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1 – 10 of over 37000Ann M. Herd, Brittany L. Adams-Pope, Amanda Bowers and Brittany Sims
As the world of healthcare changes rapidly, healthcare leaders and managers must hone their leadership competencies in order to remain effective in their organizations. With…
Abstract
As the world of healthcare changes rapidly, healthcare leaders and managers must hone their leadership competencies in order to remain effective in their organizations. With changes such as the Affordable Care Act, increasing medical school costs, decreased graduation rates, and increased needs for care, how are current and future healthcare leaders adapting? In light of the large-scale changes in the healthcare field in recent years, the purpose of this study was to investigate which National Center for Healthcare Leadership (NCHL) competencies were referenced by exemplary healthcare leaders as most important for success in today’s changing healthcare environment. Interviews were conducted with 26 mid- and upper-level healthcare leaders identified by the C-level executives in their organizations as exemplary performers. Change leadership, self-development, talent development, and team leadership were the top four NCHL competencies most frequently referenced, with thematic analysis revealing additional underlying themes in the exemplary leaders’ dialogue.
Lisa van Rossum, Kjeld Harald Aij, Frederique Elisabeth Simons, Niels van der Eng and Wouter Dirk ten Have
Lean healthcare is used in a growing number of hospitals to increase efficiency and quality of care. However, healthcare organizations encounter problems with the implementation…
Abstract
Purpose
Lean healthcare is used in a growing number of hospitals to increase efficiency and quality of care. However, healthcare organizations encounter problems with the implementation of change initiatives due to an implementation gap: the gap between strategy and execution. From a change management perspective, the purpose of this paper is to increase scientific knowledge regarding factors that diminish the implementation gap and make the transition from the “toolbox lean” toward an actual transformation to lean healthcare.
Design/methodology/approach
A cross-sectional study was executed in an operating theatre of a Dutch University Medical Centre. Transformational leadership was expected to ensure the required top-down commitment, whereas team leadership creates the required active, bottom-up behavior of employees. Furthermore, professional and functional silos and a hierarchical structure were expected to impede the workforce flexibility in adapting organizational elements and optimize the entire process flow.
Findings
The correlation and regression analyses showed positive relations between the transformational leadership and team leadership styles and lean healthcare implementation. The results also indicated a strong relation between workforce flexibility and the implementation of lean healthcare.
Originality/value
With the use of a recently developed change management model, the Change Competence Model, the authors suggest leadership and workforce flexibility to be part of an organization’s change capacity as crucial success factor for a sustainable transformation to lean healthcare.
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The purpose of this paper is to report on ethnographic research that investigated how self-employed nurses perceive the contemporary healthcare field, what attributes they possess…
Abstract
Purpose
The purpose of this paper is to report on ethnographic research that investigated how self-employed nurses perceive the contemporary healthcare field, what attributes they possess that facilitate their roles as change agents, what strategies they use to influence change, and what consequences they face for their actions, thus contributing to what is known about organizational change in institutionalized settings such as healthcare.
Design/methodology/approach
Focussed ethnography was used to explore self-employed nurses’ work experiences and elucidate the cultural elements of their social contexts, including customs, ideologies, beliefs, and knowledge and the ways that these impact upon the possibilities for change in the system.
Findings
These self-employed nurses reflected on the shortcomings in the healthcare system and took entrepreneurial risks that would allow them to practice nursing according to their professional values. They used a number of strategies to influence change such as capitalizing on opportunities, preparing themselves for innovative work, managing and expanding the scope of nursing practice, and building new ideas on foundational nursing knowledge and experience. They had high job satisfaction and a strong sense of contribution but they faced significant resistance because of their non-traditional approach to nursing practice.
Originality/value
Despite dramatic restructuring in the Canadian healthcare system, the system remains physician-centered and hospital-based. Nursing ' s professional potential has been largely untapped in any change efforts. Self-employed nurses have positioned themselves to deliver care based on nursing values and to promote alternative conceptions of health and healthcare. This study offers a rare exploration of this unique form of nursing practice and its potential to influence health system reform.
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Clair Reynolds Kueny, Alex Price and Casey Canfield
Barriers to adequate healthcare in rural areas remain a grand challenge for local healthcare systems. In addition to patients' travel burdens, lack of health insurance, and lower…
Abstract
Barriers to adequate healthcare in rural areas remain a grand challenge for local healthcare systems. In addition to patients' travel burdens, lack of health insurance, and lower health literacy, rural healthcare systems also experience significant resource shortages, as well as issues with recruitment and retention of healthcare providers, particularly specialists. These factors combined result in complex change management-focused challenges for rural healthcare systems. Change management initiatives are often resource intensive, and in rural health organizations already strapped for resources, it may be particularly risky to embark on change initiatives. One way to address these change management concerns is by leveraging socio-technical simulation models to estimate techno-economic feasibility (e.g., is it technologically feasible, and is it economical?) as well as socio-utility feasibility (e.g., how will the changes be utilized?). We present a framework for how healthcare systems can integrate modeling and simulation techniques from systems engineering into a change management process. Modeling and simulation are particularly useful for investigating the amount of uncertainty about potential outcomes, guiding decision-making that considers different scenarios, and validating theories to determine if they accurately reflect real-life processes. The results of these simulations can be integrated into critical change management recommendations related to developing readiness for change and addressing resistance to change. As part of our integration, we present a case study showcasing how simulation modeling has been used to determine feasibility and potential resistance to change considerations for implementing a mobile radiation oncology unit. Recommendations and implications are discussed.
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Françoise Johansen, Derk Loorbach and Annemiek Stoopendaal
Healthcare systems are facing persistent challenges, such as dealing with an ageing population, related increases in chronic diseases and healthcare costs facilitated by…
Abstract
Purpose
Healthcare systems are facing persistent challenges, such as dealing with an ageing population, related increases in chronic diseases and healthcare costs facilitated by technological progress. The authors argue that the boundaries of optimisation are being reached and a more fundamental change or transition is necessary. The purpose of this paper is to explore the contours of this transition in the Netherlands. The authors do this from the perspective of healthcare organisations that have participated in the “Expedition to Sustainable Healthcare”: a learning programme organised by the Dutch Network for Sustainable Healthcare aimed at creating frontrunners in this transition.
Design/methodology/approach
The paper combines conceptual with experimental empirical work. The authors use the transition research frameworks to conceptualise persistent problems and transitional dynamics in the healthcare system. In a longitudinal study, the authors analysed how the participating organisations developed after the expedition.
Findings
The process validated the initial understanding of persistent sustainability challenges. An integral approach to sustainable healthcare is translated as a transformation of culture, structures and practices and the development of capacity for crossing borders and domains, inside and outside of the organisation. To facilitate and stimulate such a process the authors found that problem structuring and collective identification of persistent problems and the unsustainability in the healthcare system is a crucial step towards a shared view and discourse that supports change.
Originality/value
A transition in the Dutch healthcare system is just starting to emerge and has barely been subject of research. This paper provides an empirical description of a transition management process in this context. The authors hope to lay a foundation for future work that seeks to explore transitions in healthcare in theory and practice.
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Susan Albers Mohrman and Abraham B. (Rami) Shani
The chapter redefines the focus of the changes required to create sustainable healthcare away from fixing healthcare organizations and toward reconfiguring the constituent…
Abstract
Purpose
The chapter redefines the focus of the changes required to create sustainable healthcare away from fixing healthcare organizations and toward reconfiguring the constituent elements of the healthcare ecosystem and redefining how they interrelate to yield value more sustainably.
Methodology/approach
Based on a review of recent literature on healthcare reform, we argue that unlike other sectors, healthcare organizations cannot change themselves without changing their connections to the rest of the healthcare ecosystem, including other healthcare organizations, patients, governments, research institutions, vendors, and the citizenry at large. This is because these are not only stakeholders but also integral parts of healthcare processes.
Practical implications
Interventions intended to create more sustainable healthcare must bring together knowledge and perspectives from across the ecosystem, and must converge different sources of information and analysis to generate novel ways of connecting across the ecosystem. Change within a healthcare system cannot achieve the magnitude of transformation needed to become sustainable.
Social implications
If the healthcare ecosystem evolves in the manner described in this chapter, the healthcare ecosystem will no longer center around particular institutions and doctors’ offices but rather be defined by flexible and variable interactions between co-acting elements of the ecosystem.
Originality/value of chapter
The chapter treats the context as the focus of change in order to change the healthcare system. It proposes three kinds of flows: knowledge, clinical, and resource that are already beginning to change and that will eventually result in fundamentally different approaches to healthcare.
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Luca Gastaldi and Mariano Corso
Drawing on the experience of the Observatories, a set of interconnected research centers in Italy, this chapter explains why academics are in one of the best positions to…
Abstract
Drawing on the experience of the Observatories, a set of interconnected research centers in Italy, this chapter explains why academics are in one of the best positions to orchestrate interorganizational initiatives of change and development, and highlights two prerequisites that appear necessary to render salient this orchestrator role of academics: (i) the extensive use of multiple approaches of collaborative research and (ii) the creation and maintenance of a platform allowing the management and diffusion of the network-based learning mechanisms underlying each change and development effort. The contributions extend existing knowledge on organization development and collaborative research.
The purpose of this paper is to investigate the process and impact of patient involvement in locally defined improvement projects in two hospital clinics. The paper particularly…
Abstract
Purpose
The purpose of this paper is to investigate the process and impact of patient involvement in locally defined improvement projects in two hospital clinics. The paper particularly aims to examine how patient narratives, in the form of diaries and radio montage, help to create new insights into patient experience for healthcare professionals, and support professionals’ enrolment and mobilisation in innovation projects.
Design/methodology/approach
Two case studies were undertaken. These drew upon qualitative interviews with staff and participant observation during innovation workshops. Patient diaries and a recorded montage of patient voices were also collected.
Findings
The findings illuminate translation processes in healthcare innovation and the emergence of meaning making process for staff through the active use of patient narratives. The paper highlights the critical role of meaning making as an enabler of patient-centred change processes in healthcare via: local clinic mangers defining problems and ideas; collecting and sharing patient narratives in innovation workshops; and healthcare professionals’ interpretation of patient narratives supporting new insights into patient experience.
Practical implications
This study demonstrates how healthcare professionals’ meaning making can be supported by articulating, constructing, listening and interpreting patient narratives. The two cases demonstrate how patient narratives serve as reflective devices for healthcare professionals.
Originality/value
This study presents a novel demonstration of the importance of patient narratives for translating healthcare innovation in a clinical practice setting.
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V. Vaishnavi, M. Suresh and Pankaj Dutta
The purpose of this paper is to identify, analyze and develop a model to measure the interactions among different factors of organizational readiness for change in service sector…
Abstract
Purpose
The purpose of this paper is to identify, analyze and develop a model to measure the interactions among different factors of organizational readiness for change in service sector specific to healthcare organization. The total interpretive structural modeling (TISM)-based readiness for change is to build a theoretical framework to understand the mutual interactions among the factors and to identify the driving and dependence power of these factors.
Design/methodology/approach
TISM is used to identify factors that contribute to analyze the readiness state before starting a change implementation process in healthcare. Matrice d’Impacts croises-multiplication applique´ a classement analysis is used to find the driving and dependent factors of change in healthcare.
Findings
This paper identified 12 factors of readiness for change from literature review followed by expert interview to understand the inner connection of factors and study inner relationships. The result says that state of affairs, recent trends in healthcare sector, technology advancement and interdependence among departments are key factors for readiness of change.
Research limitations/implications
This research mainly focused on readiness factors for change in the healthcare sector.
Practical implications
This study will be useful for researcher and practitioners to understand the readiness factors for change.
Originality/value
In this research work, TISM-based readiness for the change framework structural model has been proposed for healthcare organizations which is a new effort in the area of organizational change management in this sector.
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Maria Karanika-Murray, Zara Whysall, Yu-Ling Liu-Smith, Ceri Feltbower and Emma Challans-Rasool
Complex and sudden change that healthcare organizations often have to respond to, such as during the recent pandemic, can create major disruptions and a prolonged state of alert…
Abstract
Purpose
Complex and sudden change that healthcare organizations often have to respond to, such as during the recent pandemic, can create major disruptions and a prolonged state of alert. Although the impact of such crises can be predominantly negative, rapid adjustments during this time can also yield positive change that can support organizational response to crisis, if managed well. Using insights from organizational learning and organizational change theory, the aim of this study was to understand organizational learning during sudden change. Specifically, the authors aimed to understand the experiences and types of gains and losses in the processes of complex and disruptive change in one large healthcare organization in the UK.
Design/methodology/approach
Focus group data were used from 23 focus group discussions with 575 participants representing all functions and departments in one Healthcare Trust.
Findings
The participants revealed the rich gains, losses, and lessons experienced in response to sudden change that can promote organizational learning. Perceived losses are more likely to drive a desire to refreeze “back to normal” and perceived gains more likely to lead to an emphasis on embedding gains and changing to better. Therefore, on balance, the substantial, in number and variety, gains and learnings point to a learning organization. This is an essential attribute for responding to disruptive change successfully and facilitating organizational recovery in a post-pandemic world.
Practical implications
The findings highlight the importance of timely harnessing of the organizational learning emerging from crises and how this can inform a more resilient organization, as well as supporting sustainable organizational cross-learning.
Originality/value
By extending these insights on workers’ adaptation to sudden change, the findings can help to advance the science and practice of organizational learning and support organizational recovery, especially as they describe the new status in UK healthcare organizations.
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