Can you change anaemia management

1

• Can you change anaemia management
• in your transplant patients?

2
Measure it!

• How many patients are anaemic?
• What is range, mean, median Hb?
• Compare with national/local recommendations or
  local/national results
• Present your results

3
Centre protocol

• If no written protocol/standard write one with
  a nephrologist and get agreement.
  National/European guidelines are useful starting
  points
• If protocol exists, who monitors deviation from
  target?

4
Success usually depends on

• Spending time to understand the cues and clues
• Accurate summary of issues raised, and control of
  direction of discussion
• In-depth agreement to ensure an action is on a
  solid basis
• Attention to the political processes of the
  organisation and the involvement of relevant
  people
• Delivery of any promises on time to the required
  standard
• The management of the project by establishing a
  structure or forum to highlight/resolve issues

5
Reasons for failure

• Not involving influential people early - the make
  or break people
• Proposing solutions before problems are diagnosed
  
• Presenting reports full of content without an
  equal regard for the process of discussion
• Moving too quickly, causing surprises and
  creating defensive behaviour amongst others
• Not recognising the effect of change in one part
  of the system on another part of the system
• Margerison CJ (1988) Managerial Consulting
  Skills - a practical guide Gower