rise of long-term health conditions, diseases linked to lifestyle and diet, ageing or climate change. You cannot deliver a solution to an epidemic of diabetes the way that DHL delivers a parcel.

So any model, method that is primarily process centered may find itself compromised - providing just one cylinder's worth of power in a four cylinder engine. In Hodges' model I have identified the 4Ps. PROCESS, PURPOSE, POLICY, and PURPOSE (to which we must now add PROBITY). It will be interesting to see how value is defined across service forms of engagement, intervention (including signposting) and the new set of outcome measures to follow whether local, national, service-reported or patient reported outcome measures. Leadbeater continues:

The key will be to redesign services to enable more mutual self-help, so that people can create and sustain their own solutions. The best way to do more with less is to enable people to do more for themselves and not need an expensive, professionalised public service. Enabling people to come together to find their own, local solutions should become one of the main goals of public services. Services do a better job when they leave behind stronger, supportive relationships for people to draw on and so not need a service.

So Jo(e) Public needs to reflect, compare, evaluate, learn, collaborate and make informed decisions in order to stay well amongst many other things. They need to be engaged holistically.

Where is the model for this...?

I believe I know.

The Wall Street Journal has something to add here The Doctor Will Text You Now and relating to my earlier posts on 'Beware Reflex Moves'. Relationships matter, but if nurses are out there assessing, assessing, assessing who is doing the education, dividend added therapy outcome focused?

If e-health is going to make a real contribution in augmenting and freeing high value care resources then this in turn depends on the value invested in relationships.

Louis Petrillo, 57, a psychologist in Westfield, N.J., says he regularly turns to his family’s doctor, Robert Eidus, for online advice about his frail 90-year-old mother, who finds office visits difficult. His son who is away at college also used an online visit when he had sinus problems. “I can get into his virtual office anytime,” says Dr. Petrillo. He feels the online care works well largely because Dr. Eidus knows his family members’ regular health complaints.

If older adults move home and need new primary care services, what are most probably(?) well established patient - doctor (patient - primary care team!) relationships are not just undermined they are undone! A person's sense of community is fractured. ...

Yes that image speaks volumes.

Do read the two articles mentioned - excellent.

Image source: Guardian

Mathews, A.W., The Doctor Will Text You Now, JULY 1, 2009, The Wall Street Journal Interactive Edition

Relative poverty (3) - sciences

[The introduction is repeated across these posts: intrapersonal, political, sociology]

There are many paradoxes in life and many of these are concentrated in the realm of health and medicine (a major sub-division of life and death).

For decades the link between poverty and standards and quality of health has been recognised and politicised in the media and policy. Just this past week was news of a Bill to make the eradication of child poverty a legal obligation not something that can be the political objective at the start of a Government and then cast aside.

Many things are relative and poverty is often described in this way applying to individuals, social classes, communities, regions and whole nations. Using the domains of Hodges' model what reflections does this prompt? Let us see:

SCIENCES: We tend to think of economics and the definition of poverty in materialistic and monetary terms. In this domain things become things. Processes and much more besides - people are objectified and commodified: prostitution, child labour, child soldiers, people trafficking - individuals as numbers at a certain time, certain place. The person reduced to a process - service.

On the sciences front in an explicit way our poverty of knowledge ('education, education, education') becomes apparent as we try to place value on the environment and not only our personal use, but national use of the green and blue. A new economics is indeed called for.

In the current 2009 Reith Lectures (closing lecture this week) Professor Michael Sandel presents A New Citizenship. Within these lectures Prof Sandel explains how fees change services, values and expectations with examples of child care and blood supply in health care. Organisations have to be aware of their assets with laptops, PCs and umpteen other pieces of equipment and resource possessed of their own unique ID.

Yes, according to my interpretation of Hodges' model the points raised here belong in the political domain, and yet we are so befuddled, intoxicated and to a certain extent deluded with the sciences, technology and material things (de-vices?) that in contemplating poverty we must extend the political realm. ...

From now on the public's attitude to science as individuals and families, communities and nations is going to be critical to change our understanding and more importantly our experience of poverty - material, relative or otherwise.

Image source: BBC

Additional links:

The Simonyi Professorship: hair for the Public Understanding of Science at Oxford University

'Poverty' on W2tQ

Sciences care (knowledge) domain links resource

Political care (knowledge) domain links resource

Relative poverty (2) - political

[The introduction is repeated across these posts: intrapersonal, sciences, sociology]

There are many paradoxes in life and many of these are concentrated in the realm of health and medicine (a major sub-division of life and death).

For decades the link between poverty and standards and quality of health has been recognised and politicised in the media and policy. Just this past week was news of a Bill to make the eradication of child poverty a legal obligation not something that can be the political objective at the start of a Government and then cast aside.

Many things are relative and poverty is often described in this way applying to individuals, social classes, communities, regions and whole nations. Using the domains of Hodges' model what reflections does this prompt? Let us see:

POLITICAL: Although we are told that change is happening swathes of humanity face -

poverty of choice or no choice but poverty.

There are those who are able to decide and yet denied choice due to a politics or state that spits explicit corruption denying the people their expressed and collective will. Although previously described as 'black and white' politics must become participative AND must become 'green and (truly) global'. As events in 2009 attest here in the UK, politicians, those key workers / case practitioners in this domain (should paradoxically) disavow personal ambition and at times yet to be decided the party whip system. Yes, these matter, but again space (vacancy) is needed to accommodate - permit and facilitate true focus.

This is no chance opposition of domains in Hodges model.

The diagonal of INTRAPERSONAL and the seat(s) of power and governance
is mediated through the social domain.

Like health professionals, politicians and civil servants must wipe the slate clean: constantly. This is why transparency in politics is so crucial to trust, engagement, and grounded politics. ...

'P' is for politicians not just the 'people'.
Politicians need to be engaged coherently.
Touch is the interface for them too.

A week is a long time in politics because the sun never shines (not even in 'victory'). For these people being open, transparent, non-judgemental ... means their vision is refreshed by a perpetual rain.

Only then will they see poverty and be reminded of it -
even if poverty and even more so if poverty
represents where they came from ...

Image source: Equator Network

Additional links:

Reith Lectures 2009 BBC 'A New Citizenship'

'Poverty' on W2tQ

Political care (knowledge) domain links resource

'Information' a definition

Exactly what information is (at least one very useful technical definition of it) is answered by the mathematical theory of information. A rich field with many applications to biology, linguistics, and electronics, the theory is couched in the language of bits, each bit of information conveying one binary choice. [Hence 5 bits, for example, convey 5 such choices and are sufficient to distinguish from among 32 (or 2⁵) alternatives, there being 32 (2⁵) possible yes-no sequences of length 5.] Bits serve too as units in the numerical measure of such notions as the entropy of information sources, the capacity of communication channels, and the redundancy of messages.

Source: Paulos, J.A., (1991) Binary numbers and codes, Beyond Innumeracy, p.26.

Additional links:

W2tQ 'information'

W2tQ 'Ye Olde paper: 1996 "Humans, information and science'

Bee in my bonnet and a place to call home

For some years (over a decade) I've had a bee in my bonnet about the impact of relative-ly sudden house moves that older adults often make following sudden bereavement.

This prompted a first and no longer maintained website 'Beware Reflex Moves'.

This rather silent issue still stands and is arguably growing in volume.

There are surely a series of studies to be made here. Like most forms of life, the patient-nurse encounters of all those years ago have evolved: the ability of Jo(e) Public and their families to independently visit, select and move their relative into residential care is a new factor.

Self-funding frees up valuable resources as people can essentially circumvent the formal assessment processes of social services (and health), negotiating directly with the home of their choice for a place. This place may be many, many miles away from what was home. Amid increasing demand this arrangement works well much of the time. When it fails though, the impact is a personal and social catastrophe that can also reverberate across two health and social care economies. The person's original social services and their new location - that of their family.

Here the 'diagnosis' may not just be bereavement reaction / depression, but dementia too.

So, the advice remains beware of reflex moves.

Wish those bees had stayed in that bonnet - they might be safe now.....

Image source with thanks: http://www.flickr.com/photos/lelonopo/2378726643/

Relative poverty (1) - intrapersonal

There are many paradoxes in life and many of these are concentrated in the realm of health and medicine (a major sub-division of life and death).

For decades the link between poverty and standards and quality of health has been recognised and politicised in the media and policy. Just this past week was news of a Bill to make the eradication of child poverty a legal obligation not something that can be the political objective at the start of a Government and then cast aside.

Many things are relative and poverty is often described in this way applying to individuals, social classes, communities, regions and whole nations. Using the knowledge domains of Hodges' model what reflections does this prompt? Let us see:

INTRAPERSONAL: On one level highlighting poverty here appears a nonsense as usually we think of material wealth; the ability of people to be able to put decent quality - nourishing food on the table. In the miserable trap that poverty presents, it is perverse to suggest that health and social care workers - indeed all 'customer facing personnel' seek poverty. But they should exercise: poverty of thought.

Health and social care are often couched in terms of being a safety net, especially in community care - this conception emphasizes health and social care as a physical resource. In the intra-interpersonal domain though we are concerned with individual mental life, beliefs, attitudes, thoughts and emotions....

So here it is as if we must adopt the philosophy of Bruce Lee and turn the 'art of fighting without fighting' into the 'art of caring without caring' through a momentary forgetting in order to care effectively. We suspend our thoughts - take a mental breath, bring our training and current evidence to the fore. The conceptual safety net does not work if it comes pre-filled with bias, prejudice, pre-conceived ideas and negative expectations. There is of course a very poignant irony in calling for people to forget, suspend belief - even for an instant - at this time and in this domain. For health and social care workers in wiping the slate clean we do not think, but are VERY receptive to what follows.

This is where the wealth is:
between us.

We should not play the greedy capitalist and keep collaborative tools like Hodges' model to ourselves.

It was made to share: in my mind and yours a global health resource...

Image source: BBC

safety net: http://blogs.jamaicans.com/metinking/2009/04/30/a-jamaican-legacy-that-deserves-our-support/

Additional links: 'Poverty' on W2tQ

Political care (knowledge) domain links resource

COMMENT - 22 June 2009:

Would this article of mine along with its rapid responses add to your discussion?

http://www.bmj.com/cgi/content/citation/325/7354/51

http://ukpmc.ac.uk/articlerender.cgi?artid=478323 (full text)

Would you like to send me a book chapter on your experiences with the Hodges model in healthcare?

http://www.igi-global.com/requests/details.asp?ID=...

Regards,

Rakesh
Rakesh Biswas

Hello Rakesh,

Many thanks for your input and invitation. I don't think I could make the deadline for the book which is a pity, I've completed two book chapters for IGI thus far. The website is priority and Drupalcon Paris. I will think about this though and e-mail you soon - or please contact me directly at h2cmuk at yahoo.co.uk.
I've another three posts with this title. The post above rather grew to stand alone.
Anyway thanks again your input is most welcome and appreciated.
Regards
Peter