Why Dimension Four ® ?
Isochron Dimension Four® in practice
By
Iebe Ypma of
Alastor consulting
Copyright © 2010 Alastor Group Ltd, All Rights Reserved
Who are we?
• Alastor is an independent management consultancy that specialises in
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helping its clients to realise benefit from their investment in organisational
and process change
We have worked with a range of organisations in the public and private
sectors, both in the UK and internationally, operating at both strategic and
operational levels to help our clients to improve organisational performance
Alastor is staffed by experienced consultants with a strong track record in
the effective implementation of practical solutions
Alastor is a member of the Isochron network and is an authorised reseller
of the D4 ® methods, tools and techniques
Both Iebe Ypma and Kimball Bailey are fully certified and accredited in the
use of the D4 ® methodology, and have used it on practical client
engagements.
Both are also experienced trainers, having specifically also run training
courses in the D4 ® methodology for other clients of Isochron
Copyright © 2010 Alastor Group Ltd, All Rights Reserved
Why Dimension Four®?
• Distribution Centre, Whitwood Common Lane, 1979
• Project Manager for a large automated warehouse built at Whitwood, near
Leeds
• The distribution centre and warehouse at Whitwood Common Lane which now
belongs to Tibbett and Britten, was originally built for Elida Gibbs Ltd, as a
distribution centre for toiletries products made at their factories in Leeds (toothpaste,
shampoo, deodorant, etc). It was built in 1978 and became fully operational in 1979.
In the mid 1980's the site was sold to Tibbett and Britten
Copyright © 2010 Alastor Group Ltd, All Rights Reserved
Why Dimension Four®?
Project Manager for the Whitwood Distribution centre
• A large automated warehouse
• Designed all procedures, including shop floor picking and packing processes
for 9,600 items per hour
• One central warehouse for production from two factories
• The order processing system for the warehouse guaranteed no stock outs
post order acceptance
• Designed replenishment procedures to ensure no stock outs, for two SI
Ordermatic machines operating independently but sharing the same
replenishment face
• Picking and packing process guaranteed no errors
• Specified a full warehouse simulation, run overnight, to ensure that quality
requirements were met
Copyright © 2010 Alastor Group Ltd, All Rights Reserved
Why Dimension Four®?
Project Manager for all IT in the Whitwood Distribution centre :
• Including 4 hour fire proof computer centre
• Relational databases did not exist
• Transaction monitors were in the early stages of development
• Data recovery and data locking (of data in an on line and real time
environment) techniques were in their infancy
• No spreadsheets
• Early implementation of DEC 11/70 processor in the UK
• Integrated process control equipment for:
– Conveyors
– Bar code recognition on pallets
– High rise forklift trucks
• ……….
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Why Dimension Four®?
• And project management techniques were not as well advanced:
Copyright © 2010 Alastor Group Ltd, All Rights Reserved
Why Dimension Four®?
A: Explosion of detail
from starting point of
Forecast Plan
Explosion of
detail / scope
Time
Copyright © 2010 Alastor Group Ltd, All Rights Reserved
Why Dimension Four®?
• The major insight:
• We needed to get pallets of mixed parcels to Boots, error free
Copyright © 2010 Alastor Group Ltd, All Rights Reserved
Why Dimension Four®?
• We needed to get pallets of mixed parcels to Boots, error free
• This, in Dimension Four ® is called a Recognition Event ®
Copyright © 2010 Alastor Group Ltd, All Rights Reserved
Why Dimension Four®?
B: Collapse of detail
and complexity,
working back from the
Recognition Event ®
Complexity
and
Uncertainty
Recognition Event ®
• Working back from the Recognition Event ®
•
Time
eliminated a lot of complexity
and realigned priorities
Planning projects by working back from the end point is called Backcasting ®
in the Dimension Four ® methodology
Copyright © 2010 Alastor Group Ltd, All Rights Reserved
Why Dimension Four®?
B: Collapse of detail and
complexity, working
back from the
Recognition Event ®
A: Explosion of detail
from starting point of
Forecast Plan
Complexity
and
Uncertainty
Recognition Event ®
Time
• The Dimension Four ® methodology has structured and developed tools and
techniques that closely mirror my experience and intuitive learning from a
number of large innovative projects
Copyright © 2010 Alastor Group Ltd, All Rights Reserved
Some Other Examples:
• Adult Social Care
• Contents Confidential
• Extracts are presented only to
demonstrate usage of Dimension Four®
Copyright © 2010 Alastor Group Ltd, All Rights Reserved
Adult Social Care
Extracts of data are presented only to demonstrate usage of Dimension Four®
SERVICE (TOTAL ENGLAND) £billion
Strategic Management (adults & generic)
Assessment and care management
Nursing care placements
Residential care placements (own provision)
Residential care placements (provision by others)
Supported and other accommodation
Direct payments
Home care (own provision)
Home care (provision by others)
Day care
Equipment and adaptations
Meals
Other Services
Supporting People
TOTAL ADULT SERVICES £billion
OLDER
PEOPLE
0
1.01
1.58
.78
2.47
.05
.10
.81
1.16
.36
.13
.09
.27
.14
8.96
• The scale of Adult Social Care expenditure across 150 local authorities in
England
Copyright © 2010 Alastor Group Ltd, All Rights Reserved
Adult Social Care
Extracts of data are presented only to demonstrate usage of Dimension Four®
Recognition Events™
PPF1: Live independently
RE1
RE2
RE3
RE4
RE5
RE6
RE7
RE8
RE9
I meet a man with mild learning disabilities who has never been a
client of social care services. He lives successfully in the community.
I can access a wide range of help and support easily in my local area.
Physical obstacles have been removed so that, even though I am a
wheelchair user, I can access wherever I wish to go independently.
I am able to attend my appointments/social/education activities easily
via public transport. I do not have to book special transport well in
advance.
I can afford to heat my home
I can rely on my neighbours to help me in an emergency.
I have telecare which gives me the confidence to return home from
hospital.
I know how and where to get aids and adaptations fitted in my home
when I need them.
When I ask for information about local services in my area, I am
offered it in an easy read format.
PPF2: Stay healthy and recover quickly from illness
RE10
I am able to use health resources to buy support which meets my
needs, rather than the traditional route of medication.
• A snapshot of some of the Recognition Events ® for adult social care agreed
by representatives of the 150 local authorities in England
Copyright © 2010 Alastor Group Ltd, All Rights Reserved
Adult Social Care
Extracts of data are presented only to demonstrate usage of Dimension Four®
Opportunity Sets
Y01 - Y06 +B02
Recognition Events
Models of Care
B01
B03
B04 and R04
3rd Sector /
Voluntary Org /
Community /
Carebay/Web
Implement Current Based Commission- Community
Engagement
ing
IB process
G01
Cash Collection
G02
Self-Assessment
G03
Agency Fees
G04
Shared Services Enhanced Carer
G05
G06
Shared Services Shared Services - Integrated
Back Office / Front Response (Out of
Hours)
Office
G07
Shared Services Integrated Teams
G08
Mobile Working
R03
Care pathway
Planning
R05
Brokerage
√√√
I visit a man with disabilities in his home and he tells me he can easily
articulate his needs, with support sometimes which he gets when
required. He can identify a range of options available to meet his needs
and fund them, procure them and manage them.
R06
• Mapping existing projects or
Commission-ing
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I meet with some informal carers and they tell me they feel well
supported
I go to a communal area and can get what I want e.g. appointment for
physio, pay for service, carry out a self-assessment, book accessible
transport, arrange grass cutting, get nails cut, financial advice, help with
buying/employing a service.
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I speak with a representative sample of people who needed help and
they say it hasn't mattered who they contacted. They all knew what
advice and information to give me. They access it themsleves - it's the
same wherever they get it from. They did not have to give their details 6
times - they only had to give their personal information once.
I meet a man with learning disabilities who goes out regularly with his
friends and takes part in activities with them. He has stopped going to a
day centre.
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•
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I look at the planning regulations and see that when houses are built, it is
now mandatory to meet the needs of people with disabilities
√√
I look at an estate agent's available properties and I see that the property
descriptions address the suitability of the properties for older people or
people with disabilities
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I meet with a property developer and his banker and they tell me they
recognise the opportunity for housing for disabled people and older
people and have built their first development
√√√
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I review the services in my community and I find that services have been
developed by my community. I see that the services are inclusive and
serve the whole community, including people with learning difficulties and
people with disabilities.
I ask care professionals in health and social care about an individual's
care and all reply in terms of both health and social care. I ask finance
staff in health and social care about the costs associated with an
individual and all reply with both health and social care costs.
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I read the annual report of Health and Social Care and see that there is a
section dealing with the effectiveness of the market place in which care
services are traded.
I ask members of a team about who is transitioning from children
services into adult social services in two years time and they are able to
tell me what those peoples' needs are, where the services may be and
what level of individual budget may be provided
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√
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I meet a person who lives in his own home and he tells me he does not
feel he is "over-cared" for. The services he receives are appropriate to
his needs.
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I speak with an older person and a person with severe learning difficulties
and her advocate. They all explain the funding they have received and
where it has come from. They confirm that they have not been in
competition for the funding, and explain the choices they have in
spending the money and what it has been spent on
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I go to the home of a disabled person who tells me that he feels
responsible for his care needs and that with support he is able to look
after himself
I have a conversation with the parents of a man with severe learning
difficulties. They say it is better in 2015 for their son than in 2006 and
they can articulate how and why. I see that the man enjoys and looks
forward to his respite care, and his parents enjoy their own lives. Their
expectations of the service have been raised in the intervening period.
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•
initiatives (shown here in columns)
against the Recognition Events ®
(shown in rows) enables:
Those initiatives that do not
support Recognition Events ® to be
identified and eliminated
Those Recognition Events ® not
supported by projects or initiatives
to be identified
I read a positive article in the tabloid press which talks about personal
responsibility for social care.
I visit a Careers Fair and I see a queue of people waiting to speak about
career opportunities in adult social care
I speak to a representative sample of people and they say that they are
experts in their own care
√√√
I visit a woman in her home. She has severe disabilities and has
received all the benefits she is entitled to, achieving enough money to
afford things beyond minimum subsistence. I see that she is thus able to
go out socially and has the confidence to manage her own finances
√√√
√√√
I meet a disabled person receiving lifestyle advice so that he can identify
his aspirations and goals.
I meet people who are gainfully employed and who previously attended a
day centre and/or claimed incapacity benefit.
√√√
I visit someone who had a fall and he tells me he was temporarily
supported in his own home following the incident. He was not admitted
to hospital.
I meet a disabled older man who has been to his GP as he is feeling
depressed. He is offered [He has been helped to find and employ?]
social support instead of medication and has chosen the social care. He
is not prescribed anti-depressants and his other medication is reviewed
and reduced.
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I receive the annual external audit report and my Local Authority's
accounts are not qualified because of individual budgets
I meet a person who tells me he is confident that if he were to be abused,
someone would spot it and take appropriate action.
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I visit a person in hospital who has had their support and discharge plan
agreed at a visit to their GP prior to admission
I meet people who have had an episode of ill-health and they tell me that
they no longer need a broker/advocate's help because they have been
reabled.
I meet self-funders who have been able to buy their own reablement
service and no longer need care. They tell me they received help from
the reablement team and now no longer need any services
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• In a full (green field)
implementation of Dimension
Four® this is less likely to be an
issue as the projects and initiatives
will be generated by the backcast®
plan working from the Recognition
Events ®
Copyright © 2010 Alastor Group Ltd, All Rights Reserved
Adult Social Care
Extracts of data are presented only to demonstrate usage of Dimension Four®
Patricia, 42 year old mother of 3 children with Multiple Sclerosis
Examples of Recognition Events
•
•
•
•
•
Audit and regulation: I inspect the minute of the
local authority meeting and it endorses the decision
to move towards individual budgets as the preferred
mechanism for funding social care.
Housing: I meet with a property developer and his
banker and they tell me they recognise the
opportunity for housing for disabled people and
older people and have built their first development
that is fully inclusive and has good provision for
people with disabilities.
Integration of services: I visit a brokerage and
am offered a wide choice of social care services,
housing services; health services; employment
support.
Service accessibility: I speak with a
representative sample of people who needed help
and they say it hasn't mattered who they contacted.
They all knew what advice and information to give
me. They access it themselves - it's the same
wherever they get it from. They did not have to give
their details 6 times - the only had to give their
personal information once.
Personal responsibility: I meet a group of
people, some with disabilities, who have sought help
to identify aspirations and goals and have received
lifestyle advice and been able to access the options
available.
Examples of Programmes and Projects
Community Equipment (TCEWS)
1. Current TCEWS Project
Commissioning (Better Buying/Demand Forecasting)
1-8 Projects including Toolkit and TRACS
Service Solutions (Brokerage)
1. Brokerage Bible
2. Outcome Based Specification
Support Related Housing and Technology
1. Assistive Technology
2. Development of Support Related Housing
Crisis Response
1. Social Care 101 Reactive Response Co-ordination
2. 24/7 Reactive Support Services
Copyright © 2010 Alastor Group Ltd, All Rights Reserved
Adult Social Care
Extracts of data are presented only to demonstrate usage of Dimension Four®
•
The benefits model takes into account:
–
–
–
–
Lag between engagement and benefits realisation
Range of addressable spend
Range of potential savings (or increases)
Likely council uptake rate (incorporating the fact that councils starting late may get lower
benefits)
– Extent of applicability to a given cost area
•
We have applied a statistical approach (Montecarlo simulation – a standard
Isochron technique) to combine these ranges into a benefit / confidence curve
90%
confidence
50%
(median)
confidence
Copyright © 2010 Alastor Group Ltd, All Rights Reserved
Adult Social Care
Extracts of data are presented only to demonstrate usage of Dimension Four®
> 100m
3
50m – 100m
9
Easy
4
1
10
< 50m
Scale of Benefit
2
Avg
8
6
5
7
Difficult
Ease of Implementation
• The matrix of initiatives allowed each of the 150 local authorities to select
those initiatives that best met their local need and capabilities
Copyright © 2010 Alastor Group Ltd, All Rights Reserved
Summary
Recognition Events
Recognition Events to Value Flashpoints
Value Flashpoints
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Thank You
Iebe Ypma
Mob
E-mail
+44 77 8511 4875
[email protected]
Copyright © 2010 Alastor Group Ltd, All Rights Reserved