Hodges' Model: Welcome to the QUAD: November 2006

- learn about the conceptual framework Hodges' model. A tool that can help integrate HEALTH and SOCIAL CARE, INFORMATICS and EDUCATION. The model is situated, facilitates person-centredness, integrated - holistic care and reflective practice. A new site using Drupal is an ongoing aim - the creation of a reflective workbench. Email: h2cmng @ yahoo.co.uk Welcome

Friday, November 24, 2006

There Are Four P's in "Hodges model"

People are not very good at multitasking (surprise, surprise!).

In conversation people discuss one topic or thing at a time. If the subject alters, the change of context is indicated through a verbal redirect "There's something else...", or a gesture. When writing, paragraphs help structure our prose. If there are several tasks to perform, then it really is a case of "one at a time thank you!". Although, as the saying goes though - where there's a will, there's a way - hence the constant emphasis on EFFECTIVE team working.

Reality is of course rarely presented to us in discrete contextualised packets. Experience is not always filtered to the extent that only information relating to one context is delivered to our senses. Can you imagine the informational equivalent of the IV drip? (Virtual reality?) And yet this is what our brains are tasked with, to select, sort and prioritise....

There are exceptions:- the arrival of news about an impending birth or sudden illness or accident. Then informationally speaking the world is ordered and yet a personal chaos ensues. We move like the wind...

So usually several contexts are knotted and presented together. Predicatable consequences may follow; confusion, a task may be left incomplete, risk becomes a dance partner, although at first this passes unnoticed as we are still going with the flow. A key message becomes garbled, the meaning fails to get through.

The amount of information needed by a team is erm... well - a big number! The demand for data and information on just process and policy is monumental. Project management tools are no guarantee against satisficing. The volume of information and human fallibility can fracture discipline and has us saying "that’s far enough", or "that will do for now".

So without untying the contexts, unwrapping the complexity - key parts of the picture may be missing. Sometimes even when the picture is complete, we forget about the frame and picture hook? Just which way is 'up' if that matters a[r]t all?

In the same way that items of data can have meta-data (that is data about data), could it be that Hodges’ care domains have their own meta-terms of reference? These terms characterise each of the care domains and their respective contents. In the same way that process is integral to project management, perhaps there are terms that can contribute to the overall effectiveness and scope of Hodges’ model? What I have in mind is the following:

Purpose Process
Practice Policy

Surely this rather complicates matters? For an artist this would actually prove a very limited palette. And yet this is a common strategy – reduce the palette to four colours. This greatly affects the 'masterpiece' assuring discipline and influencing style before the paint is even amb(r)ushed.

For project managers armed with their PM tools the 4Ps really are a handful, but well worth getting to grips with.

Tuesday, November 21, 2006

Advocacy No. 1

What’s your view on nurses as advocates?

For nurses advocacy is seen as a constant facet of the role. It may not be as pronounced these days, but it is always present. If a person (patient or carer) needs an advocate in that 'non-legal' sense, then as nurses we are ready and willing to assist and present the patient's views. Quite a few years ago there was much navel-gazing that questioned the appropriateness of nurses as advocates. Where are the boundaries and how do you define non-legal? How independent can nurses be?

This no doubt presaged the advent of formal and dedicated advocacy worker schemes, a development reinforced by the emphasis on human rights over the past decade. Rather than travelling along the care pathway WITH the patient, carer(s) and health care team, advocacy workers are ready to get involved - independently - as the care situation reaches a crossroads (and pauses momentarily). In my experience though it is not easy to find longer-term independent advocacy input. Sometimes it is the very need to call 'time' - to seek space to reflect and weigh pros and cons - that is an issue.

Unless their role is radically changed, nurses will always be an initial advocate. Nurses are in the midst of care, their privileged relationship and proximity to the patient, their knowledge of the issues, diagnosis, interventions and prognosis makes advocacy a natural (caring!) response. I raise this because if advocacy is a political concept and the nurse’s role as advocate is less than it used to be, then what is left - beyond the political essentials of pay & pensions?

This blog is in danger of becoming a litany of examples by which I reveal my age. ... Back in the late 1970s and 1980s nursing was far more political and in the UK those were certainly employee-employer troubled times. They had quite an effect did those Union badges! Metallic drops of red, blue and green that adorned so many lapels, instant decoration for the grey suit with waistcoat that I used to wear (my mum thought I looked smart for once). Mental health always seemed more, shall we say union-attuned, than general nursing and yes the power of the unions had a lot to answer for in the UK; but where are we today?

Acting as an advocate you really can make a difference. Individual needs are nursing's bread & butter; but why stop at one person, when the needs of the many...?

Perhaps my view on this is a personal illusion, brought on by the purchase of Jane Salvage's ‘Politics in Nursing’ (1985)? Did this book, like most, merely reflect the times? I must confess the book did not 'activate' me. (Although, as the website may demonstrate, my head was lost above the clouds.)

In my student and early years the advice was keep your nose clean; deposit your assignments on time into the school of nursing's coffers and get through the current placement. There were exceptions as might be expected in a huge aged asylum, though thankfully when necessary action did not fall upon the conscience of one individual (that takes real conviction, courage & dedication). The issue was 'public' witnessed by several colleagues, all dedicated to high quality care. A case of a problem shared…...

The point of all this: If nursing has largely withdrawn from the role of advocate, than what is left politically? Maybe for you nursing is still there, the sparks flying as the activists sharpen advocacy's edge? The nursing pioneers Nightingale, Seacole, Makiwane, Breckinridge, Walking Bear Yellowtail, Peplau; and many others set an agenda. To what extent have we (nurses) addressed this? What remains to be done and what new challenges do we face?

The pioneers made a real difference. Not only did they build the ship, they set us on a course. If I were a student I'd be shouting "Are we there yet!" Has nursing arrived? If not, why not, how can we correct course and where - in the time of constant re-invention - is the new horizon?

Friday, November 17, 2006

Multi-touch interface demo 10mins TED2006

If you have not already seen it - check out this video demo of a hands-on interface from TED2006 - Technology, Entertainment, Design conference in February featuring:

Jeff Han

I came across it c/o the Instructional Technology Forum. Enjoy.

TED2007 watch that space!

Wednesday, November 08, 2006

Podcast part 1: available at last....!

I've an audio file that I feel passes for muster. I've tried to inject some animation and enthusiasm, which is not easy at 0000 hours. Anyway - thanks to ccPublisher and the Internet Archive you can now download it if you wish.

In the podcast I mention that it will run for just under 30 minutes. In the end it's actually 31:33.4 - not too far out. There are no bells and whistles (thank goodness), no fancy opening music.

There are three files provided (a learning package?):

1. The podcast itself in mp3 at 30MB 128bit.
2. The podcast notes including my responses to the two questions posed.
3. A powerpoint summary of 10 slides.

At 30MB it is a large file, but it will I trust reward your patience. As I'm writing this I've just noticed that ccPublisher has also created a 64bit version 15MB, plus Ogg Vorbis 22.2MB (Open Source).

I've checked the files (except for the XML & OV) and they download fine.

If you find the podcast of help please let me know, especially if it proves useful within education. Wherever you are working, if Hodges model appears to offer something to you get in touch.

Part 2 will follow in due course, after I complete that other project...

Wednesday, November 01, 2006

Podcast part 1: delayed but ... this weekend!?

Well it's November and no podcast. Yes, mention was made of October, but I did say don't hold your breath. There are two test audio files at 27 mins and 25,000k that I can point to, so very nearly there except that the microphone stand (hey this guy's serious!) got in the way of my foot. Should be fully cooked and served this weekend, if the walking windmill can stand still...

I have to get part 1 through the door sharpish because I need to finally nail the Serres-Hodges paper. I've to reduce the current version from 8k words to between 5-7k when completed, which MUST be at the end of the month. To support this effort I'm reading 'Small Places, Large Issues' by Thomas Hylland Eriksen, excellent introduction to social and cultural anthropology.

Before I go (and gargle) the Idea Factory did the job in terms of my getting on board with Skype. I now have a working internet phone - at least the test call worked. It was easy to install too.

The event also rekindled a potential research question I've wondered about for many years. A question that like Hodges' model grows in relevance each year - more to follow ...