Know that feeling of being with kindred spirits? That's how I felt yesterday.

We were in Saint Paul’s and St George's Episcopal church in Edinburgh. A magnificent venue for the first of a series of 'U Lab Scotland' preparatory events. Over 200 people attended. Some had to take seats in the balcony. Such was the interest in this event. 

U Lab is based on Theory U, an approach to change that aims to unleash the collective energy and intelligence in a group. The process encourages participants to view complex issues through a different lens and observe deeply.  After a period of deep reflection solutions emerge through a process of 'prototyping' and testing. Otto Scharmer and colleagues from MIT have been developing the approach over many years with a growing excitement worldwide.  

Change as an Emergent Property

I've had an interest in change as an 'emergent property' for a number of years. I took an 'intensive' programme similarly called 'Change Lab' run by Adam Kahane in Utrecht a few years back. The programme, based on action enquiry, followed the U process and it was truly inspiring. I still draw on the learning in my current work in helping people and organisations navigate change.

Hearing the principles of U Lab being introduced by Scottish Government officials created a frisson of excitement inside me, and I suspect in many others. It was a defining moment. And perhaps another indication of the groundswell in Scotland of people searching for something different.

Over eight years on and he still speaks about it. How he sat with his wife as she took her last breaths. Their two sons had joined them at the hospital after the urgent phone calls. Two daughters lived too far away. They wouldn't have got there in time.

He reflects on how, when both sons arrived at the hospital, he said in a hushed tone to his wife "that's them both here now, pet". She had been drifting in a semi-coma, unresponsive, for some hours but he describes how she squeezed his hand seconds before slipping away. He's convinced it was her way of saying good bye.

Who could argue with him? Who would want to? It was the final instalment in the story of their lives. The most poignant moment in fifty-five years of marriage.

 Managing quality in healthcare seems like a rather sedate affair in the academic literature. In my experience it’s more like trying to control a herd of wild horses!  

I know….sounds a bit dramatic.

But this is how I see it when I reflect back on my service management days. It’s important to keep control of all the key elements of quality to achieve genuine service improvement. The challenge for all leaders in healthcare is to maintain a steady hand.

The wild horses I’m referring to are the Six Dimensions of Quality —

timely,

safety,

person centred,

efficiency,

effectiveness

equity