Hodges' model? Simple: it's a rich, complicated, complex picture

In wider reading (relations, maths... and) drafting a post concerned with 'universal construction' I came across:

Rasanathan, K., Montesinos, E. V., Matheson, D., Etienne, C., & Evans, T. (2011). Primary health care and the social determinants of health: essential and complementary approaches for reducing inequities in health. Journal of Epidemiology and Community Health (1979-), 65(8), 656–660. http://www.jstor.org/stable/23050931

Figure 2 stood out for rather obvious reasons:

individual

|

INTERPERSONAL : SCIENCES

humanistic ------------------------------- mechanistic

SOCIOLOGY : POLITICAL

|

group

Figure 2 'works' and not merely because it is clearly 'all political', but I would have swapped 'leadership reforms' with 'service delivery forms'. Trying to emphasize leadership at the individual level empowered to actually effect change. This could quickly change as per the situation. I also appreciate the jigsaw graphic.

You soon appreciate the complex nature of health care:

Primary, Secondary, Tertiary, Quaternary care and prevention. Add social care, welfare, all the fields of medicine, surgery, nursing, education, policy, information, literacies, human rights, consent, mental capacity, mental health law, forensic psychiatry, self-care, local, national and global health, urban, rural, remote, virtual environments, ethics, developed and developing nations, ecosystems and funding.

And this just scratches the surface ...

Hodges' model: the puzzle of holistic care

Like many day-to-day 'customer' facing businesses, it is very difficult to get health and social care just right ('just' is not good enough).


If you are faffing about with clothes and belongings when an emergency ensues you have just become an adornment yourself: one that is in the way. In the SCIENCES domain fail to assess mobility and balance and who is going to catch them when they fall? Not you: health and safety! It's a problem for the mental health team is it? Could this confused gentleman be constipated? Nice place is it? OK, crease your eyes up and tell me where the door is; what about the hand-rail?

Are you ready to crowd surf?

That's good because there is an abundance of outstretched hands ready in the SOCIOLOGICAL domain. If, however, you do not attend to the patient's instructions regards information sharing - even if it was a relative you spoke to - just where are you going to hide?

(Ouch - that's gotta hurt! Sounds like they dropped you.)

Fail to assess mood and motivation comprehensively in the INTERPERSONAL domain and will you be able to say how Mrs Green really feels, behind that Mona Lisa smile? Will you know how to observe her, will you and your colleagues know just what you are looking for?

Did you miss that opportunity with the patient, carer - family in the POLITICAL domain to resolve the (ongoing Sunday afternoon) issue? You know the one about mum's medication, agitation, the appropriateness of the care environment and the outstanding referral to the community mental health team? Well yes, you might wonder what that buzz is. It's a complaint just passing you by(e).

Basic, holistic, integrated, person-centered care and much more. Now that's the real puzzle.
A puzzle worth spending a whole career trying to find the pieces - never mind the solution ....

Think Tank Invitation: Environment, Citizenry, Ecosystem & Health [1]

Dear Welcome to the Quad blog visitor,

Thank you for your ongoing interest and accepting this think-tank invitation.

In the session you and your fellow delegates are asked to debate and order the following:

• citizenry
• ecosystem
• environment
• health promotion

Various bodies from national governments, lobby groups, media and UN constantly stress the need to address each of these factors. They are, however, often considered in isolation from each other at a time when integration is vital.

Your task then is to solve this four-piece jig-saw puzzle. Success, however, is not only measured by a completed puzzle. You must collectively debate and agree on how to cut the jig. Which - if any - factor should have priority? Where exactly do citizens figure in this picture?

Obviously a four-piece puzzle is child's play. The adult (citizen!) challenge comes from your decision: Is this puzzle arranged 2 x 2 or 1 x 4? More to follow... RSVP indeed...