scholarly journals Merger and post-merger integration at Oxford University Hospitals: mixed-methods evaluation and lessons learned

2022 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Edward John Maile ◽  
Mahima Mitra ◽  
Pavel Ovseiko ◽  
Sue Dopson
Keyword(s):  
United Kingdom ◽  
Mixed Methods ◽  
Qualitative Data ◽  
Single Case ◽  
Hospital Setting ◽  
Lessons Learned ◽  
University Hospital ◽  
University Hospitals ◽  
Content Type

Purpose Hospital mergers are common in the United Kingdom and internationally. However, mergers rarely achieve their intended benefits and are often damaging. This study builds on existing literature by presenting a case study evaluating a merger of two hospitals in Oxford, United Kingdom with three distinct characteristics: merger between two university hospitals, merger between a generalist and specialist hospital and merger between two hospitals of differing size. In doing so, the study draws practical lessons for other healthcare organisations.Design/methodology/approach Mixed-methods single-case evaluation. Qualitative data from 19 individual interviews and three focus groups were analysed thematically, using constant comparison to synthesise and interpret findings. Qualitative data were triangulated with quantitative clinical and financial data. To maximise research value, the study was co-created with practitioners.Findings The merger was a relative success with mixed improvement in clinical performance and strong improvement in financial and organisational performance. The merged organisation received an improved inspection rating, became debt-free and achieved Foundation Trust status. The study draws six lessons relating to the contingencies that can make mergers a success: (1) Develop a strong clinical rationale, (2) Communicate the change strategy widely and early, (3) Increase engagement and collaboration at all levels, (4) Be transparent and realistic about the costs and benefits, (5) Be sensitive to the feelings of the other organisation and (6) Integrate different organizational cultures effectively.Originality/value This case study provides empirical evidence on the outcome of merger in a university hospital setting. Despite the relatively positive outcome, there is no strong evidence that the benefits could not have been achieved without merger. Given that mergers remain prevalent worldwide, the practical lessons might be useful for other healthcare organisations considering merger.

Appraising clever people: lessons from introducing performance reviews for academics in a UK University

2015 ◽  
Vol 47 (2) ◽  
pp. 81-85 ◽  
Author(s):  
Hedda Bird
Keyword(s):  
Performance Management ◽  
Single Case ◽  
Lessons Learned ◽  
Content Type ◽  
Performance Review ◽  
Highly Educated ◽  
Performance Reviews ◽  
Practical Challenge ◽  
Set Up

Purpose – The purpose of this paper is to build understanding of how to engage a highly educated workforce with the benefits of performance management through sharing the lessons learned from introducing performance reviews (appraisals) into an academic environment. Design/methodology/approach – The paper presents a case study of a four-year programme in a UK higher education establishment. The author was closely involved in the last two years of the programme, and completed a detailed evaluation of the programme for the client. Findings – Performance management creates significant value within a highly educated workforce through bringing together individual capability and expertise to focus on delivering the strategy. Obstacles to success such as routine complaints of “time-wasting” and “pointlessness” can be overcome by wide and deep engagement with employees throughout the design and development of the approach. Research limitations/implications – This is a single case study; however, the author has worked on many similar programmes with highly educated work forces with very similar results. Practical implications – The vast majority of staff positively want a high-quality performance review; the practical challenge is to channel this desire into shared ownership and responsibility for the success of performance review in practice. Originality/value – Literature abounds with analysis of what is wrong with performance review, this paper is a rarer piece in that it develops our understanding of how to set up performance management and review for success.

Application of Lean Six Sigma in conservative dentistry: an action research at an Indian dental college

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Ajay Noronha ◽  
Shreeranga Bhat ◽  
E.V. Gijo ◽  
Jiju Antony ◽  
Suma Bhat
Keyword(s):  
Action Research ◽  
Six Sigma ◽  
Single Case ◽  
Lean Six Sigma ◽  
Lessons Learned ◽  
Healthcare Sector ◽  
Content Type ◽  
Conservative Dentistry ◽  
Tools And Techniques

PurposeThe article evaluates the obstacles, lessons learned and managerial implications of deploying Lean Six Sigma (LSS) in a dental college hospital in India.Design/methodology/approachThe work adopts the action research (AR) methodology to establish a case study, which is carried out using the LSS define–measure–analyze–improve–control (DAMIC) approach in a dental college. It uses LSS tools to enhance the productivity and performance of the Conservative Dentistry Department of a dental college and to unravel the obstacles and success factors in applying it to the education and healthcare sector together.FindingsThe root cause for high turn-around time (TAT) is ascertained using LSS tools and techniques. The effective deployment of the solutions to the root causes of variation assists the dental college to reduce the TAT of the Conservative Dentistry process from an average of 63.9 min–36.5 min (i.e. 42.9% improvement), and the process Standard Deviation (SD) was reduced from 2.63 to 2 min. This, in turn, raises the sigma level from 0.48 to 3.23, a noteworthy successful story for this dental college.Research limitations/implicationsWhile the results and recommendations of this research are focused on a single case study, it is to be noted that the case study is carried out with new users of LSS tools and techniques, especially with the assistance of interns. This indicates the applicability of LSS in dental colleges; thus, the adopted modality can be further refined to fit India's education and hospital sector together.Originality/valueThis article explains the implementation of LSS from an aspiring user viewpoint to assist dental colleges and policymakers in improving competitiveness. In addition, the medical education sector can introduce an LSS course in the existing programme to leverage the potential of this methodology to bring synergy and collaborative research between data-based thinking and the medical field based on the findings of this study. The most important contribution of this article is the illustration of the design of experiments (DOE) in the dental college process.

Implementing the open-source Koha-ILS at the Deutsche Schule Charlotte

2016 ◽  
Vol 32 (4) ◽  
pp. 253-269 ◽  
Author(s):  
Martin D. House
Keyword(s):  
Open Source ◽  
Selection Process ◽  
Single Case ◽  
Good Alternative ◽  
Lessons Learned ◽  
Online Support ◽  
Successful Implementation ◽  
Web Based ◽  
Content Type

Purpose This study aims to present the successful implementation of the Koha-integrated library system (ILS) for libraries that seek an open-source alternative. This study is best suited for small libraries with limited collections and limited funding. The selection process between Koha and Evergreen is described, as is cataloging, patron setup and library workflow changes. Finally, lessons learned are presented. Design/methodology/approach This is a case study which describes the events as they occurred between 2013 and 2014. Findings The Koha-ILS appears to be the open-source system with the most online support, easiest to install and manage. Although the experience of libraries may vary, the Deutsche Schule Charlotte library took the pragmatic approach. Koha was chosen because it could be successfully installed, had an intuitive and web-based interface and could be easily explained to volunteers. Research limitations/implications This is a single case study at a very small library. Practical implications This study broadly demonstrates the requirements for implementing the Koha-ILS and how it can be accomplished even with library volunteers. Social implications The Koha-ILS can be a good alternative, despite limitations, for small libraries who need a robust ILS system with few bells and whistles. Originality/value This study presents a finite view of the implementation and use of the Koha-ILS. The physical setting, availability of capable volunteers and administration’s willingness to experiment with a system may not be reproducible in other locales.

scholarly journals Leveraging intellectual capital in developing countries: evidence from Kenya

2018 ◽  
Vol 19 (3) ◽  
pp. 562-580 ◽  
Author(s):  
Silvia Ferramosca ◽  
Alessandro Ghio
Keyword(s):  
Developing Countries ◽  
Mixed Methods ◽  
Intellectual Capital ◽  
Single Case ◽  
Local Level ◽  
Content Type ◽  
Positive Effects ◽  
High Degree ◽  
The Relationship

Purpose The purpose of this paper is to explore how organization’s resources and community aspects shape intellectual capital (IC) performance in developing countries. In fact, it is still unclear to what level organizational aggregation can influence forms of IC performance in the simultaneous presence of strong traditional legacy and eagerness for development. Design/methodology/approach The study is based on a project of aggregation of artists in Kenya. It uses a mixed methods approach. Findings The analysis first documents that multiple capital resources, i.e., human, social, and organizational contribute to improve IC performance. Social and organizational resources have the largest positive effects. This study then supports the importance of community aspects in fostering IC performance. In this light, it appears to facilitate knowledge interaction and interrelationship networks rather than accentuate possible pre-existing groups’ rivalry. Research limitations/implications The results are inferred from a single case study, and so the reader is given the caveat that the results cannot be easily generalized. The evidence gathered can represent a useful ground on which to build future studies comparing different legal, social, cultural, and economic contexts. Practical implications This study gathers insights on how organization’s resources can lead to IC performance in developing countries and in a setting characterized by a high degree of institutional complexity. It also addresses the call for more research on programs implemented at local level to leverage IC and to valorize traditional knowledge in a sustainable and concrete way. Originality/value Evidence on IC in developing countries is still scant, besides their potential for growth. This study attempts to address this gap. Moreover, it pays attention to the context by analyzing the community aspects. Finally, the use of mixed methods further validates previous evidence on the relationship between organization’s resources and IC performance.

scholarly journals Fun, inspiration and discovery: from momentary experiences to overall evaluations

2017 ◽  
Vol 29 (7) ◽  
pp. 1937-1955 ◽  
Author(s):  
Wei Liu ◽  
Beverley Sparks ◽  
Alexandra Coghlan
Keyword(s):  
Mixed Methods ◽  
Single Case ◽  
Customer Experience ◽  
Content Type ◽  
Mixed Methods Approach ◽  
Key Variables ◽  
The Relationship ◽  
Method Approach ◽  
Practical Implications

Purpose This paper aims to use a concurrent mixed method approach to explore the key variables that can influence customer experience at a food and wine event. Design/methodology/approach A concurrent mixed methods approach, using a participant-generated image (PGI) method, together with a recall survey, provided images with associated narratives, descriptive statistics, correlations and hierarchical multiple regression analysis to explore how attendees appraise their experiences based on their goals and the link between experience appraisals and overall evaluations. Findings Through the PGI method (N = 25), the authors determined that customer experience at the event could be viewed as a hierarchical model, comprising a fundamental sensory experience together with three higher-order customer experience components (fun, discovery and inspiration). A separate concurrent recall study (N = 598) demonstrated the relationship between the same four customer experience components and overall satisfaction as well as recommendation and repeat visitation. Practical implications The results suggest that to promote positive customer experiences, along with the product of the event itself, event managers should focus on activity programs that are fun, inspirational and novel, as well as sensory. Originality/value This study focuses on a single case study of an event to examine and extend our understanding of customer experience. The use of a concurrent mixed methods approach provides us with different types of data from two separate samples of participants. By integrating data from each study the authors are able to build a conceptual model of the salient dimensions of customer experience and then quantitatively analyze how these salient dimensions are related to outcome variables.

scholarly journals Albania vs Norway – FM at two university hospitals

Facilities ◽  
2017 ◽  
Vol 35 (7/8) ◽  
pp. 462-484
Author(s):  
Knut Boge ◽  
Anjola Aliaj
Keyword(s):  
Strong Support ◽  
University Hospital ◽  
Comparative Case Study ◽  
Facilities Management ◽  
University Hospitals ◽  
Content Type ◽  
Adequate Food ◽  
The University ◽  
House Production

PurposeGiven the premise of de facto universal standards for FM, this paper aims to investigate development of facilities management (FM) at an Albanian and a Norwegian university hospital through examination of two hypotheses: the university hospital has recognised FM and established a designated FM organisation (H1) and the university hospital provides adequate food and catering services at ward kitchens and buffets (H2). Design/methodology/approachThis is an exploratory and descriptive comparative case study based on a diverse cases’ designs. FindingsThere is limited and strong support for H1 at the Albanian and Norwegian university hospitals, respectively. Both the Albanian and the Norwegian university hospitals rely on in-house production of facilities services, but the Albanian university hospital has outsourced food and catering services. FM and provision of facilities services are deeply integrated within the Norwegian university hospital’s core activities. There is also limited and strong support for H2 at the Albanian and Norwegian university hospitals, respectively. Hence, the Albanian Ministry of Health and the Albanian university hospital’s top management have a comprehensive, but not impossible, task, if the aim is to catch up with the Norwegian university hospital concerning FM. Research limitations/implicationsThis is an exploratory and descriptive comparative case study. Large N studies should be carried out both in Albania and Norway and preferably also in other countries to corroborate and develop the findings. Originality/valueThis is the first comparative study of FM at an Albanian and a Norwegian university hospital.

A practical framework for achieving value creation and capture in healthcare through process improvement

2022 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Jane Evans ◽  
Sandra Leggat ◽  
Danny Samson
Keyword(s):  
Conceptual Framework ◽  
Process Improvement ◽  
Single Case ◽  
Hospital Setting ◽  
Current Approach ◽  
Single Case Study ◽  
Hospital System ◽  
Content Type ◽  
Financial Benefits

PurposeThe 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.Design/methodology/approachA 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.FindingsThe 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.Practical implicationsThe 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).Originality/valueThis is the first paper to examine and enhance an existing framework to assist hospitals balance cost and quality through PI.

scholarly journals Managing a variable acute patient flow – categorising the strategies

2015 ◽  
Vol 20 (2) ◽  
pp. 113-127 ◽  
Author(s):  
Olle Olsson ◽  
Håkan Aronsson
Keyword(s):  
Single Case ◽  
Patient Flow ◽  
University Hospital ◽  
Future Research ◽  
Content Type ◽  
Acute Patient ◽  
Proactive Measures ◽  
Practical Implications ◽  
Empirical Generalisation

Purpose – This paper aims to explore if actions used at a hospital to manage a variable acute patient flow can be categorised using the concepts of lean, agile and leagile. Design/methodology/approach – Empirical evidence from a university hospital was gathered by interviews, internal documents, shadowing and participation in meetings. Identified actions used at both hospital level and departmental level are categorised as lean or agile, while combinations of actions are compared with different leagile approaches. Findings – Actions from every lean and agile category derived from literature are used at the hospital, however in varying extent. Many agile actions are reactive, indicating a lack of proactive measures. Actions that directly manage external variation are also few in numbers. Leagile approaches of all three combinations derived from literature are also used at the hospital. Research limitations/implications – As a single-case study is used, empirical generalisation to other hospitals cannot be deduced. Future research assessing the appropriateness of different actions for managing a variable acute patient flow is encouraged. Practical implications – The use of actions within both lean and agile categories indicate the possibility of combining these process strategies in hospitals, and not only focusing on implementing lean. By cleverly combining lean and agile actions, leagile approaches can be formed. Originality/value – The use of lean in health care has been a topic of research, while the use of agile has been sparsely researched, as well as the combination of the two.

scholarly journals The importance of university, students and students’ union partnerships in student-led projects

2019 ◽  
Vol 20 (8) ◽  
pp. 1409-1427 ◽  
Author(s):  
Sarah Jayne Briggs ◽  
Zoe P. Robinson ◽  
Rachel Louise Hadley ◽  
Rebecca Laycock Pedersen
Keyword(s):  
Qualitative Data ◽  
Single Case ◽  
Learning Opportunities ◽  
Change Agency ◽  
Single Institution ◽  
Content Type ◽  
Units Of Analysis ◽  
Key Staff ◽  
The University

Purpose This paper aims to explore a single-institution case study of partnership working between students, the University and Students’ Union, through four student-led sustainability projects. The paper analyses the role and value of these partnerships and provides advice for other institutions on effective partnership working between these stakeholders. Design/methodology/approach A single case study of partnership working with multiple embedded units of analysis (four projects) is presented based on reflections of practitioners involved in the projects who have different roles within the University and Students’ Union. Findings The longevity and effectiveness of student-led projects, and disciplinary-breadth of students engaged, can be enhanced by greater collaboration with, and integration into, University and Students’ Union systems. Partnership working between different stakeholders is key to overcoming challenges and the success of student-led projects, helped by key staff “enablers”. These projects provide myriad learning opportunities for developing change agency skills, even where projects are relatively short-lived and could be seen as failures in terms of longevity. Research limitations/implications This analysis is based solely on practitioner reflections, with limited direct quantification or qualitative data on the projects’ impacts on the students themselves. Originality/value This paper draws together the experiences and reflections of four practitioners with different roles within the University and Students’ Union across four different projects and provides advice to generate student-led sustainability projects which have longevity and impact for wider student populations and future generations of cohorts.

The implementation of dynamic capabilities for small and medium-sized enterprises in creating innovation

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Adya Hermawati ◽  
Eden Gunawan
Keyword(s):  
Design Methodology ◽  
Qualitative Data ◽  
Dynamic Capabilities ◽  
Single Case ◽  
Group Discussion ◽  
Future Research ◽  
Cross Sectional ◽  
Content Type ◽  
Collection Methods

Purpose The purpose of this paper is to analyse the adaptation process of small and medium-sized enterprises (SMEs) to volatile environment supported with learning, knowledge and innovation. Design/methodology/approach This study used an inductive approach to analyse qualitative data obtained from an SME operating in the international market. Various data collection methods, including interview, focus group discussion and observation, were used to allow the researchers to undertake triangulation. Findings This study demonstrates that managers should be eager to adjust their innovation to a changing environment and continually update pre-determined plans. Learning is an ongoing process required for innovation, requiring up-to-date support from knowledge produced via learning. For this reason, learning is required in all dynamic capability processes. Research limitations/implications The single case study design offers deep and detailed insights regarding the process of how firms create innovation based on learning in an uncertain environment. Future research could investigate whether the findings of this study are generalisable using a large number of subjects and a cross-sectional method. Originality/value This study offers insight to relatively empirical evidence on how firms respond and adjust to volatile environment using an integrative perspective covering learning, knowledge and innovation. In addition, this offers insight regarding how knowledge can be developed based on learning from the environment and converted into innovation through dynamic capabilities.

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