The problem
As I described in an earlier post, some elementary students in Ontario were suspended for incomplete immunization records. This series of posts is an effort to come up with ideas using each of the 40 Principles.
Remember the cardinal rule: there are no stupid ideas, only ideas that may serve to inspire the best idea. Ideally we’d be working on this together and riffing on each other’s ideas. I am deliberately not censoring my ideas or leaping to reasons why they won’t work.
Let’s see if we can give this process a shot in the arm.
Principle 11 – Cushion In Advance
“Can something be done in advance to protect it?”
In previous Principles I have suggested we could do a better job of alerting parents in advance. Cushioning isn’t preventing, it’s reducing the consequence of failure. The failure here is that the child gets expelled.
Here’s a possibility. Doctors are advised of the likelihood of several students suddenly needing their records updated around the start of term and are urged to keep short appointments open for record updating or giving immunizations.
Principle 12 – Equipotentiality
“What if we could avoid lifting it?”
This Principle is primarily about avoiding the effort and waste of lifting and lowering something, either physically or its temperature or some other energy state. To apply this to ensuring students have their immunizations is going to take some metaphorical thinking.
What if, rather than a visit to the doctor office, the doctor visited the child at the hospital. Most parents choose the school and the doctor geographically, so any given doctor would only need to visit a handful of schools. They could do the shot and inform the school at the same time.
This is puts the child, the doctor and the school at the same “level” for equipotentiality. It reframes “what if we could avoid lifting it” to how can we reduce the aggregate number of steps involved for the parents and doctor.
Principle 13 – The Other Way Round
“What if it was backwards?”
“In America, there’s plenty of light beer and you can always find a party. In Russia, Party always finds you.”
Yakov Smirnoff
My immediate first thought was, “Why don’t we have the child give a shot to the doctor?” Alas, I’m not sure if a Russian reversal joke this will solve the problem.
Here’s another reversal: Since the school has the authority to kick children out for not having their shots up to date, why don’t we give the responsibility for administering and recording immunizations?
Principle 14 – Spheroidality & Curvature
“What if it was curved?”
A loop is a curve and what we have here is a fractured feedback loop. The parents, the doctor and the school all want one thing – the child to be immunized. But the feedback loop is absent. The doctor gives the child the shot, then the record held by the parent is updated (ideally) and the parent gives a copy to the school (ideally).
What if the doctor only got paid (by the province – we have a single payer health care system here in Ontario) for the immunization visit when the school confirms that the doctor gave it by informing the province? I’d wager the doctor would stay on top of the issue.
Principle 15 – Dynamics
“What if it could adapt to circumstance?”
Most of my ideas so far assume the student is settled into the area and has a doctor and a school already. There are, of course, myriad possible family circumstances. The family could be from out of town, out of province, or out of the country and the child’s medical records could be in transit, lost or incompatible with Ontario requirements. The family could be disrupted by divorce or death – is the parent now responsible for the child’s records now in possession of them?
In each of these circumstances parents could be offered (and deserve) a grace period rather than immediate suspension of their child.
Principle 16 – Partial or Excessive Action
“What if we didn’t have to be precise?”
As I said in the first immunization post, I am not a doctor. But what if we took excessive action by preparing a single standard shot for children of every age? Sure it might contain something you’ve already taken but what’s the harm?
A quick bit of researchers suggests this would be fine. Taking multiple shots at once is fine, and inadvertently taking a shot you’ve already taken is fine.
Principle 17 – Another Dimension
“WHY ISN’T IT 3 DIMENSIONAL?”
What if instead of a piece of paper, the parent could track immunizations with physical (3D) tokens or medallions? Collect all twelve! At least they’d be harder to lose. Maybe immunization fridge magnets?
(I said no ideas are bad but even I’m having a hard time reserving judgement on this one. But beware censoring your own ideas! If we were in a group setting this could trigger someone else’s aha moment.)
Principle 18 – Mechanical Vibration
“What if vibration could be used to make an improvement?”
I’m drawing a blank! Comment if you have an idea.
Principle 19 – Periodic Action
“What if we broke the process into intervals?”
The idea that comes to mind is that we make immunization for school age children an annual event timed relative to the start of the school year rather than timed relative to the child’s birthday. For everything there is a season, and right before school opening could be shot season. This would make the sequence of getting a shot and informing the school happen one after the other to avoid delays and missing information.
Principle 20 – Continuity of Useful Action
“Can we replace periodic action with continuous action?”
Here I am framing the useful action as being the doctor’s responsibility to ensure that the child is up to date with their shots at every visit. Thus the parent would only need to produce confirmation that the child had been to an Ontario doctor in the last year.
