Implementing and sustaining transformational change in health care: lessons learnt about clinical process redesign

McGrath, Katherine; Bennett, D; Ben-Tovim, David I.; Boyages, Steven; Lyons, Nigel; O'Connell, T. J.

doi:10.5694/j.1326-5377.2008.tb01692.x

Cited by 11 publications

(15 citation statements)

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“…As a result, a total of five redesigns are described in this review. Our search on the internet using Google ® provided extra information about the redesigns of DH [38], FMC [39-41] and LRI [42,43]. …”

Section: Resultsmentioning

confidence: 99%

“…In three redesigns (FMC, DH and UWHC), we found factors for success in the retrieved literature, including: senior management support [41]; clinical leadership and involvement [41,45,46]; team-based problem solving [41]; adequate Information and Communication Technology (ICT) support [41,45]; administrative support [46]; ambitious targets [41]; external facilitators [41]; organisational readiness [41]; selection and execution of projects in order of urgency [41]; using a change strategy that already proved to be successful [45]; and good communication and training in the quality improvement techniques [41,45]. …”

Section: Resultsmentioning

confidence: 99%

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Towards an organisation-wide process-oriented organisation of care: A literature review

Vos

Chalmers

Dückers³

et al. 2011

Implementation Sci

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BackgroundMany hospitals have taken actions to make care delivery for specific patient groups more process-oriented, but struggle with the question how to deal with process orientation at hospital level. The aim of this study is to report and discuss the experiences of hospitals with implementing process-oriented organisation designs in order to derive lessons for future transitions and research.MethodsA literature review of English language articles on organisation-wide process-oriented redesigns, published between January 1998 and May 2009, was performed.ResultsOf 329 abstracts identified, 10 articles were included in the study. These articles described process-oriented redesigns of five hospitals. Four hospitals tried to become process-oriented by the implementation of coordination measures, and one by organisational restructuring. The adoption of the coordination mechanism approach was particularly constrained by the functional structure of hospitals. Other factors that hampered the redesigns in general were the limited applicability of and unfamiliarity with process improvement techniques.ConclusionsDue to the limitations of the evidence, it is not known which approach, implementation of coordination measures or organisational restructuring (with additional coordination measures), produces the best results in which situation. Therefore, more research is needed. For this research, the use of qualitative methods in addition to quantitative measures is recommended to contribute to a better understanding of preconditions and contingencies for an effective application of approaches to become process-oriented. Hospitals are advised to take the factors for failure described into account and to take suitable actions to counteract these obstacles on their way to become process-oriented organisations.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Towards an organisation-wide process-oriented organisation of care: A literature review

Vos

Chalmers

Dückers³

et al. 2011

Implementation Sci

View full text Add to dashboard Cite

show abstract

“…Also, the ideas exemplified in another section are at clear odds with what I experience daily as a senior clinician. To illustrate, McGrath and colleagues write of “engaging clinical leaders” and that “solutions need to be evidence‐based” 3 . Regrettably, the opposite is the reality.…”

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confidence: 99%

“…Senior medical clinicians are sidelined and the decision‐making process becomes the domain of a few select individuals, thus making it sclerotic, remote from the clinical interface and, at times, autocratic. Further, some management decisions are implemented without any of the supposed evidence base that McGrath and colleagues 3 refer to. Perhaps of greater concern is the notion of “stretch targets” 3 .…”

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confidence: 99%

“…Further, some management decisions are implemented without any of the supposed evidence base that McGrath and colleagues 3 refer to. Perhaps of greater concern is the notion of “stretch targets” 3 . These are considered “essential to stimulate real innovation”, but, translated into plain English, sound like asking staff to work harder with no additional resources.…”

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confidence: 99%

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