- 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

Sunday, February 24, 2008

Holistic Bandwidth [I] - Where's the brush?

Apart from those intervals and instances (times!) when emergency intervention is needed, holistic care is seen as a primary goal in health and social care theory, practice and policy.

IF care is not holistic THEN it could be argued that there is care dissonance.

The high quality non-critical, general efforts in the PHYSICAL [SCIENCES] care domain -

fluids, diet, warmth, pressure sore care, comfort, security, infection control ....

can be compromised by lack of attention to the EMOTIONAL [Intra-INTERPERSONAL] care domain -

respect, empathy, unconditional +ve regard, non-judgemental attitude, time, space, attention ....

- what the patient (carers and others*) expect to follow does not occur.

Artist's paletteRather like cognitive dissonance acute discomfort results when care of the required high quality (holistic, timely, person-centred...) is not applied across the board (h2cm).

(In being human) everyone recognises the BASICs of CARE (discuss?):

It is the remembering that is the problem.

Remembering demands an assured space in the organisational memory - such that staff in those other spaces - wards, clinics, patient's homes, residential homes are able to fulfil the holistic spectrum of care needs.

Dissonance encourages game playing with beliefs [1-n players].

It is very easy and a fairly well understood human trait for us to become pre-occupied with what we do. (As you will have noticed I have a problem with brackets and italics...) When at work (i.e. not day-dreaming) "It is what we do that counts."; but care variances bound to professional disciplines and particular clinical settings should not be wielded as a foil.

So, perhaps this dissonance can be represented as distance:
  • patients and carers may not articulate their discomfort - at the time
(and hence is perceived of less consequence to the service - at the time);
  • as the distance between concepts and their meanings.
Could this distance provide a measure of holistic bandwidth? No doubt, it already has somewhere in the literature? The first holistic bandwidth metric suggested above is acknowledged in policies around the response to complaints, which stress the need to deal with the complaint there and then if possible. Is this enough and what about the distances between concepts and meanings?

more to follow....

I Googled 'organisational dementia' and found the following reference:
‘Sustaining New Industrial Relations in the Public Sector: The politics of trust and co-operation in the context of organisational dementia and disarticulation’ (with M. Martinez Lucio), in P. Dibben, P. James, I. Roper, and G. Wood (eds.) Modernising Work in Public Services London: Macmillan. 2007.

*There is probably a major cost on staff morale here also.