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Kia āta kōwhiri Choosing Wisely

The Choosing Wisely campaign seeks to reduce harm from unnecessary and low-value tests and treatment.

The six Whakakotahi 2018 teams met in Wellington on 16 October 2018 for their second learning session. Each team had the opportunity to present their work to date to share learnings, and to take part in workshops throughout the day.

After a round of introductions, Dr Greg Hamilton from planning and funding at Canterbury and West Coast district health boards presented their integration journey. He discussed the challenges the team was facing in the early 2000s through to now and how they overcame those challenges using integrated health and social services. The data showed how they were able to reduce hospital admissions by improving utilisation of people-centred community care.

After each team shared their storyboard, all attendees took part in a workshop run by Jane Cullen, quality improvement advisor for the Whakakotahi programme, on the human side of change. Groups were encouraged to think about change differently, as a complex issue and that people aren’t necessarily resistant to change if they can see the benefit in it. Jane presented the ‘switch’ theory of change which uses a rider on an elephant on a path as the metaphor for change – the rational rider, the emotional elephant and a clear path. For effective change you need to direct the rider, motivate the elephant and shape the path. You can view a summary of this theory in this extract (186KB, PDF) from Jane’s presentation.

Jane then introduced the groups to the TRIZ theory of inventive problem solving. TRIZ asks how an improvement project can be reliably ensured to fail, then participants are asked to identify tasks that would contribute to failure, and then how to stop them to prevent failure.

Finally, Jane ran through a 15 percent solution workshop. It is said that workers have control over 15 percent of what they do, with management, structures, systems and processes controlling the other 85 percent. Jane challenged the groups to think about what 15 percent was in their control, and what actions they could take within that to progress their projects.

A selection of the teams’ presentations are below.

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Last updated: 6th December, 2021