EP 112: Designing Careful and Kind Care | Dominique Allwood
How can revolt against industrialized healthcare? Can we design careful and kind care?
Dr. Dominique Allwood is a healthcare leader with almost 20 years of experience working as a medical doctor and public health physician in healthcare in the UK. She enjoys variety and juggling multiple roles and is currently Chief Medical Officer of UCLPartners, a health innovation partnership across a population of 5.2 million people, and Director of Population Health at Imperial College Healthcare NHS Trust, at a large teaching hospital in London. She is interested in a range of areas including improving equity, population health, anchor institutions, accelerating net zero in healthcare, clinical engagement, and quality improvement. She has worked extensively across healthcare in delivery, leadership, management and advisory roles for provider and commissioner organisations, academic institutions, national policy bodies, management consultancy, charities and think tanks. She holds an MPH, has previously undertaken a Darzi Fellowship in Clinical Leadership, and is an Associate Editor for BMJ Leader Journal. She is a Governor of University College Hospital and a Board member of The
Patient Revolution in the US. She was previously named a Rising Star in the Health Services Journal and shortlisted for a prestigious national mentoring award. She is currently completing an MBA at Henley Business School.
Episode mentions and links:
Careful, kind care is our compass out of the pandemic fog
Restaurant Dominique would take you to: Lefteris O Politis
Bonus: This is Athens: A beginners guide to souvlaki
Follow Dominique: LinkedIn | Twitter
Episode Reflection
This week’s episode with Dr. Allwood was like therapy for me. For those of us who obsess over the design of care and the pursuit of more human-centered systems, it often feels like a Sisyphean task. So when you have the opportunity to hear from someone who just gets it, who had lived the struggle and is pushing that same boulder, it makes the task feel just a little bit lighter. Dominique had a lot of awesome takes on how we can begin to better understand our broken systems and what we can do to change them. So, if you haven’t yet, go listen to that episode right now! For my reflection, I wanted to turn to the mentioned article which was co-written by Dominique and one of our previous guests and favorite people, Victor Montori. Of course, we have to start by talking about the soul-shattering quote from the article that Bon quoted in the episode.
“Relentlessly pursued, however, industrialised healthcare turns patients into widgets and clinicians into production line workers, the work of caring reduced to processing people through the system. Industrial healthcare has exhausted care givers and patients, and morally injured, burned out, and spent clinicians, making it humanly unsustainable.”
I mean, honestly, there is not much to say about this other than it’s probably the best and most succinct description of what is wrong with healthcare today. The challenge we all face is what to do about it. Do we rebel as caregivers? As patients do we demand change? Haven’t we already tried those things and gotten nowhere? I think we need more of what The Patient Revolution is doing. We need full-on revolt, from all parties, on all sides.
On to the next painfully resonant quote.
“Covid-19 and its pandemic fog arrived as industrialised healthcare was reaching its apogee. A “new normal” was heralded beyond the covid-19 pandemic, but no threshold or dawn has become apparent in the transition from the pandemic to the post-pandemic world. Instead of a before and an after, a thick fog now envelops and disorients patients and healthcare professionals.”
I mean, damn, the fog. We’ve all heard of covid fog, that foggy, tired feeling that many have and continue to experience after getting covid-19. But the idea that fog now envelopes the whole system and everyone in it is EXACTLY how it feels. Something has happened to our clarity of vision. The crystal clear mission drive that led us to become caregivers in the first place almost feels like a dream today. It’s like we were kids and suddenly uncle covid came over for the holidays and told us that there was no such thing as magic and it was our parents leaving money under our pillow all along. Or maybe it’s better to liken it to the fog of war, we’ve come home, but we’ll never be the same. On the bright side, burnout and wellness are being taken seriously, maybe for the first time ever, in healthcare. As previous podcast guest Rick Griffith said, we must be optimistic because we have to do this, we have to move forward, and we are creating the system right now that will either perpetuate or solve these ills.
Now for something a little more positive.
What are the antidotes to industrialized healthcare? Dominque also discussed the following manifestations in this week’s episode. They are, “hurry”, “blur”, “burden”, and “cruelty.” Dominique described the antidote to “blur” being, “seeing patients in high-definition” and the “shift away from saying what’s the matter with you to what matters to you.” I would imagine the antidote to “hurry” is to slow down. It’s artisan and personal. This brings me back to Episode 106 with Joanne Cheung where we discussed the problems with the term “care delivery,” likening it to getting a quick bite delivered to you versus sitting down for a slow, handcrafted meal with family. What would you call the antidote to burden? Maybe ease, calmness, or relief? Despite all the technology at our fingertips, getting and providing care continues to be a burdensome task. More tech, more problems. And then there is kindness, the antidote for cruelty. Can we really rely on the kindness of individuals to put “care” in healthcare? NO! Not when we are working within systems that perpetuate cruelty. We need a kinder system all around!
That’s all I got for now. I hope you enjoyed this week’s “therapy session” as much as I did. Thanks, Dr. Allwood, for leading the way to re-humanize health.
Written by Rob Pugliese
Excerpts from: Montori V M, Allwood D. Careful, kind care is our compass out of the pandemic fog BMJ 2022; 379 :e073444 doi:10.1136/bmj-2022-073444
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Bon Ku: How can we revolt against industrialized healthcare? Can we design careful and kind care? I'm Bon Ku, the host of Design Lab, a podcast that explores the intersection of design and health.
Today's guest is Dr. Dominique Allwood. She is a healthcare leader with almost 20 years of experience working as a medical doctor and public health physician in the UK. She is currently the Chief Medical Officer of UCLPartners, which is a health innovation partnership across a population of 5.2 million people. And the Director of Population Health at Imperial College Healthcare NHS Trust at a large teaching hospital in London.
She is interested in a range of areas that include improving equity, population health, anchor institutions, accelerating net zero in healthcare, clinical engagement and quality improvement. Dominique has worked extensively across healthcare and delivery, leadership management and advisory roles for provider and commissioner organizations, academic institutions, national policy bodies, management, consultancy, charities, and think takes.
Dominique has a master's in public health and has previously undertaken a Darcy Fellowship in clinical leadership and is an associate editor for BMJ Leader Journal. She is a governor of University College Hospital, and a board member of The Patient Revolution. In her spare time and Dominique is currently completing an MBA at Henley Business School.
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That's how you support us. Now my conversation with Dominique Allwood.
Interview
Bon Ku: Dr. Dominique Alwood, welcome to Design Lab. I've really been looking forward to our conversation.
Dominique Allwood: Thanks Bon it's so good to be with you. So thank you for the invite. I'm looking forward to chatting with you.
Bon Ku: Let's start off with your current role of the type of work you're doing and how you got there. You had mentioned that, way back in the day, you had actually studied graphic design and you wanted to pursue that as a career, but you ended up being a, becoming a physician.
Dominique Allwood: I did. So my current roles are a mixture of things. I'm somebody that likes variety, so I'm, I'm juggling two jobs. One is as Chief Medical Officer of UCL Partners, which is a health innovation partnership based in the UK. We cover, you know, about 10% of England's population and we span innovation and research trying to tackle big health challenges.
So that's a, that's a cool role. I'll talk more about that a bit later. And I'm also Director of Population Health for a large hospital, Imperial College Healthcare Trust in London. Sits in the borough of where, you know, houses of Parliament and Big Ben. So it's an exciting place. But I guess those two roles are really interesting and complimentary in many ways around healthcare around tackling some of the big population health and equity challenges.
But, the way that I got into those was pretty circuitous. So my background is as a physician and, public health physician, but I didn't always want to do medicine. When I was younger, I was actually really interested in design and art and graphics. So I did most of my work experience at high school in design studios and it was only when I was coming up to studying from kind of exams and thinking about what to do next at university that a teacher spotted in me some like interest also in science as well as art. And she said, oh, you know, you in medicine, you can combine some of these things that you like. And I started thinking about actually oh, wouldn't that be quite exciting to become a doctor? And I, you know, I'm really interested in people and what makes uh, us healthy. And so I, I applied for medicine. So I, I nearly became a designer, but I went down a completely different path. And then actually during my clinical training, really enjoyed the emergency room.
It was very exciting and responsive. So, I maybe had like some alter life of yours Bon where you're combining like design and ed. But at some point I, I found some of the clinical work very difficult. We were often providing care where we were just patching our patients up and sending them back to the conditions that they had come from and the problems that had caused while they were there.
And I also, started getting more interested in quality improvement. So I moved out of clinical medicine and actually into public health to look at the bigger picture of healthcare and also combine that with quality improvements.
Bon Ku: Yeah. You are our perfect guest. This blended background of design and medicine even though it was a while ago, that you studied design, do you feel that impacts the type of physician that you are now or the type of work that you do?
Dominique Allwood: I really think so, because I guess partly when you're going through kind of undergraduate, medical training, it's all very scientific, and you're learning all about sort of molecules and anatomy, but as you move through training and then into practice, you realize that it's a. you know, it's a service that you are working in with people who are your colleagues.
And this is about care. It's about helping people. It's about understanding humans. It's about empathy. And the first things I learned when you were thinking about design was start with empathy, start with problems, start with people, and understand from the user perspective. And I think in healthcare we get really caught up with starting from the perspective of often the health service itself or the organization or the, the policy perspective.
And actually this is about the interface between those who are coming to seek care and those who are coming to give it and understanding the problems from their perspective. So I think my design background, was in the back of my mind trying to break free and managed to find some outlets at some point during my career.
Bon Ku: I love that you had written an article, in the BMJ with a previous guest, Victor Monto ri It's titled, "Careful kind care is our compass out of the pandemic fog." I love that article. I read it voraciously and I said, oh, I gotta have Dr. Allwood on, on the podcast. And can I read a one line from the article?
Dominique Allwood: please do. Oh gosh, I'm, I'd be grateful to hear you quote me.
Bon Ku: Yeah, you said, "relentlessly pursued, however, industrialized healthcare turns patients into widgets and clinicians into production line workers. The work of caring reduced to processing people through the system. Industrial healthcare has exhausted caregivers and patients and morally injured, burned out, and spent clinicians making it humanly unsustainable."
Wow, that resonated with me. What was the inspiration for writing this article?
Dominique Allwood: There were a number of things actually, I guess, I've been really looking around colleagues and during covid thinking about how healthcare really has changed over time. And, and during Covid really we wanted to react fast and learn quickly, and we were able to draw on lots of different things to, deliver healthcare in quite extreme circumstances.
And it made me think about the fact that, when we're under pressure, what are the things that really matter when we've got, you know, finite resources, what are the things that we really value? And that comes down to care. Care is the thing that sits at the heart of all of that. And as I was starting to explore that more, I came across the work of Victor Montori and Maggie Breslin, with the Patient Revolution, and joined up as a fellow, and now sit on the board of the patient revolution.
And Victor and I were talking about, What was it during Covid that really brought a lot of these things to our head? And how does Covid give us an opportunity to come out of the pandemic and think differently about what we want our future to look like within healthcare? And we were reflecting on what does this mean to have.
Industrialized healthcare where we started to really just see patients as this blur and process them through a sort of conveyor belt. And there's a large number of things that contribute to that, including this, you know, depletion of resources and pressure on health services. But one of the things that I also was thinking about was quality improvement actually, and I, I have a real tension around this because I've been someone who's studied the discipline of improvement science and drunk the Kool-Aid, and I really believe in the method and the approaches. But I guess overdone along with the other factors that cause these issues in healthcare, we can be at risk of turning healthcare into quite an industrialized delivery mechanism. And so Victor and I decided we wanted to write something that set out what some of these issues are and how do you then create the conditions for careful and kind care.
And that's really what the piece is about. So thank you for highlighting it.
Bon Ku: I feel like one of those production line workers working in this huge industrial complex, and I think many of my patients feel like they're just widgets. And dehumanize during the process. You talk about antidotes to industrialize healthcare. Can you give us a sense of is there an antidote to this?
What does that look like? Are there some
Dominique Allwood: examples?
Oh. It's a good question. So in, in the piece we talk about we've characterized four pathologies of industrialized healthcare and they're about hurry. This kind of rush through it, seeing patients not having enough time. It's also about blur where patients are just passing through in front of you and they just look the same and, you don't see them with any kind of real sense of detail.
We talk about the burden of healthcare both on patients and our expectations on those caregivers, and we also talk about cruelty. And so what we are saying is in this piece and in some of our wider thinking and work, that, we think the antidotes to industrialized healthcare and those pathologies is careful and kind care and the things that we're thinking about in there.
So I'll, I'll pick an example. One of them is around blur. So what might we do if we start to turn blur into something different? The antidote to blur for us is seeing patients in high definition. So actually they kind of come into sharp focus and it's about not only seeing the person that comes to present to you in your clinical encounter, but actually seeing their life around them and seeing their biography as well as their biology. So wouldn't it be amazing if the electronic health record started with the patient's story rather than like their smoking status and their biomedical parameters? And so, this starts to speak then to other things that are kind of happening in healthcare. This kind of shift away from saying what's the matter with you to what matters to you?
And I think we've come full circle almost back into kind of where we got into, around design thinking about these human-centered approaches, having empathy and understanding from people's perspectives, the issues they're facing. So I think that's just one example of what's an antidote to this industrialized healthcare.
But there are lots more that we are thinking about in that piece, but also through the work of the patient revolution.
Bon Ku: I love this concept of the biography, so my medical record would not just read, old emergency room doctor presenting with abdominal pain. But you know, someone who is a father, someone who is a husband, passionate about surfing, presenting with abdominal pain, and who probably eats too much meat on Friday nights.
Dominique Allwood: And you see that really changes your outlook about like what this person might have been doing before they got sick, where they wanna get back to and that starts so I think give you not just a sense through how we might interact with our patients, but also our colleagues. You know? I think that healthcare and delivery is a shared endeavor and it's collaborative and we want to be bringing our whole selves to work.
So this, seeing everyone in the kind of their whole self is really an important part of what I'm trying to do in my work.
Bon Ku: Yeah. I love that cuz I have such a limited time with patients working in an emergency room, but I always try to ask them some personal question. Whether it's like the type of work they did before in the past and it brings out a lot of humanity. I was just taking care of patient who I was about 80 years old from Philadelphia.
And she had this rich history. She used to live in New York City and work in like the prison system there and had this like crazy life and ended up getting breast cancer, had to move back to Philadelphia, close to family. And she was very like, articulate. And even that's, It took like 90 seconds, but to get that little bit of biography helped me remember her.
And it wasn't just this 80 year old female patient who coming with abdominal pain that we ended up getting a CAT scan on that there was this flavor, it's like locked into my memory more, you know, she's more of a human.
Dominique Allwood: Yeah, and I think it's a real tension, isn't it, in medicine because. In some ways we're almost taught that we need to try and detach ourselves from people so that we can do things that, might seem very difficult around procedures or, you know, bad news, et cetera, so that you're not carrying all these things all the time.
But there is a, a risk to that, which is it dehumanizes the people in front of you. And I guess if you think about the word, kind care. And the stem of that is about kin and kindness. It's kinship. It's about treating someone like your family member. And I think a lot of the things that we see in healthcare where people have had bad experiences is because we haven't related to them as if this would be the care that I'd want from my friend or family.
And so, yeah, it's it's a challenge I think, and, and it's a really tricky area, but it's so important and so feels so crucial to the way in which we want care to be in the future.
Bon Ku: I'm going to be a devil's advocate here and go, Hey, healthcare is, you know, at a breaking point. Like, can we really be kind in healthcare? Is there really room for that?
Dominique Allwood: Well, I mean, it's a great question. I am in the Debates about this kind of stuff with a lot of people, but I think many of the people I'm speaking to, and the starting point for many of us is why take that stance? Can we afford to not be? And if we think about all of the issues that stem from behavior, communication and a lot of the problems that we see in healthcare relate to the fact that we, haven't had the starting point of being kind, being respectful, being civil. And when we talk about kind care, that's also not just about kindness as a kind of behavioral practice that's also thinking about paying best attention to the patient's time and the caregiver's interaction with that. So I think flipping the question on its head and saying, can we afford not to be, how sustainable will healthcare be if all of the staff that wanted to come and work in healthcare and had a common mission and purpose to care are not able to do that now people are leaving healthcare in the thousands.
You know, we, we are seeing so many shortages of healthcare workers
Bon Ku: So many. it's the worst I have ever seen of so many good people leaving healthcare. How do you create the conditions for kindness to thrive? Can you incentivize people to be kind?
Dominique Allwood: That's also a great question, isn't it? Well, I mean, there's lots of areas that I'm starting to explore about, resilience, wellbeing in the workplace, what it means to feel mission and purpose and connected to the work that you do. So how often do we talk to our colleagues about that?
And I think feels really important that we have these conversations. And I guess for me, one of those ways in is to start to understand from other people's perspective and put yourself in their shoes. And I think that's why. I've been very drawn to in the past, things like experience-based co-design or human-centered design because you're starting with problems and issues and insights from that person's perspective and starting to think how can we try and work with and solve them?
And guess we all, we constantly need to be evolving as we go through our lives with the jobs that we do and the healthcare that we want to deliver. And I think it's really important that we, we do constantly question like, how do we create these conditions? What makes this be the thing that we want to focus on?
But I, I guess for me it's often about having space to be collaborative with your colleagues. Taking that mindset of showing up as a whole person to work. Having the opportunity to really think about mission and purpose. That's really hard when it's, you know, busy and people are time pressured. But it's a bit like some of the public health challenges and prevention, those things seem important, but they're not always in the urgent box. The urgent boxes, be reactive. Fix the things in front of you, move to the next thing. Rush, rush, rush, and hurry. And we know that if we don't make time for the important things like creating the conditions, like thinking about how we might go upstream and work in prevention to help people be healthier, then we will constantly be in this kind of hamster wheel and. mean, I'm not a huge fan of quotes, but one that does definitely stick with me is, I think it's Einstein who says, 'Insanity is doing the same things over again and expecting to do, get something different out of it.' And I think we have to break some of these patterns and cycles. So it takes courage, it takes, you know collaboration.
It takes a different mindsets and it takes being creative. And so I think those things are really important.
Bon Ku: Yeah. We, we have to design for kindness in thinking about the future of how healthcare services are delivered and it, we're not putting that first and foremost cuz we're so reactionary cuz there are real fires that we need to put out on the daily basis but I think it'd be helpful for us to be forward facing.
And so I love the work that you are doing and the article that you put out, uh, we'll put a link to that in the show notes. The readers can listen. It's open source, it's great. It's under our paywall so everyone can read it. You wrote another really nice article on the role that hospitals can play in society as being anchor institutions. Can you speak about that?
Dominique Allwood: Yeah, sure. So I guess a lot of the things that I'm interested in stem from this notion of care. So care or, and about our patients with each other as our staff. Communities through this concept of being anchor institutions and then caring about our planets. Or, I can come back a bit more and talk about the, the sustainability angle, but it's woven into anchor.
So anchor institutions are organizations that are typically not for profit, but not always. They're often some of the biggest organizations in a local area, like a hospital, like a university, they often have a social mission and they are kind of rooted in the fabric of those places.
And by their very virtue, they influence health through the, the impact on social determinants or the wider determinants of health. So they often are the biggest employer. So they are offering jobs to local people. They're often the biggest spender of resources and investors, they often use some of the biggest sets of natural and physical resources and assets.
So , they're able to influence health through the way in which they go about the practice of the work. And so a lot of the work I've been interested in more recently is how can healthcare organizations and healthcare systems influence health, not just through the direct delivery of the care they provide, but the way in which they work.
And so, you know, in other sectors, they've been at this for a long time. It's often called environmental social governance, E S G, or corporate social responsibility. But I don't think in healthcare, we've really realized and made the most in the past of being intentional about the assets we have and the way in which we operate and behave.
With our communities. And then this is the really important piece because you could create a whole load of schemes around local employment, or we're gonna spend 10% more with local businesses. But really this is about trying to change the relationships with communities and shift with power so it's not just these big hospitals doing out to the patients, but it's also about some of the people who haven't yet come through the walls of the hospital. And the hospital that I work at is you know, deemed one of the safest in England, we have all these metrics to show our hospital mortality rates are very low. But when you look out of the walls of the hospital around and our local communities, you see huge disparities in health.
And these inequities seem really unfair and unjust. And actually we have a big role to play as healthcare institutions in tackling that. So that's the piece starts to touch on that and then bring this lens of equity in because in the UK many people have now started to get on what I call the anchors bandwagon, which is, oh, I've got the scheme and this project and this thing I'm doing.
But actually they're not necessarily being intentional about why they're doing that. It's about equity, it's about justice, it's about communities, it's about power shifting, it's about care. So that was what the piece was about. So thank you for flagging that. I hope readers might find that interesting
Bon Ku: Yeah. Yeah. And we'll, we'll put that link to the show notes as well. And then you talked about like planetary health. What's the linkage there?
Dominique Allwood: So, well, I that the common thread of care runs through all of this. So I think spending time trying to improve healthcare in some ways is going to be futile if we start to have healthy patients. But a sick planet, you know, the biggest health challenge we are facing at the moment is climate change.
And I'm really starting to work more significantly now in helping to support and accelerate our healthcare organizations to achieve their net zero targets and ambitions. So through my work in , and we're taking a sort of innovation pipeline approach, so trying to understand the insights and the problems from the perspective of healthcare organizations and patients and how we start to tackle challenges of green, how we look to other industries.
So for example, you know, airports, they're also big houses of people and people move around a lot and they need to be energy efficient. And so how can we learn from other industries, other places, and bring some of that learning in. How do we learn quickly and test and prototype solutions. So using design thinking to do that and drawing on, you know, academic expertise, evaluation design, innovation, and then how do we use implementation methods to really implement well? Implement at scale and evaluate impact. So yeah, I'm starting now to transcend this sort of I guess interest in population health and move it into some of these bigger picture mission-based challenges.
Bon Ku: Well, Europe does such a better job than we do here in the US on planetary health and policy initiatives. We had a recent guest on, Chethan, who thinks a lot about this, and he quoted something like, the US healthcare industry is responsible for like 10% of greenhouse gases. And is that the same for Europe as well?
Is it, is it such a major factor and. this seems like it's not even on most people's radar.
Dominique Allwood: Yeah, it, very much the same for us. I think there's a statistic that's like something like one in five vehicles on the road at any one time in the UK is related to the healthcare industry, either transporting some kind of goods or someone traveling to an appointment or a staff member traveling into work.
I mean, the, NHS has 1.6 million employees. You can imagine the amount of movement and activity that creates in terms of emissions, et cetera. So it's a really significant problem. In some ways, we're lucky because as the NHS we can take a sort of collective effort to do this work, you know, in some ways it's, it's a really big challenge.
We've really got to up our game in what we do and think about all of the different ways in which we touch environmental sustainability through our direct use of resources and also the whole of the supply chain and what we call these Scope Three Emissions and all of our suppliers that we work with.
So it's a, it's a massive area. There are many people in healthcare starting to get really interested in this and, and we are looking through like the lenses of behavior change around individual behaviors and organizational behaviors, but it. It's an area where we do need to engage people more, and there's this interesting dichotomy where you might be someone at home who has chosen to eat less meat, recycle more, get an electric car, think more sustainability about the clothes that you buy.
But yet at work, you're just gonna chuck your sandwich wrapper in any old garbage bin and not use the recycling one because it's too far down the corridor. So we've gotta tap into like, why do people behave differently in certain settings and what, can we do? Everyone has a role to play from even small things like, you know, powering down the PC through to how they might change their whole clinical pathways.
So there's loads of opportunity to do some really interesting things in healthcare, but we have to do them quickly.
Bon Ku: Yeah, I love that. And I wanted to know if you could comment on your own personal journey in terms of your mix ethnicity and how that impacts the work that you're doing.
Dominique Allwood: Sure. Yeah. I mean, maybe what I've conveyed or have tried to is that I'm really interested in, sort of layering of different ideas and concepts, approaches, disciplines, viewpoints and I guess that probably comes in part from some of my background and, and I am of mixed ethnic heritage.
I'm half Indian. My mom was born in East Africa. I'm Park Greek, little bit Italian. Part English. My dad was born in Scotland and had some of his childhood in South Africa, and, and they both met in London and I was born in Switzerland. And so I've, you know, I've got this quite mixed heritage. I grew up in a, a very unethically diverse area in England.
It was pretty white and for a long time, wasn't quite sure how I sort of fitted in with the, background that I had and in many ways tried to almost like, ignore that and uh, wasn't sure how to kind of embrace it. , teenagers can be really awkward about these things as well. And so it wasn't until I went to university and found Real comfort in meeting so many diverse people.
And it wasn't just about ethnicity, it was diversity of all kinds, and that felt really like an amazing eye-opening experience. So I've become really passionate about thinking about diversity and inclusion and how we enable people to bring their whole selves to work and, and what we do to call out some of the stuff where it's not okay and how we're treating people and the way in which organizations and individuals do that.
And so I've spent quite a bit of time in my more recent years trying to work in these areas and also mentor others. So choosing particular people to give my mentoring attention to, and yeah, it's, it's really become an important area for me. And if you think about for example, looking at the leadership of many healthcare organizations, I think it's really important that they look like and reflect the people that they're there to serve.
But often we've got these institutions who have very ethnically undiverse characteristics and, and diversity, lacking diversity in many ways, you know, gender, et cetera. And so I'm really keen about how we think about leadership and the importance of that and the signals that gives all of our staff, our patients, and our communities.
So I've been starting to do more work in that space.
Bon Ku: How would you describe that the role of creativity plays in your work?
Dominique Allwood: So I think. there probably isn't an hour that goes by in my day-to-day work that I'm not now drawing on what I've learned to be this important area of creativity. I think one of the ways that I got into that was through facilitation. And I, I really learned the importance of facilitation because in healthcare, much of our work is done through interacting with people that's either one-on-one clinical interactions of which you need to be to facilitate time well. You have a small window in which to speak to people and get information and convey information. Or that's a group of colleagues in a team coming together for a huddle or a handover or you know, a procedure or whether that's in a management role in healthcare, where you're coming together in a meeting, or whether you are facilitating some kind of workshop or ways in which to progress projects.
I think facilitation is a totally amazing but often underrated skillset. And so I started learning more about it and within that I've started to blend in some I guess design thinking. So for example, one of the things that I draw on a lot is the double diamond approach of helping people see that where there's lots of complexity and messiness that we can have a process by kind of expanding and then converging around problems and then expanding again and converging around solutions.
And it's been super interesting to see people in these meetings and groups where some of them you can just see, they just wanna do ideas the whole time. And there's others like, can we just get on and prioritize and pick things. And if people know there's a process that takes 'em through that they have more comfort in that.
And then I started also learning about other design techniques when I was developing uh, work to support us creating a big national quality improvement community. And we brought in lots of design thinking methods through that. So I think having creativity is really important in healthcare because we're often trying to look at how to do something better or spread a thing that we already know works and, and keep iterating it.
And so this kind of test and iterate, having space and time to be creative, have processes that take people through that even if you're short of time, you can really do a lot in a very small space. And so, it's about thinking about possibilities and not being sort of limited. And I think those are all the things that we struggle with in healthcare. We're often very reactive. We're often quite top down. We're often trying to think about limits. We're often trying to standardize, and so it's really important to think about all the opposite things around being proactive and being about possibilities and being able to be open to new thinking and ideas.
And so I'm really keen that we bring more creative thinking into our workplaces wherever we can, because those are the times I often see people most fulfilled. And if you look at the news at the moment in the UK, You'll see many healthcare professionals, understandably, very frustrated with their working conditions at the moment and their pay.
And I'm sure that's the same for many healthcare professionals around the world. So how do we think about all the things that give people mission and purpose in their work that aren't those structural things that we have less control over? And how do we do that through creative outlets? I think it's really important.
Bon Ku: I love that perspective. we don't talk about creativity enough, the need for it and the power that creativity can play in healthcare. And we face some of the, the most complex challenges on the planet. And I get so sick and tired of artists, musicians, and others talk about the value of creativity in their work.
Cuz I'm, I'm jealous. I was like, well, why don't we do that in medicine? Why don't we do that in healthcare of speaking to that. And the role and the power that creativity can have and helping us tackle some of our problems. Oh, there's so many more questions I wanna ask you. Maybe one final question I'd like to ask guests is if one of our listeners were to visit you, where would you take them to eat?
Dominique Allwood: Oh wow. Well, I live, I think in one of the best cities in the world for food, so that is in London. But I also, given that I have this mixed, you know, melting pot of a background, also have a lot of other different pieces of roots to my history. So I would actually take you to Athens where I'm often found, and there are some amazing, amazing little kebab shops.
They're like these hole in the wall, and the people there, like they make this one thing only. This is just this one thing on the menu, and that's it. There's no deviation variation. You can't adjust the stuff in there. It's just the kebab, the juicy tomatoes, the seasoned onions, the amazing bread that acts like a plate, but also like a pillow that mops up all the juices wrapped in a bit of paper, standing up, eating kebabs in an amazing little hole in the wall place.
Bon Ku: You have made me so hungry. I have that vision in my brain right now, and I know it's really late at night there for you in London. So I appreciate you taking time out of your evening to join us. I've learned so much. It was such a joy to have you on the show.
Dominique Allwood: Thanks so much for having me Bon, it's been such a great conversation.
Bon Ku: You can find Dominique on Twitter at D R D O M I N I Q U E a L L w.
Design Lab is produced by Rob Pugliese, editing by Fernando Queiroz. Our theme music was created by Emmanuel Houston and the cover design by Eden Lew. See you next week.
