News

Policy makers need to incentivise the cultural change necessary for innovation

06.01.2014 - 10:30
Niall Downey

We want to create the setting that allows individuals to take the initiative to benefit themselves and society as a whole.

We believe in people that try out new ideas, take risks, aren’t afraid of failure. People who pick themselves up and keep going till they get there. They adapt, change, learn, reform, grow and create.

People like Niall Downey. In early 2011, he set up Frameworkhealth Ltd, a start-up company based in Northern Ireland.

Using his unusual dual qualifications as both a surgeon and an airline pilot, Niall had a unique vision: bringing aviation safety techniques – some of the most stringent in the world - to healthcare, to try to reduce the number of patients being inadvertently harmed by simple human error in our health services.

Innovating for our safety

It is now broadly accepted that 10% of hospital admissions suffer harm due to human error. It is also accepted that between 3-10% of these suffer harm leading to or contributing to their death.

In a small area such as Northern Ireland, where Niall is from, this amounts to around 40 avoidable deaths per week. Extrapolate this across the EU and you have approximately half a million avoidable deaths per year!

As Captain Downey puts it, “This is equivalent to two Airbus A380 Super-Jumbos crashing every day around the EU - a mind-blowing statistic!”

We need to incentivize innovation for the groups it will benefit Captain Niall Downey

Aviation suffered from a similar malaise in the 1970s culminating in the Tenerife disaster in 1977 when almost 600 people were killed in one avoidable accident.

“This led to new thinking,” explains Niall, “and eventually led to our current model of Crew Resource Management - a strategy making optimum use of all the resources already available to us. Aviation deaths worldwide are now generally less than 1000 annually despite over 1 billion passenger movements per year. Early research applying similar techniques to healthcare conservatively suggest an improvement rate of over 40%.”

Problems, persistence and innovative solutions

Niall was in a unique position, thanks to his qualifications, to see where one industry’s best practice could be applied to the benefit of all Europeans in another, through training medical staff. So he took his idea to those who could use it most. But having an idea and having other people believe in it is not enough.

“I have had meetings with major stakeholders in the healthcare area and, despite great interest, there has been very slow uptake in commissioning courses. Like most large, long-established groups, healthcare suffers from inertia - an inability to respond quickly to new thinking or new ways of doing something, i.e. innovation!” says Niall.

So what can legislators do to ensure people with great ideas can bring them to the market to the benefit of consumers?

Legislating for the long term

“Policy makers need to find ways to incentivise the cultural change which is necessary for the long-term success of a new way of thinking. We need to incentivise innovation for the groups it will benefit,” according to Niall.

“Legislators see health as a funding black hole. Former Irish Taoiseach, Brian Cowen, memorably described health as like Angola-landmines going off without warning regularly!”

Taking a broader, long-term view is necessary, Niall feels. “We need them to see that reducing error greatly decreases demand on the health service with less bed-days wasted due to complications, more efficient use of staff etc. and huge potential for reductions in expenditure.”

Legislators could help by giving innovative ideas oxygen by getting them access to decision-makers and incentivising new ways of doing things in areas where the status quo is obviously failing

Recent figures in the UK suggest error costs approximately £2 billion per year; should this same rate apply across the EU, this would give nearly €20 billion. If the error reduction of at least 40% is realistic, savings are potentially €8 billion or more annually, plus all the social and societal benefits inherent with less disgruntled patients/families and more fulfilled staff.

These are the kind of long-term facts that need to be taken into account when legislating, according to Niall.

Training and funding at the regional level

Support establishing Niall’s company was available from a regional business development agency that is part of the UK’s Department of Enterprise, Trade and Investment.

“They helped with a business plan and basic administrative training - some follow-up courses were also available although these weren’t really of use to my company due to our quite specialized market and product,” Niall explains.

But this kind of help at the regional level can often be key to getting an innovative idea on its way to market.

Research funding could initially be directed towards covering the cost of providing training - followed up with assessment of trained versus untrained teams

In Niall’s case, “Research funding could initially be directed towards covering the cost of providing training - followed up with assessment of trained versus untrained teams.”

“Definitive proof that error management works is notoriously difficult to obtain due to the low levels of reporting so lack of accurate baselines. We need policy makers to focus on education to change the healthcare culture surrounding error. This needs a combination of carrot (incentives for units undergoing training such as increased funding/staff) and stick (compulsory training/checking as part of annual revalidation checks as in aviation).”

Niall’s message to legislators

“Healthcare appears loathe to change long-established practices despite mounting evidence of its failings. It is becoming increasingly insular in it’s thinking, rather than looking to other industries who have already solved similar problems. “

“Legislators could help by giving innovative ideas oxygen by getting them access to decision-makers and incentivising new ways of doing things in areas where the status quo is obviously failing. There is support for the antenatal care and delivery of newborn businesses - let’s not watch them wither and fail due to lack of opportunities in their infancy!”

We are part of the same team – helping each other, doing whatever it takes, to find solutions to challenges.

We believe in people. #believeinpeople

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