Holistic Bandwidth: All or Nothing
Quite a few years ago (Jones, 2004), I took the term bandwidth from the information and communication technology (ICT) world and applied it to health and social care. We seem to have been trying to achieve holistic and integrated care for decades. When care assessment, planning, intervention and evaluation is limited in scope this creates a narrowing of perspective, a bottleneck. Just as bandwidth problems used to affect the quality of on-line experience, so the bandwidth in health and social services ultimately affects the quality of care.
There's nothing wrong with perspective.
It's essential to making sense of the world. And after all, that railway line travels all the way to the vanishing point and it doesn't stop there. Road or railway - there's enough space reading between the lines to launch a whole film and literary genre.
I've said it before – but it really is ironic that many of the constraints in ICT have been overcome through broadband, memory costs/capacity and multi-core processors; while health services still struggle, still need to change:
From DISEASE - TREATMENT to PREVENTION - ENABLING ...
Single-track thinking is no longer sufficient, even if it is reassuring being able to see where you came from.
There’s an interesting non-trivial aside that follows from this bandwidth notion. The old conundrum of quality versus quantity.
Quality and quantity are the ties that bind, the Gordian knot. Cut this one at your peril!
Failure to focus on priorities, to take in that single, that utmost life-threatening perspective could result in disaster. Intensive care is the obvious example. Failure to attend to the physical priorities because of what seem new-age, airy-fairy ideas will quickly get you noticed.
There’s probably a paper out there on quality, quantity and appeals to holistic care. Returning to bandwidth I have wondered about how to measure this? Integrated care pathways and variance might be one approach, serious incident reports may be another revelatory approach? If it’s a care concept and moves ((uses energy) has currency) measure it!
There are a raft of measures for all sorts of things including, mood, behaviour, nursing care related, quality, risk and dependency. If you know of any that might measure holistic bandwidth, please let me know and add a comment here.
In the meantime I’ll ramble on - travelling h2cm's tracks…
Jones, P. (2004). Viewpoint: Can Informatics And Holistic Multidisciplinary Care Be Harmonised? British Journal of Healthcare Computing & Information Management, 21, 6, 17-18.
Gordian knot image c/o Bernice Steinbaum Gallery.