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The purpose of this article is to look at method study, as devised by the Gilbreths at the beginning of the twentieth century, which found early application in hospital quality assurance and surgical “best practice”. It has since become a core activity in all modern methods, as applied to healthcare delivery improvement programmes.

The article traces the origin of what is now currently and variously called “business process re‐engineering”, “business process improvement” and “lean healthcare” etc., by different management gurus back to the century‐old pioneering work of Frank Gilbreth. The outcome is a consistent framework involving “width”, “length” and “depth” dimensions within which healthcare delivery systems can be analysed, designed and successfully implemented to achieve better and more consistent performance.

Healthcare method (saving time plus saving motion) study is best practised as co‐joint action learning activity “owned” by all “players” involved in the re‐engineering process. However, although process mapping is a key step forward, in itself it is no guarantee of effective re‐engineering. It is not even the beginning of the end of the change challenge, although it should be the end of the beginning. What is needed is innovative exploitation of method study within a healthcare organisational learning culture accelerated via the Gilbreth Knowledge Flywheel.

It is shown that effective healthcare delivery pipeline improvement is anchored into a team approach involving all “players” in the system especially physicians. A comprehensive process study, constructive dialogue, proper and highly professional re‐engineering plus managed implementation are essential components. Experience suggests “learning” is thereby achieved via “natural groups” actively involved in healthcare processes.

The article provides a proven method for exploiting Gilbreths' outputs and their many successors in enabling more productive evidence‐based healthcare delivery as summarised in the “learn‐do‐learn‐do” feedback loop in the Gilbreth Knowledge Flywheel.

The purpose of this paper is to provide a comprehensive description, justification and modus operandi for implementation of cellular operations within healthcare delivery supply chains. The methodology outlined has a sound theoretical basis, has been proven in a wide range of market sectors (including hospitals) and hence qualifies for consideration as a contribution to “new management theory”.

Approach is based on the well established management‐by‐projects (MBP) methodology for analysis, design and effective implementation of change. There is detailed coverage of the five‐step MBP programme with specific applications in healthcare. The importance of “people involvement” as a core requirement is demonstrated via the set‐up of task forces to design and operate such cells. These groups integrate cognate activities so as to provide seamless patient flow within the healthcare delivery process. MBP is derived from a systems perspective. This in turn is concerned with maintaining quality, reducing uncertainty, smooth transference, synchronisation, schedule adherence, and minimisation of throughput times.

The outputs from case studies executed in a large UK teaching hospital confirm the substantial benefits accruing from cellular operation. In both materials supplies and urology admission processes significant improvements result form adoption of the MBP change methodology. This includes substantive 50 per cent reduction in patient throughput times, plus 25 per cent increase in bed utilisation. Measurable cost benefits are achieved in materials supply, especially via simplification of ordering systems.

The healthcare applications demonstrate the applicability of MBP within this specialised scenario. However, the solutions depend on the innovatory capability of the relevant task forces who execute the projects. Since these necessarily include participation by coal‐face “players”, i.e. doctors, nurses, support staff, etc. advised by internal “change experts” the solutions adopted are shaped to be the best and most appropriate “local” schema.

It is essential that task forces be properly constituted, well trained, well advised, and actively practice the plan‐do‐check‐act cyclic route of well‐tested improvement. “Train‐Do” is the key. However, in healthcare especially, the “Elephant Must Be Eaten in Bite Sized Chunks”. In other words the organisation needs visible progressive change, unit‐by‐unit, thus avoiding saturation of scarce resources.

Brings together the MBP methodology and cellular organisational concepts into an integrated, sustainable, systems based approach to the analysis, design and implementation of effective change.

The article discusses how care programmes and integrated care pathways can be linked, finding ways to improve healthcare process professional and logistical quality from a supply chain and a network point‐of‐view.

The authors argue that owing to cost containment goals and increasing healthcare demand, healthcare services systems are challenged to improve service quality, whilst at the same time finding ways to improve delivery processes. It explores if the combination of two instruments, care programmes and integrated care pathways, can meet both goals. This combination is illustrated by an example from the Institute of Mental Health Care Eindhoven en de Kempen.

Analysis suggests that care programmes can be combined with integrated care pathways, leading to a situation where both quality and process improvement can be reached. These instruments are complementary.

The article is largely conceptual; ideas are presented to stimulate thinking rather than to prove an argument.

Combining care programmes and integrated care pathways has implications for the way we think about and organise healthcare processes.

There have been few publications on instruments combining both a network and a supply chain approach to describe and understand healthcare processes.

Taking the physician sourced observation that “wasting time is always more expensive than saving it” leads naturally to the conclusion that effective and efficient patient‐centred healthcare delivery systems are highly desirable targets for the National Health Service (NHS) and similar providers. But has “joined up healthcare” even been achieved, and if so, how? What procedures must be in place to maximise the chances of its occurrence? This paper aims to investigate these issues.

This paper answers these questions experientially via “Insider Action Research” projects plus careful critique of published case studies.

Recurring themes for effective improvement of healthcare delivery organisations emerge in the paper, as do identification of the inevitable barriers to change.

The paper takes stock of NHS service developments in a broader theoretical light.

The purpose of this paper is two-fold. First, it sets the context for the special issue by considering conceptions of patients and their roles in service delivery and improvement. Second, it introduces the contributions to the special issue, and identifies thematic resonance.

The paper utilises a literature synthesis and thematic analysis of the special issue submissions. These emanated from the Ninth International Organisational Behaviour in Healthcare Conference, hosted by Copenhagen Business School on behalf of the Learned Society for Studies in Organizing Healthcare.

The articles evidence a range of perspectives on patients’ roles in healthcare. These range from their being subject to, a mobilising focus for, and active participants in service delivery and improvement. Building upon the potential patient roles identified, this editorial develops five “ideal type” patient positions in healthcare delivery and improvement. These recognise that patients’ engagement with health care services is influenced both by personal characteristics and circumstances, which affect patients’ openness to engaging with health services, as well as the opportunities afforded to patients to engage, by organisations and their employees.

The paper explores the relationally embedded nature of patient involvement in healthcare, inherent in the interdependence between patient and providers’ roles. The typology aims to prompt discussion regarding the conceptualisation patients’ roles in healthcare organisations, and the individual, employee, organisational and contextual factors that may help and hinder their involvement in service delivery and improvement. The authors close by noting four areas meriting further research attention, and potentially useful theoretical lenses.

The purpose of this study was to examine the concept of value in healthcare through a practical appraisal of the applicability of a conceptual framework, which is aimed at supporting the measurement and realisation of financial benefits from process improvement (PI) activities in a hospital setting.

A single case study of a hospital system in Melbourne, Victoria, Australia, was used to assess the applicability of the framework. The study sought to verify the framework's intention, that PI methods could be used to address known wastes that contribute to the cost of providing healthcare. The case study examines the current approach taken by the hospital to measure and realise financial benefits from PI activities and compares these to the components of the Strategy to Balance Cost and Quality in Health Care framework to assess its applicability in practice.

The case study revealed that the steps described in the framework were fundamentally in place albeit with some variation. Importantly, the case study identified an additional step that could be added into the framework to support hospitals to better define their portfolio of initiatives to deliver value. The case study also clarified three types of contributory elements that should be in place for the application of the framework to be successful.

The Framework to Achieve Value in Healthcare is offered to hospitals as a model by which they can look to reduce expenditure through the removal of non-value adding activities. The modification to the conceptual framework has arisen from a single case study and would benefit from further testing by other hospitals in other policy settings (i.e. other countries).

This is the first paper to examine and enhance an existing framework to assist hospitals balance cost and quality through PI.

Public sectors have responded to grand societal challenges by establishing collaboratives – new inter-organizational partnerships to secure better quality health services. In the UK, a proliferation of collaboration-based healthcare networks exists that could help to enhance the value of investments in quality improvement programs. The nature and organizational form of such improvements is still a subject of debate within the public-sector literature. Place-based collaboration has been proposed as a possible solution. In response, the purpose of this study is to present the results and findings of a place-based collaborative network, highlighting challenges and insights.

This study adopted a social constructionist epistemological approach, using a qualitative methodology. A single case study was used and data collected in three different stages over a two-year period.

The study finds that leadership, data-enabled learning through system-wide training and development, and the provision of an enabling environment that is facilitated by an academic partner, can go a long way in the managing of healthcare networks for improving quality.

Regardless of the tensions and challenges with place-based networks, they could still be a solution in maximizing the public value required by government investments in the healthcare sector, as they offer a more innovative structure that can help to address complex issues beyond the remit of hierarchical structures. This study is limited by the use of a single case study.

Across countries health systems are moving away from markets to collaborative models for healthcare delivery and from individual services to population-based approaches. This study provides insights to inform leaders of collaborative health models in the design and delivery of these new collaborations.

As demand rises (as a result of increasing complexity and demographics) in the western world, health systems are seeking to redefine the boundaries between health service provision and community self-reliance and resilience. This study provides insights into the new partnership between health institutions and communities, providing opportunities for more social- and solidarity-based healthcare models which place patients and the public at the heart of change.

The city place-based network is the first of such organizational form in healthcare collaboration in the UK.

The purpose of this article is to explore how one higher education institution (HEI) has embraced the apprenticeship agenda and is successfully providing an apprenticeship programme for nursing associates (NA) a new profession within health and social care in the United Kingdom.

This is a descriptive case study narrative about one programme from one HEI, selected for its relevance for the subject area of apprenticeships. This descriptive approach allows the provision of apprenticeships within HEI to be explored in depth by one institution.

This case study identifies the considerable value of apprenticeships within HEI for the students, the employers and the HEI. It also identifies that there are challenges within this. These findings will be of interest to those entering into the apprenticeship arena, especially within healthcare, and may inform an academic discourse in this area.

It is acknowledged that this case study does not seek to compare apprenticeships with other programmes. However, there is value in providing an academic narrative around the challenges of this provision which will be informative for others developing higher apprenticeships in the United Kingdom or similar delivery of apprenticeship models internationally.

There is value in providing an academic narrative around the challenges of this provision which will be informative for others developing higher apprenticeships in the UK or similar delivery of apprenticeship models internationally

These findings will be of interest to those entering into the apprenticeship arena, especially within healthcare, and will inform the academic discourse in this area.

This is original work and provides a new body of knowledge to the inform HEIs engaging with the relatively new context of higher and degree apprenticeships, as well as the new role within healthcare of the nursing associate.

In the UK healthcare sector, funding and provision of public care facilities has been primarily the responsibility of government through the National Health Service (NHS). After decades of under-investment and consequent effects on the quality of care, new procurement routes are currently being used to improve the standards of facilities to meet the requirements of modern care services. This paper critically reviews these new procurement routes in terms of concepts and suitable areas of application, and examines how the principal procurement methods have evolved into the forms used for UK healthcare facilities. The paper outlines recommendations for further research in assessing the suitability or otherwise of these new procurement methods, both for construction projects generally and specifically for healthcare facilities.