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HSE Transformation: How Is The Medicine Working?

by Tom O'Connor on November 30th, 2009
Prof. Brendan Drumm, CEO of the HSE

Prof. Brendan Drumm, CEO of the HSE

In launching its new Transforming Public Services (TPS) initiative, the government, no doubt, will be looking for pointers from the Health Services Executive (HSE), its largest constituent unit (with over 110,000 staff and a budget of over €14 billion), who have already embarked on a similar journey over the past 4 years.

Tangible Progress
There, the huge transformation programme, involving a somewhat stuttering start, now appears to be realising the long-sought service improvements promised, as recently articulated by its CEO, Prof. Brendan Drumm, in his November 14th interview with RTE:

– Irish ranking on the European Health Index up from 28th to 13th position
– €500M taken out of the cost base in 2 years
– Waiting times on elective procedures reduced from 2-5 years to 2-5 months
– 4000 less hospital-beds than projected now needed – saving €1.5B/year
– Day case and outpatient procedures up 25%
– Homecare packages up 70% in 3 years
– 25% drop in hospital MRSA in 2 years.

These metrics serve as positive testimony to the vision & tenacity of the HSE leadership & as a welcome relief to the inevitable frustrations they must have felt at times, with regard to how their message of progress was getting across to their stakeholders & the general public, alike.

In complimenting this HSE transformation effort, the OECD may have had a point, however, in suggesting that its rationalisation of the acute hospital network may have progressed more smoothly, if it had been able to show stakeholders an example of a community-based primary care team at work earlier (comprising GP’s, physiotherapists, occupational therapists, advanced nurse practitioners, psychologists, social workers, etc.).

Managing Impatience
In general terms, this speaks to how human impatience needs to be proactively managed as part of any change management programme and how change leaders can easily become overly consumed with analysis, planning & visioning activities to the detriment of producing some fast tangible examples of progress – grabbing the interest & support of key stakeholders early.

Kotter speaks to this phenomenon in Step 6 of his 8-Step model with his exhortation to: Plan for & Create Short-Term Wins.

A New Sense of Urgency
There is a similar thrust to an Taoiseach’s own words on 26 November, 2008, commenting on the report of The Task Force, set up to make recommendations based on the OECD findings:

‘I believe the analysis in complete; it is now time to act and we must deliver early results’

Ironically, the very real sense of urgency, deriving from the current fiscal crisis, promises him a much shorter timeline for implementation of this present TPS programme than that which was afforded to the earlier Strategic Management Initiative (SMI) – which found the budget surpluses operating during the Celtic Tiger years quite unhelpful to its agenda.

PS. For related Torc training programmes, please click on the following links:
1. Essentials of the Croke Park Agreement 
2. Managing Merger Integrations
3. Change Management For Managers
4. Managing the Human Aspects of Change
5. Managing the Process Aspects of Change

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