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Article
Publication date: 7 March 2019

Terry J. Boyle and Kieran Mervyn

Many nations are focussing on health care’s Triple Aim (quality, overall community health and reduced cost) with only moderate success. Traditional leadership learning…

Abstract

Purpose

Many nations are focussing on health care’s Triple Aim (quality, overall community health and reduced cost) with only moderate success. Traditional leadership learning programmes have been based on a taught curriculum, but the purpose of this paper is to demonstrate more modern approaches through procedures and tools.

Design/methodology/approach

This study evolved from grounded and activity theory foundations (using semi-structured interviews with ten senior healthcare executives and qualitative analysis) which describe obstructions to progress. The study began with the premise that quality and affordable health care are dependent upon collaborative innovation. The growth of new leaders goes from skills to procedures and tools, and from training to development.

Findings

This paper makes “frugal innovation” recommendations which while not costly in a financial sense, do have practical and social implications relating to the Triple Aim. The research also revealed largely externally driven health care systems under duress suffering from leadership shortages.

Research limitations/implications

The study centred primarily on one Canadian community health care services’ organisation. Since healthcare provision is place-based (contextual), the findings may not be universally applicable, maybe not even to an adjacent community.

Practical implications

The paper dismisses outdated views of the synonymity of leadership and management, while encouraging clinicians to assume leadership roles.

Originality/value

This paper demonstrates how health care leadership can be developed and sustained.

Details

Journal of Health Organization and Management, vol. 33 no. 2
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 28 January 2019

Kieran Mervyn, Nii Amoo and Rebecca Malby

Public sectors have responded to grand societal challenges by establishing collaboratives – new inter-organizational partnerships to secure better quality health services…

Abstract

Purpose

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.

Design/methodology/approach

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.

Findings

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.

Research limitations/implications

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.

Practical implications

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.

Social implications

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.

Originality/value

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

Details

International Journal of Organizational Analysis, vol. 27 no. 4
Type: Research Article
ISSN: 1934-8835

Keywords

Article
Publication date: 18 April 2019

Lawrence Charles Bellamy, Nii Amoo, Kieran Mervyn and Jacqueline Hiddlestone-Mumford

The purpose of this study is to examine the use of tools and techniques of strategy and strategic analysis within small- and medium-sized enterprises (SMEs) as a part of…

1633

Abstract

Purpose

The purpose of this study is to examine the use of tools and techniques of strategy and strategic analysis within small- and medium-sized enterprises (SMEs) as a part of the strategy formation process.

Design/methodology/approach

This study uses a qualitative, multiple-case-based investigation with semi-structured interviews and secondary data sources to create a context-rich insight to the area examined.

Findings

The findings indicate a strong orientation towards operational tools deployment aligned with financial management and resources and process planning, monitoring and control. Strategic perspectives of the respondents indicate an implicit, rather than explicit deployment of strategy tools and unstructured deployment, but general awareness of the resulting component issues. Clearer strategic approaches and strong implementation appear to positively influence success, when measured by growth.

Research limitations/implications

This study is limited to nine organisations within a UK geographic region, and therefore, larger-scale investigation would be beneficial to extend and confirm the findings in differing contexts.

Practical implications

With resource scarcity potentially stymying the opportunity for owner-managers to develop more structured approaches to strategic analysis and development, consideration should be given to how owner-managers can further develop their strategic thinking to support enhanced strategic outcomes for their organisations. Furthermore, strategy educationalists may wish to reflect upon the manner in which they prepare delegates for strategic roles, where the SME context may differ radically from corporate experience.

Originality/value

The methodology for this study differs substantially from previous investigations within the field, which has had relatively few contributions, as it uses in-depth, context-rich qualitative techniques to investigate the micro-processes at play. The conclusions capture new insights and indications and identify areas for further investigation, hence adding to the understanding of a complex and heterogeneous field.

Details

International Journal of Organizational Analysis, vol. 27 no. 2
Type: Research Article
ISSN: 1934-8835

Keywords

Article
Publication date: 19 September 2018

Rebecca Malby, Kieran Mervyn and Terry J. Boyle

The purpose of this paper is to review the impact of the clinical leadership programme, in enabling the Darzi fellows to lead change projects in health and care services…

Abstract

Purpose

The purpose of this paper is to review the impact of the clinical leadership programme, in enabling the Darzi fellows to lead change projects in health and care services, and to secure quality healthcare in the NHS beyond the lifetime of the programme.

Design/methodology/approach

A longitudinal empirical investigation of clinical leaders (n=80) over an eight-year period was framed through an activity theory (AT)-driven research methodology using a mixed-methods approach.

Findings

AT illuminated how change was sustained in the NHS in London through the Darzi Clinical Leadership Fellowship. By any reasonable measurement, this programme excels, with learning and positive behavioural change sustained after the Fellowship across the NHS. Further recognition is needed of the continuing development needs of fellows as they take on more responsible leadership roles in their careers.

Research limitations/implications

Darzi fellows are a hard-to-reach group. The sample represents a response rate of 34 per cent. In total, 77 per cent of respondents emanated from cohorts 5 to 8 programmes.

Practical implications

The investment in a clinical leadership programme focused on systems leadership for quality generates value for the NHS.

Social implications

Countless interventions flowed through London’s healthcare community and beyond as a result of the Fellowship. This research exposed how Darzi fellows continue to lead innovation for alternative healthcare outcomes. Many proactive fellows employ a suite of learned skills and capabilities to lead systemic change.

Originality/value

This research is the first known longitudinal clinical leadership development study undertaken. The Darzi programme has created a unique clinical network of mutually supportive, team-centric systems thinkers and doers, with an evidence-based approach to systems change. Many fellows are catalysing sustainable change in the healthcare environment.

Details

Journal of Health Organization and Management, vol. 32 no. 6
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 11 November 2013

Rebecca Malby, Kieran Mervyn and Luca Pirisi

The largest organisation in the western world, the UK National Health Service (NHS), might be best viewed as a network of interdependent organisations. However, the public…

Abstract

Purpose

The largest organisation in the western world, the UK National Health Service (NHS), might be best viewed as a network of interdependent organisations. However, the public has only recently begun to see it as a living network. Public reforms and financial crises have increased the need for professionals to innovate and improve their role. The overarching question is how this new clinical leadership can positively affect the functioning of the system and its performance. Therefore, the purpose of this paper is to clarify how leaders can be most effective in managing health networks.

Design/methodology/approach

A pragmatic approach was taken because of the topical and strategic importance of networks and leadership in the current climate, and hence a need for greater understanding of this largely unknown phenomenon. A focus group interview with Organisational Development experts from the Centre for Innovation and Health Management (CIHM) at Leeds University Business School was followed by three scoping reviews and high-level follow-up conversations with CIHM members, network leaders from the NHS and third sectors.

Findings

Issues that have emerged include: how networks are designed; which factors enhance its likelihood of success and predicate its failure; discussions of illuminating effective leadership.

Research limitations/implications

The Stories of Effective Leadership Networks were provided by the network founders, who may have sought to emphasise the benefits (as opposed to downside) of their network. An ideal scenario would have been the inclusion of patients and carers and perhaps administrative staff to reduce bias.

Originality/value

Considering the limited evidence base from the literature about medical leadership for network management, the involvement of network leaders and the ability to draw-upon CIHMs knowledge and expertise has been fundamental for determining lessons that may enhance the leadership function of the UK's health system network.

Details

The International Journal of Leadership in Public Services, vol. 9 no. 1/2
Type: Research Article
ISSN: 1747-9886

Keywords

Abstract

Details

Networks in Healthcare
Type: Book
ISBN: 978-1-78635-283-5

Article
Publication date: 26 July 2019

This paper aims to review the latest management developments across the globe and pinpoint practical implications from cutting-edge research and case studies.

349

Abstract

Purpose

This paper aims to review the latest management developments across the globe and pinpoint practical implications from cutting-edge research and case studies.

Design/methodology/approach

This briefing is prepared by an independent writer who adds their own impartial comments and places the articles in context.

Findings

Considerable awareness of strategic tools among UK SMEs is not reflected in the low usage levels that prevail. In addition, deployment is generally more for operational than strategic purposes. But if firms could overcome the formidable obstacle of resource scarcity and adopt a more structured approach, better exploitation of strategy tools and a focus oriented towards growth rather than mere survival would become possible.

Originality/value

The briefing saves busy executives and researchers hours of reading time by selecting only the very best, most pertinent information and presenting it in a condensed and easy-to-digest format.

Details

Strategic Direction, vol. 35 no. 9
Type: Research Article
ISSN: 0258-0543

Keywords

Content available
Article
Publication date: 18 April 2019

George Lodorfos

350

Abstract

Details

International Journal of Organizational Analysis, vol. 27 no. 2
Type: Research Article
ISSN: 1934-8835

Article
Publication date: 1 June 1986

Endecotts manufacturers and suppliers of industrial test sieves, are taking advantage of their position by displaying the Kitemark on sieves produced to the British Standard.

Abstract

Endecotts manufacturers and suppliers of industrial test sieves, are taking advantage of their position by displaying the Kitemark on sieves produced to the British Standard.

Details

Pigment & Resin Technology, vol. 15 no. 6
Type: Research Article
ISSN: 0369-9420

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