Beyond the schoolyard: The power of kinship and collective creativity

28 Mar 2024 0 comments Topic:

We would like to thank Professor Paul Batalden for this thought-provoking blog. As we reflect on his words and our work with Bridges, the sentiments here represent a fundamental imperative to create long lasting, sustainable health systems that will enable people to live well and work differently. We are grateful for Paul’s ongoing support and interest in our Bridges journey.


Opening the prospect of a new way to work is in some ways like inviting young school children to play in a surrounding schoolyard: they may cautiously congregate close to the school building until some fence or border identifies the boundaries and full expanse of the entire playing field. Today, the pressures and expectations facing a health professional-person are legion. Some take early retirement, some take up a time-and-attention-consuming hobby, some stay—but “burned out”—in their positions. Digitally-informed professional work seems unbounded, filled with fatigue and fear. The temptation these days is to stay close to what is known and the comfort of familiar habits. In these times, how might a change-maker successfully invite change?

We might begin by acknowledging that all services are in some way coproduced. Most of the time two parties—one a professional-person and the other a patient-person—are involved. The two persons are actually “kin” to each other. As humans they have the inherent capacity for generosity, creativity, and kindness. Inviting a change among persons engaged in shared creative work might begin by exploring it with both sets of eyes. This way of moving beyond “soloist-seeing” can help us imagine interventions in shared work which might even be more sustainable.

As we move from “seeing” the possible new ways, we can begin to imagine the design and the tests of the possible changes.

Because any intervention is part of an ecosystem that includes the proposed change and its related infrastructure, we can explore the patterns involved. We can explore the routine actions and the behavioral habits of the people involved, their interactions and their use of technologies, the policies of significance, the celebrations and sources of joy and meaning, the deeper assumptions of how we deal with one another—and the new “others”…all part of the change-ecosystem. We realize that for any change to be sustainable, it must “fit.” As we test the possible new ways in our context, we can notice how the setting itself might make our efforts easier or harder.

Doing this exploration and change development requires open, honest conversation. It helps to create a safe, generative space in the midst of very busy lives. A shared language helps foster a pattern language which contributes to the architecture or “structure” for our interdependent work of noticing and changing. This collaborative work also allows us to deepen our experience of “kinshipness” as our discovery and curiosity progressively give way to new ways of being.

Roger Martin suggests the benefit of the reflective question, “What Will Need To Be True?” to make any strategy really happen. This reflective provocation might be a helpful way to help secure the sustainability of any hoped-for improvement intervention:

Roger Martin – What would have to be true?

Finally, the “news” and the words we use with each other to share our experiences in our improvement efforts matter. Amanda Ripley suggests that news that is truly fit for a 21st century person should have hope, agency and dignity. I think these attributes applied to our change reports can be helpful as together we try to make healthcare service fit for good 21st century health. Best wishes for the next decades:

Amanda Ripley – I stopped reading the news. Is the problem me – or the product?

Paul Batalden

Emeritus Professor, The Dartmouth Institute for Health Policy and Clinical Practice and The Jönköping Academy for the Improvement of Health and Welfare

March 20, 2024

For more information about codesign, person-centred healthcare and quality improvement why not listen to Paul ‘Power of Production’ podcast series.

 About Paul – Podcasts – Jönköping University (

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    As a team we share the same ethos and philosophy that drives our passion to create the best experience and environment for patients to live well. Bridges provide opportunities for both patients and professionals to work collaboratively to enhance self-management skills, knowledge and confidence.
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