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Purposeful Design

27 April 2018

In this supplementary video to the "Exploring System Leadership" series, I propose Purposeful Design as a useful way of framing system change when the opportunity is not just to do work differently but also to do different work. 


Tom Lewis

01/05/2018, 09:05 pm

Great vlog Andy. This is timely for pathology services which are currently trtryi to do the same thing as they've always done, just cheaper. The hope is that by forcing collaboration and consolidation into networks we will save money through economies of scale. Now whatever one's views as to the likelihood this will happen, surely this is our opportunity to rethink our purpose. We are designed to service acute problems centred on hospitals. And yet most of our work no longer comes from hospitals, and is not acute. So the most interesting thing we should now be asking ourselves is "what would purposeful design of a pathology service look like now?"


01/05/2018, 10:05 pm

Thanks Tom - I can readily agree to all of that. Scale is such a seductive idea but I think is best treated as a consequence rather than a focus. A good sequence for redesigning/improving can be (i) learn how to be effective (no requirement for scale or efficiency) (ii) learn how to make (i) efficient (no requirement for scale) (iii) learn how to scale (ii). Keeping this sequence makes change manageable, systematic and avoids us falling into the trap of only discovering the flaws in our plans after we have spent a fortune at scale. To your point, starting with effectiveness also necessitates questions about purpose and value.

Jane mills

01/05/2018, 10:05 pm

i agree Tom. I recently attended a pathology workshop in the north in which design methodology was introduced and used to help reimagine the future service model. Alas at this time, most were more comfortable with debating “how many hubs and spokes”. And I hope that they will continue to explore a purpose based design for a service model as they develop options. I am sure we would all welcome creative thinking - it’s timely for new thinking and design to emerge.  I don’t believe the agendas of consolidation and purposeful service design are mutually excluding. 

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