Care is a 4 perspective business ...

Health care as practised in whichever sector prides itself on being business-like and professional. As we are often reminded health care costs. Health care is a business and like finance a very serious one.

On the computer graphics card notice the four display ports? This card - the NVIDIA® Quadro® NVS 450 is apparently capable of driving up to four 30" displays and is designed to meet the needs of today’s most demanding business user.

I wonder if there is another application that could also utilise
four perspectives? What about the business of care?

Big pictures: Hodges’ model and Future Studies

I came across a 1996 paper by Richard Slaughter - The Knowledge Base Of Futures Studies As An Evolving Process. The paper highlighted a problem faced by future studies which was (and still may be?) grappling with its knowledge base:

Why, then, is it necessary to have a knowledge base of futures studies (KBFS)? There are several reasons. First, as Norwegian futurist Kjell Dahle pointed out at the World Futures Studies Federation conference in Barcelona in September 1991, the lack of a common knowledge base greatly complicated the work of those preparing courses, planning research, teaching and developing FS projects. The field is well known for its breadth, geographical scope and range of disciplinary paradigms. Where, in all this diversity, should newcomers, particularly intending students, begin? …

As also cited on the h2cm website Slaughter notes the significance of Wilber’s quadrants as a key resource and approach -

I have referred to this work at some length because over several years Wilber’s developing account has reframed my own thinking about present and future options, both personal and collective. Such a framework integrates insights from a wide field and provides FS with powerful new understandings and tools which go beyond one-dimensional thinking (e.g. rationality, technique, forecasting) and a single privileged culture (Western culture). Here, then, is an emerging basis for big-picture thinking and action into the new millennium and beyond. Here too is where some of the most substantial developments in the KBFS are likely to occur.
[My emphasis.]

Health and social care is not only focused on the future -

It is concerned about the PAST, NOW and FUTURE

- BUT it is always future oriented.

So future studies community look over here – now (please!)

Source: Slaughter, Richard A. (1996). The Knowledge Base Of Futures Studies As An Evolving Process, Futures, 28, 9, 799-812.

What Hodges' model is not - prescriptive

Even though models of nursing (health and social care?) are not exactly flavour of the month at present, if they were then Hodges' model could avoid getting involved in the interminable debates that often surrounds this or that model. As per a previous post therapies, models and computing languages can have much in common with legions of supporters - champions who may have a great deal invested professionally and personally.

Hodges' model is neutral in this respect: it is not prescriptive. It does not dictate the particular approach (problem-based, solution focused, person-centred, family partnership, psychosocial, developmental, educational, recovery, self-care, citizen-centred...), but obviously wherever Hodges' model is used the values expected of the professional must follow. Hodges' model provides a very high level, generic arena with potential applications across home, all clinical, social care and pastoral settings, other work places, communities, businesses, governments, high schools, colleges, prisons and for the more adventurous the space station and beyond. This may suggest that Hodges' model is in some way 'above' other models, looking down as they fight it out in their disciplinary enclosures below; but this is far from it. All the tools we use must to subjected to debate, research and critique.

So wherever you are physically and wherever the (care) situation leads you cognitively (within and between one or more care domains) Hodges' model can be utilised. This freedom, this diversity of application does not come free. Allied with our values using Hodges' model requires work and effort. We can obtain an appreciation of the task and the work involved when we consider Hodges' model in terms of user interface design and progressive disclosure - to follow.

Original image source: http://www.medicinescomplete.com/mc/bnf/current/images/diamorphine_prescription.gif

The symbol '+'

Apart from a multitude of symbolic meanings the figure below also provides the structural foundation for Hodges' model and as symbols.com notes:

The cross with arms of equal length is an extremely old ideogram used in most cultures. It is also one of the basic gestalts in Western ideography (as opposed to the basic elements, which are derived entities). The cross is found in every part of the world, in prehistoric caves and engraved on rocks.

In my interview with Brian Hodges' over 10 years ago in May 1997, Brian provided an account for how he arrived at this structure (summarised below). As mentioned elsewhere on this blog, the website, symbols.com and other sources - the cross, or 2x2 matrix is a common device to explain and structure. The four elements, the four humours (or humors) yellow bile, black bile, phlegm and blood, the seasons; there are so many things that can be characterised in this way.

With '+' as a starting point for me to reflect on Hodges' model I see each line as an individual. This agent or subject could include patient (person) and health care worker; lecturer and student and many other examples.

The act of cros-sing, the intersection of the axes represents two human beings being in a situation.

Space and time brings people together:

and also forces us apart - physically and temporally.

Adding an arrow to one end of these axes creates the dynamic of communication.

The angular distance in the alignment of those arrows offers hope -

• in our common humanity we are never in 180 degree opposition;

and yet acknowledges:

• the isolation of the individual -
  
• and the challenge.

The work that must done. Hence the primacy of communication skills and values; in order to bridge individual being, ti:me and space.

Perspective is helpful here as an extension:

While we may get close to another person, through relationships that entwine the lines - be they spun by professional obligations, friendship, family ties, or intimate sexual relationships - the two lines are always distinct: part of an elaborated knot.

Is it just the special ties that must forever seek to be one+

---

The best way to explain h2cm is to review the questions Brian Hodges originally posed.

To begin, who are the recipients of care? Well, first and foremost individuals of all ages, races and creed, but also groups of people, families, communities and populations. Then Hodges asked: what types of activities - tasks, duties, and treatments - do nurses carry out? They must always act professionally, but frequently according to strict rules and policies, their actions often dictated by specific treatments including drugs, investigations, and minor surgery. Nurses do many things by routine according to precise procedures, rather like the stereotypical matron with machine-like efficiency? If these actions are classed as mechanistic, they contrast with times when healthcare workers give of themselves to reassure, comfort, develop rapport and engage therapeutically.

This is opposite to mechanistic tasks and is described as humanistic; what the public usually think of as the caring nurse. In use this framework prompts the user to consider four major subject headings or care domains of knowledge. Namely, what knowledge is needed to care for individuals - groups and undertake humanistic - mechanistic activities? Through these questions Hodges’ derived the model axial structure.