Become 1% better every single day

Become 1% better every single day

Simple maths.

If we aim for an improvement of 1% each and every day, by the end of the year we will end up 37 times better than when we started.

Conversely, if we get 1% worse at sometime each day for a year, we will decline nearly down to zero.

According to James Clear, author of ‘Atomic Habits’, “what starts as a small win or a minor setback accumulates into something much more.

So how can we improve?

Whether we are approaching behavior change as an individual, a parent, a coach, or a leader, we should ask ourselves the same question:

“How can we design a world where it’s easy to do what’s right?”

Reset your environment so that the actions that matter most are also the actions that are easiest to do.

When you master habits of preparation, habits of execution become easy.

To create a good habit:

1. Make it obvious

2. Make it attractive

3. Make it easy

4. Make it satisfying

To break a bad habit:

1. Make it invisible

2. Make it unattractive

3. Make it difficult

4. Make it unsatisfying

James Clear, #habitstacking #atomichabits

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Western Sydney GP Leaders

Western Sydney GP Leaders

A pleasure to host the final GP Leaders Dinner for the year on Wednesday at El-Phoenician Restaurant in Parramatta.

The WSyd GP Leaders Dinner continues to be an incredible forum for collaboration and shared learnings. A diverse range of topics.

1) Social media and podcasts;

2) Consumer-clinician collaboration through The King’s Fund Collaborative Pairs model – brought to Australia by Consumers Health Forum of Australia and delivered in partnership with Primary Health Networks; to

3) Measuring and publishing measures of high-performing primary care in Australia

Great to spend the evening with my passionate colleagues and hear a diverse range of perspectives, united by a common thread of delivering exceptional care to the community.

WentWest Ltd and our partners have embraced the concepts of the Patient-Centred Medical Home and our GP Leaders are leading the nation in implementing the principles of person-centred, comprehensive, coordinated, accessible and evidence-based interdisciplinary primary care.

Cheers to a bigger and better 2019.

Forming a healthy world view

Forming a healthy world view

“The most important question you can ever ask is if the world is a friendly place.”

For if we decide that the universe is an unfriendly place, then we will use our technology, our scientific discoveries and our natural resources to achieve safety and power by creating bigger walls to keep out the unfriendliness and bigger weapons to destroy all that which is unfriendly and I believe that we are getting to a place where technology is powerful enough that we may either completely isolate or destroy ourselves as well in this process.

If we decide that the universe is neither friendly nor unfriendly and that God is essentially ‘playing dice with the universe’, then we are simply victims to the random toss of the dice and our lives have no real purpose or meaning.

But if we decide that the universe is a friendly place, then we will use our technology, our scientific discoveries and our natural resources to create tools and models for understanding that universe. Because power and safety will come through understanding its workings and its motives.”

Albert Einstein

10 Health Care Rules We Desperately Need to Break

10 Health Care Rules We Desperately Need to Break

Seriously, there are some things that we do in health care that are just too prescriptive. Occasionally, we get health care so wrong that we do silly things – like waking patients up to give them sleeping tablets.

Sometimes, breaking the rules is exactly what’s needed to improve patients’ experience of their care.

The Leadership Alliance (Alliance), convened by the Institute for Healthcare Improvement, consists of approximately 40 North American hospitals, associations, and other care systems committed to delivering on the promise of the “Triple Aim”

In 2016, organisations forming the Alliance asked this question of patients and staff:

“If you could break or change any rule in service of a better care experience for patients or staff, what would it be?”

Below, Berwick et al list the top 10 most frequent suggestions.

Breaking Health Care Rules to Improve Care

Breaking the Rules for Better Care JAMA

Break Down the Bureaucrats in 8 Steps.

Break Down the Bureaucrats in 8 Steps.

I came across these eight symptoms of bureaucratic breakdown whilst listening to The Personal MBA: Master the Art of Business by Josh Kaufman.These eight symptoms resonated with me and align almost poetically with my experiences in health care. I hope that you will find them to be of value. Does this ring true for you? Let me know what you think.Josh Kaufman attributes this to Dr Michael Sutcliffe from the University of Cambridge.

  1. The Invisible Decision – No-one knows how or where decisions are made (there is no transparency).
  2. Unfinished Business – Too many tasks are started but very few carried through to the end.
  3. Co-ordination Paralysis – Nothing can be done without checking with a host of interconnected units.
  4. Nothing New – There are no radical ideas, inventions or lateral thinking—a general lack of initiative.
  5. Pseudo-problems – Minor issues become magnified out of all proportion.
  6. Embattled Centre – The centre battles for consistency and control against local/regional units.
  7. Negative deadlines – The deadlines for work become more important than the quality of the work being done.
  8. In-tray Domination – Individuals react to inputs, that is, whatever gets put in their in-tray, as opposed to using their own initiative.

Josh states that “If any of these qualities describe your daily work experience, your team is probably suffering from a case of Communication Overhead.

The solution to communication overhead is simple – make your team as small as possible. Read more on PersonalMBA.

One of the take home messages is that beyond 8 people, each new team member requires more investment in communication than they add in productive capacity. Including them is causing more work than it is adding in benefits.

Make teams as small and autonomous as possible – “Keep teams elite and surgical” – ‘Peopleware’ by Tom DeMarco and Timothy Lister

Equally, a team of one is also not productive, as can be the case in general practice. This guides some of the philosophy behind creating pods and teamlets such as in the Patient-Centred Medical Home model.

Would love your thoughts!!

Trust – be warm first and reassure with your strength

Trust – be warm first and reassure with your strength

According to Dr Rodger Dean-Duncan, author of ‘Change-Friendly Leadership: How to Transform Good Intentions into Great Performance‘, in any organisation, people can be either:

  1. Engaged;
  2. Enrolled;
  3. Disenfranchised; or
  4. Disengaged

On average, 22% of employees are engaged in the business – and align their success with the success of their organisation.

Engaged employees are happier, more productive and are more effective at connecting with each other. The most effective and productive employees trust their managers, and each other.

Most organisations will consider one of two mechanisms to ensure employees are doing their best work.

  • Compliance – “ticking the boxes”

According to Stephen Covey, compliance mechanisms are a slow-moving and costly prosthesis for lack of trust. Nonetheless, compliance mechanisms are important and necessary to ensure those that are disengaged are still performing to a minimal standard.

  • Commitment – “being genuinely engaged and finding joy in work”

Commitment is achieved through authentic, transformational leadership, which I will explore in my next post.

According to the Harvard Business Review, and demonstrated in the image below, leaders need both warmth and competence, however “leaders who project strength before warmth run the risk of eliciting fear.” This is counter-productive. Instead, once you establish your warmth, your strength is a welcome reassurance.


Image courtesy: Tanmay Vora,