For AuthorsIf you would like to write for this, or any other Emerald publication, then please use our Emerald for Authors service information about how to choose which publication to write for and submission guidelines are available for all. Please visit www.emeraldinsight.com/authors for more information. About Emerald www.emeraldinsight.comEmerald is a global publisher linking research and practice to the benefit of society. The company manages a portfolio of more than 290 journals and over 2,350 books and book series volumes, as well as providing an extensive range of online products and additional customer resources and services.Emerald is both COUNTER 4 and TRANSFER compliant. The organization is a partner of the Committee on Publication Ethics (COPE) and also works with Portico and the LOCKSS initiative for digital archive preservation.*Related content and download information correct at time of download. Edward LugsdenNewcastle University Business School, Newcastle University, Newcastle upon Tyne, UK AbstractPurpose -The purpose of this paper is to examine a bold and ambitious scheme known as the North East transformation system (NETS). The principal aim of the NETS is the achievement of a step-change in the quality of health services delivered to people living in the North East region of England. The paper charts the origins of the NETS and its early journey before describing what happened to it when the UK coalition government published its proposals for unexpected major structural change in the NHS. This had a profound impact on the leadership and direction of the NETS and resulted in it taking a different direction from that intended. Design/methodology/approach -The research design took the form of a mixed methods, longitudinal 3.5-year study aimed at exploring transformational change in terms of content, context, process and outcomes. The sample of study sites comprised 14 NHS trusts in the North East region chosen to provide geographical coverage of the area and to reflect the scale, scope and variety of the bodies that formed part of the NETS programme. The qualitative component of the research, which the paper draws upon, included 68 semi-structured interviews, observational studies and focus groups. Data analysis made use of both deductive and inductive frameworks. The deductive framework adopted was Pettigrew et al.'s "receptive contexts for change" and four of the eight factors stood out as especially important and form the basis of the paper. being especially significant: environmental pressure, quality and coherence of policy, key people leading change, supportive organisational culture. Perhaps the most significant lesson from the NETS is that achieving whole systems change is particularly vulnerable to the vicissitudes of politics especially where that system, like the UK NHS, is itself subject to those very same pressures. Yet, despite having an enormous influence on health policy, the political context is frequently avoided in research or not regarded as instrumental in determining the ...

The research project 'An Evaluation of Transformational Change in NHS North East' examines the progress and success of National Health Service (NHS) organisations in north east England in implementing and embedding the North East Transformation System (NETS), a region-wide programme to improve healthcare quality and safety, and to reduce waste, using a combination of Vision, Compact, and Lean-based Method. This paper concentrates on findings concerning the role of leadership in enabling tranformational change, based on semi-structured interviews with a mix of senior NHS managers and quality improvement staff in 14 study sites. Most interviewees felt that implementing the NETS requires committed, stable leadership, attention to team-building across disciplines and leadership development at many levels. We conclude that without senior leader commitment to continuous improvement over a long time scale and serious efforts to distribute leadership tasks to all levels, healthcare organisations are less likely to achieve positive changes in managerial-clinical relations, sustainable improvements to organisational culture and, ultimately, the region-wide step change in quality, safety and efficiency that the NETS was designed to deliver.

Purpose The purpose of this paper is to evaluate the European Regions for Innovative Productivity project that established Innovative Productivity Centres (IPCs) to assist SMEs in the North Sea Region of Europe to develop a process improvement capability. A conceptual framework explains how a process improvement methodology developed for large firms was adapted and shaped to meet the needs of SMEs. Design/methodology/approach A comparative case study of 23 SMEs within six European countries. A protocol was developed to collect financial and operational data. This was supplemented by observations, secondary data and field notes. An established research model was used to evaluate the effectiveness and impact of the process improvement interventions. Findings The intervention context and structure of the IPCs varied by country which shaped process improvement interventions at two levels: the country and the firm. During diffusion three process improvement variants emerged that were tailored to fit the local context. Developing a process improvement capability depended upon the availability of company resources, establishing KPIs and change agent support. Originality/value The research contributes to knowledge and theory on diffusion and institutionalization by examining how SMEs responded to institutional pressures by implementing process improvement practices in different ways. Heterogeneity of both the IPCs and the external change agents were the drivers in shaping the improvement practices.

PurposeMany tools exist to chart the progress of an organisation in its quest to become a learning organization or achieve organizational learning. Aims to expand a tool already developed to include learning organization conditions as they occur through dialogue between individuals within an organisation with an emphasis on social learning theory.Design/methodology/approachLiterature relating to creating learning organizations as well as undertaking organizational learning is reviewed and critiqued. An argument for a tool in identifying learning activity functions as they take place through dialogue is presented along with the argument for expanding the tool to incorporate learning organization conditions that have been identified within the literature. The tool this work expands is the DISCOUNT scheme as developed by Pilkington. The paper closes with a discussion on justifying the use of the scheme and the future work that is to be undertaken.FindingsDemonstrates that a tool can be expanded to take into account learning organization and organizational learning conditions and how they could be identified.Research limitations/implicationsIndividuals who use the tool need a number of hours practice to become familiar with the scheme and its structure.Practical implicationsA tool has been expanded to look at learning activities as they take place within an organisation. By identifying these activities, more successful approaches to learning may be encouraged by looking at an individual's behaviour, personal and cognitive factors and the environment as is stated to apply when viewed through social learning theory.Originality/valueThis paper offers a practical tool that can be used on dialogue and other speech acts to look at learning activities within organizations with a specific focus on organizations wanting to improve organizational learning or try to create learning organizations.