Using an implementation science approach to build leader facilitation capability in healthcare: a novel approach for enhancing action learning set facilitation

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Jodie Shoobridge ◽  
Tim Schultz ◽  
Gill Harvey ◽  
Neil Kirby
Keyword(s):  
Health Services ◽  
Implementation Science ◽  
Action Learning ◽  
Organisational Change ◽  
Implementation Framework ◽  
Research Implementation ◽  
Content Type ◽  
Learning Set ◽  
Services Implementation ◽  
Learning Sets

PurposeThe study describes the implementation of a novel strategy, entitled the Action Learning Set Facilitation Model, to develop internal facilitation capability to lead change. The Model incorporated the Novice-Experienced-Expert pathway, a facilitation development approach underpinning the integrated-Promoting Action on Research Implementation in Health Services Implementation Framework, with action learning methodology.Design/methodology/approachA mixed-methods descriptive approach reports the results of 22 interviews, 182 Action Learning Sets and 159 post program survey data sets to explore facilitator experiences, strengths and potential application of the Model.FindingsAt program completion, five novice (of 174) and one experienced (of 27) facilitator transitioned to the next facilitation level. The three groups of facilitators described positive change in confidence and facilitation skill, and experience of action learning sets. Inconsistencies between self-report competence and observed practice amongst novices was reported. Novices had decreasing exposure to the Model due to factors related to ongoing organisational change. Internal facilitators were considered trusted and credible facilitators.Research limitations/implicationsThere are practical and resource implications in investing in internal facilitation capability, noting proposed and real benefits of similar development programs may be compromised during, or as a consequence of organisational change. Further research describing application of the facilitation model, strategies to enhance multisystemic support for programs and evaluation support are suggested.Practical implicationsThe Action Learning Set Facilitation Model offers promise in developing internal facilitation capability supporting change in organisations. Critical success factors include building broad scale internal capability, stable leadership and longitudinal support to embed practice.Originality/valueThis is the first application of the facilitation component of the integrated-Promoting Action on Research Implementation in Health Services implementation framework embedded to action learning sets as an implementation science strategy for leader development supporting organisational change.

Developing organizations: a system of enquiry, action and learning

2017 ◽  
Vol 31 (1) ◽  
pp. 12-14
Author(s):  
Wayne Graham
Keyword(s):  
Health Services ◽  
Small Business ◽  
Organizational Development ◽  
Design Methodology ◽  
Action Learning ◽  
Organizational Outcomes ◽  
Business Owners ◽  
Content Type ◽  
Business Practitioners ◽  
Practical Implications

Purpose This paper aims to demonstrate the applicability of an action learning model to improve organizational outcomes. Design/methodology/approach This paper extends previous work by applying the system of enquiry, action and learning (SEAL) model using an action research methodology to a small business operating in the health services industry. Findings The SEAL model is a useful approach to introduce small business practitioners to the principles of organizational development (OD). Research limitations/implications The application is limited to one small business, and subsequent studies could apply the model to more organizations that operate in industries other than health services. Practical implications Business owners from this study and previous studies have found the model to be useful in the improvement of organizational outcomes. Originality/value The SEAL model is a simplified model that introduces principles of OD and has provided value to the business owners of this study.

scholarly journals Action learning: understanding interpersonal relationships within learning sets

2013 ◽  
Vol 32 (9) ◽  
pp. 984-994 ◽  
Author(s):  
Annie Yeadon-Lee
Keyword(s):  
Interpersonal Relationships ◽  
Action Learning ◽  
Master Of Business Administration ◽  
Student Experiences ◽  
Content Type ◽  
Participant Satisfaction ◽  
Business Administration Students ◽  
Part Time ◽  
Open Coding ◽  
Learning Sets

Purpose – The purpose of this paper is to respond to calls for research into the use of action learning in management education (Hay, 2011). It reports on student experiences of action learning in a final year module for part time Master of Business Administration students. It focuses specifically on the development of an understanding of the interpersonal relationships that existed within those action learning sets; both positive and negative. The paper then discusses the subsequent impact those dynamics may have on the effectiveness of the action learning process. Design/methodology/approach – An interpretivist philosophy underpins the research framework adopted in this paper. Data were captured by means of semi-structured questionnaires distributed at both the beginning and end of the module. The data were thematically analysed using open coding. Findings – The paper used two contrasting views of the interpersonal relationships in action learning sets: Revans’ (1982) “comrades in adversity” and Vince's (2004) “adversaries in commonality” as a framework for discussion. It found that various interpersonal dynamics existed within the sets, which in this case, had the ability to influence individual satisfaction and the overall effectiveness of the set. Originality/value – The findings provide insights, via participant voice, into aspects of interpersonal relationships within action learning sets. In particular, the politics and emotions that occur within the learning sets, whilst considering the subsequent impact on both participant satisfaction and the effectiveness of action learning sets.

Using action learning sets to support change in end-of-life care

2017 ◽  
Vol 30 (2) ◽  
pp. 184-193 ◽  
Author(s):  
Karen Gillett ◽  
Liz Reed ◽  
Liz Bryan
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Action Learning ◽  
Care Staff ◽  
Life Care ◽  
Specialist Palliative Care ◽  
Content Type ◽  
Integral Component ◽  
Learning Sets

Purpose The purpose of this paper is to describe the delivery of facilitated action learning sets as an integral component of a multidisciplinary end-of-life care course. Design/methodology/approach The educational intervention described in this paper is delivered by specialist palliative care practitioners to those working with dying patients and their families in non-specialist settings. The programme consists of two components: the first taught/experience-based component takes place in a hospice. The second integral component involves action learning sets which are facilitated by specialist palliative care staff over a six-month period. This paper reports the challenges, learning and benefits of using action learning sets to improve end-of-life care. Findings Action learning sets provide support which enables staff to implement changes to end-of-life care. Participants in the successful action learning sets were motivated to change practice and identified themselves as change agents. Management support was vital to allow participants the authority to implement changes to practice. Practical implications Facilitators need to gain participant and management commitment to the action learning process before the programme begins if they are to be successful in achieving changes to end-of-life care. Originality/value Hospices and other health care organisations work in partnership to deliver this programme, and this paper demonstrates how action learning sets can increase mutual understanding and communication between specialist and non-specialist end-of-life care settings.

Using action learning to reduce health inequity in Danish municipalities

2017 ◽  
Vol 30 (2) ◽  
pp. 194-207 ◽  
Author(s):  
Anna Paldam Folker ◽  
Sigurd Lauridsen
Keyword(s):  
Health Services ◽  
Social Service ◽  
Action Learning ◽  
Health Inequity ◽  
Front Line ◽  
Content Type ◽  
Disadvantaged Groups ◽  
Line Staff ◽  
Socially Disadvantaged ◽  
Municipal Health

Purpose The aim of this study is to clarify how action learning can be used as a vehicle for promoting equal access to municipal health services for socially disadvantaged groups in a Danish context. It is the purpose of this paper to describe the methods for reducing health inequity developed in the study and to discuss how action learning methodologically contributed to achieving these results. Design/methodology/approach In the study, the front-line staff from 19 health and social service units in six different municipalities, in Denmark, each formed an action learning group to develop methods for reducing health inequity in a municipal health setting. Each group was guided by an external facilitator, according to an Action Learning Action Research phase model (ALAR-model), which structured the cyclical development of methods into four phases: diagnosing, planning action, taking action and evaluating action. Findings Two types of results of the study are reported in the paper. First, the authors present an overview of the results the 19 participating municipal units have achieved in their action learning processes, as well as two case examples of how two units have worked with action learning and the concrete methods and tools they have developed in this process. Second, they report the challenges and dilemmas the 19 units faced when working with action learning in the study. Originality/value With its use of action learning techniques and the ALAR-model, this study contributes to the development of practice-based methods to reduce unequal access to municipal health services for socially disadvantaged groups. Through the study, the front-line staff in the health and social service units has been involved in the problem-solving process, to a much greater extent than it has previously been adopted in a Danish municipal health setting.

Organizational learning in shop floor level

2016 ◽  
Vol 23 (5) ◽  
pp. 274-298 ◽  
Author(s):  
Che Keung Cheung ◽  
Shuang Geng ◽  
Kong Bieng Chuah ◽  
Yiu Chung Chau ◽  
Kar Fai Kwong
Keyword(s):  
Organizational Learning ◽  
Action Learning ◽  
Performance Measure ◽  
Fine Tuning ◽  
Shop Floor ◽  
Implementation Framework ◽  
Content Type ◽  
Floor Level ◽  
Pilot Implementation ◽  
And Performance

Purpose This paper aims to present the result of the pilot run of a research project which aims at evaluating the applicability of project-based action learning (PAL) to shop floor organizational learning (OL) component in a manufacturing company in Dongguan, China. How the PAL framework was introduced and implemented is described. The factors that influence PAL implementation are examined in this pilot implementation. The implications and effectiveness are discussed. The findings shed light on the modifications needed in the PAL framework for shop floor implementation. Design/methodology/approach This is a longitudinal case research which is conducted in a case company (APT) located in Dongguan, China. PAL framework was introduced and implemented in APT. A wave-like approach was used to repeat launching PAL projects in cycles. Data of learning and work performances were collected for review during each phase and each cycle of the project. The result presented here is from the early round of the pilot PAL implementation. Findings Result indicated that the PAL framework is applicable in the shop floor level OL. Learning and performance have been found to have improved in all the PAL groups participating in the pilot run. Result also shows that the PAL implementation framework needs some fine tuning to meet the needs of the unique shop floor environment particularly with regard to performance measure and evaluation. Originality/value No such case study has been conducted in shop floor level before. The research study will be valuable experience and example for other organizations to implement OL in shop floor level.

scholarly journals Impact of organisational change for leaders in mental health

2018 ◽  
Vol 32 (8) ◽  
pp. 980-1001 ◽  
Author(s):  
Timmy Frawley ◽  
Annabel Meehan ◽  
Aoife De Brún
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Ad Hoc ◽  
Organisational Change ◽  
Evidence Base ◽  
Quality And Safety ◽  
Structured Interviews ◽  
Content Type ◽  
The Impact

Purpose The purpose of this paper is to examine the impact of organisational and structural change on the evolution of quality and safety in health organisations, specifically in mental health services. Design/methodology/approach Data were gathered through semi-structured interviews. In total, 25 executive management team members in both public and private mental health services were interviewed and data were analysed using Burnard’s framework. Findings Three overarching themes emerged: organisational characteristics, leadership and accountability; sustaining collaboration and engagement with stakeholders; and challenges to and facilitators of quality and safety. Taken together, the findings speak to the disruptive and disorienting impact of on-going organisational change and restructuring on leaders’ ability to focus on, and advance, the quality and safety agenda. Research limitations/implications Typical with qualitative research of this nature, the potentially limited generalisability of the findings must be acknowledged. Practical implications There is a need for strategies to implement change that are informed by evidence and theory and informed by decades of research on this topic, rather than introduced ad hoc. Change agents must pair effective change management and implementation science strategies to specific contexts, depending on what is being implemented and ensure appropriate evaluation of organisational change to bolster the evidence base around quality and safety and inform future decision-making. Originality/value The study explores an identified gap in the literature on the impact of on-going organisational re-structuring and transformation on the evolution of quality and safety in mental health services.

scholarly journals Pedagogy and Process in 'Organisational Problem-Solving'

10.28945/2984 ◽  
2006 ◽  
Author(s):  
John Paul Kawalek
Keyword(s):  
Problem Solving ◽  
Organisational Change ◽  
Critical Reflexivity ◽  
Tightly Coupled ◽  
Learning Set ◽  
Organisational Problem ◽  
And Performance ◽  
Development Objectives ◽  
Learning Sets ◽  
The Way

This paper outlines a case study in which a management development learning process was tightly coupled to organisational change and development objectives. The case discusses how a research and consulting team came together to develop highly reflexive pedagogy to support the work of internal managers who were organised into teams (‘learning sets’ of sorts, but which came to be known as 'ThinkTanks'). These were to undertake ‘organisational problem solving’, which involved the integration of various inquiring activities. These learning sets had as their objective, to help members become catalysts of organisational change and performance improvement within a large organisation, applying the inquiring principles. In order to structure the discourse amongst learning set members, a range of principles and constructs were used. Central to these was a form of process modelling, (termed ‘models of teleological human process’). These were carefully introduced to learning set members, and were used to provide a ‘basis for a discourse’ amongst set members about problematic organisational processes and how to change them. These were based on system theory, in a particular form, in which models were used as a component of inquiry into current and future processes, rather than to 'specify' a given process, in an absolute sense. The inquiring activities were facilitated by 'Set Advisers', whose role it was to keep the set focused on learning outcomes, and to encourage critical reflexivity in the process. Thus members were encouraged to 'think about the way they were thinking about action', which gave a much more dynamic intellectual basis for the learning set's activities. It also enabled a rich analytical discourse, in which members were expected to justify their perceptions rather than make assertions, or 'defend assertions'. The researchers were genuinely surprised by the way the set members were able to undertake this, and indeed, on reflection, how set members felt 'liberated' by the approach taken.

scholarly journals The utility of the implementation science framework “Integrated Promoting Action on Research Implementation in Health Services” (i-PARIHS) and the facilitator role for introducing patient-reported outcome measures (PROMs) in a medical oncology outpatient department

2020 ◽  
Author(s):  
Natasha A. Roberts ◽  
◽  
Monika Janda ◽  
Angela M. Stover ◽  
Kimberly E. Alexander ◽  
...  
Keyword(s):  
Health Services ◽  
Implementation Science ◽  
Outcome Measures ◽  
Medical Oncology ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Research Implementation ◽  
Patient Reported ◽  
Parihs Framework ◽  
Science Framework

Abstract Purpose We evaluated the utility of the implementation science framework “Integrated Promoting Action on Research Implementation in Health Services” (i-PARIHS) for introducing patient-reported outcome measures (PROMs) into a medical oncology outpatient department. The i-PARIHS framework identifies four core constructs for implementation, including Facilitation, Innovation, Context and Recipients. Methods A pilot study used the i-PARIHS framework to identify PROM implementation barriers and enablers to inform facilitation support strategies, such as training clinicians and staff, workflow support, technical support and audit and feedback. Pre- and post-implementation surveys were completed by 83 and 72 staff, respectively, (nurses, doctors and allied health), to assess perceived knowledge, enablers, barriers and utility of PROMs; and acceptability of the PROM intervention was also assessed post-implementation. Results Important barriers included time constraints and previous experiences with technology. Enablers included good leadership support and a culture of learning. Facilitation strategies were used to overcome barriers identified in the i-PARIHS core domains. Compared to before the intervention, staff surveys showed improvement in perceived usefulness, perceived understanding and interpretation skills for PROMs. Staff perceptions about lack of time to use PROMs during visits remained a major perceived barrier post-implementation. Conclusion The i-PARIHS framework was useful for guiding the implementation of PROMs in routine oncology care. The four core i-PARIHS constructs (Facilitation, Innovation, Context and Recipients) identified factors that directly impacted implementation, with Facilitation having a particularly important role to overcome these barriers. Oncology clinics and health systems considering implementing PROMs should consider having a dedicated Facilitator available during PROM implementation.

scholarly journals A conceptual framework for work-applied learning for developing managers as practitioner researchers

2017 ◽  
Vol 7 (1) ◽  
pp. 35-50 ◽  
Author(s):  
Ortrun Zuber-Skerritt ◽  
Selva Abraham
Keyword(s):  
Research And Development ◽  
Conceptual Framework ◽  
Role Models ◽  
Action Learning ◽  
Organisational Change ◽  
Research Paradigm ◽  
Cognitive Approach ◽  
Applied Learning ◽  
Extensive Experience ◽  
Content Type

Purpose The purpose of this paper is to introduce a conceptual framework for work-applied learning (WAL) that fosters the development of managers and other professionals as lifelong learners and practitioner researchers – through reflective practice, action research, action learning and action leadership, for positive organisational change. Design/methodology/approach The theoretical framework is designed from a holistic, affective-socio-cognitive approach to learning, teaching, research and development. It is based on a phenomenological research paradigm and informed by aspects of various theories, including experiential learning theory, strengths-based theory, grounded theory and critical theory/realism. Findings Based on classical and recent literature and the authors’ extensive experience, the WAL model presented here is an effective and practical approach to management education, research and development. It is useful for present and future requirements of business, industry, government and society at large in this twenty-first century, and in pursuit of a world of equality, social justice, sustainable development and quality of life for all. This is because of the nature of the research paradigm, particularly its collaborative and emancipatory processes. Originality/value This paper provides a theoretical, pedagogical and methodological rationalisation for WAL. This model is particularly useful for developing individual, team and organisational learning and for cultivating managers – or professional learners generally – as practitioner researchers. These researchers may act as role models of collaborative action leadership in their organisations with a cascading effect. This paper therefore advances an incipient literature on practitioner researchers as action leaders.

Implementation of the Australasian Teletrial Model: Translating idea into action using implementation science frameworks

2021 ◽  
pp. 1357633X2110178
Author(s):  
Sabe Sabesan ◽  
Marie Malica ◽  
Chantal Gebbie ◽  
Clare Scott ◽  
David Thomas ◽  
...  
Keyword(s):  
Implementation Science ◽  
Pilot Project ◽  
Final Report ◽  
Rare Cancer ◽  
Government Investment ◽  
Implementation Framework ◽  
Advisory Groups ◽  
Regulatory Systems ◽  
Key Stakeholders ◽  
Strategic Implementation

Background: Despite Government investment, disparity in access to clinical trials continue between metropolitan and regional & rural sectors (RRR) in Australia and around the world. To improve trial access closer to home for RRR communities and rare cancer patients even in metro settings, the Australasian Teletrial Model (ATM) was developed by Clinical Oncology Society of Australia and implemented in four states. Aim of this paper is to describe the steps and processes involved in the development and implementation of ATM guided by implementation science frameworks. Method: Two implementation science frameworks namely iPARIHS and Strategic Implementation Framework were chosen to guide the project. Details of steps and processes were extracted from COSA final report. Results: ATM met the criteria for worthy innovation. For the development and implementation of the ATM, stakeholders were at national, statewide and clinical levels. A co-design with end-users and inclusion of key stakeholders in steering committees and advisory groups made the implementation smoother. Clinician levers including advocacy were useful to overcome system barriers. During the project, more patients, and clinicians at RRR participated in trials, more primary sites collaborated with RRR sites and more RRR sites gained trial capabilities. Conclusion: Pilot project achieved its objectives including improved access to patients locally, creation of linkages between metro and RRR sites and enhanced capabilities of and access to RRR sites. Implementation science frameworks were useful for identifying the necessary steps and processes at the outset. Ownership by governments and creation of streamlined regulatory systems would enable broader adoption.

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