Organisational intelligence and successful change in NHS organisations

2020 ◽  
Vol 26 (3) ◽  
pp. 78-83
Author(s):  
Alastair Beattie ◽  
Birju Bartoli
Keyword(s):  
Emergency Department ◽  
Systems Thinking ◽  
Organisational Change ◽  
Electronic System ◽  
Venn Diagram ◽  
Clinical Model ◽  
Change Projects ◽  
Multidisciplinary Group ◽  
Successful Change

Change or transformation projects within the NHS can range from an extensive organisational change, such as a new clinical model, to altered clinical processes or even the development and implementation of a new IT system. However, it is common for such projects to fail. The authors of this article used both experience and multidisciplinary group reflection to produce a Venn diagram showing the interactions between three ‘intelligences’ – intellectual, emotional and organisational – and why the use of all three together is essential to successful change projects. Organisational intelligence is not easy to define; it is something that successful systems-thinking people ‘just get’ after they have worked in their organisation for a while. This article describes what is meant by this term, provides a checklist which others may find helpful and outlines an example involving the implementation of an electronic system for triage and observations in a large emergency department.

scholarly journals Management of transient loss of consciousness of suspected syncopal cause, after the initial evaluation in the Emergency Department

2016 ◽  
Vol 1 (1) ◽  
Author(s):  
Ivo Casagranda ◽  
Michele Brignole ◽  
Simone Cencetti ◽  
Gianfranco Cervellin ◽  
Giorgio Costantino ◽  
...  
Keyword(s):  
Emergency Department ◽  
Initial Evaluation ◽  
Loss Of Consciousness ◽  
Transient Loss Of Consciousness ◽  
Risk Levels ◽  
Risk Patients ◽  
Life Threatening ◽  
Transient Loss ◽  
Multidisciplinary Group ◽  
Diagnostic Investigations

The recommendations enclosed in the present document have been developed by a group of experts appointed by the <em>Gruppo Multidisciplinare per lo Studio della Sincope</em> (Multidisciplinary Group for the Study of Syncope; GIMSI) and Academy of Emergency Medicine and Care (AcEMC). The aim is to define the diagnostic pathway and the management of patients referred to the Emergency Department (ED) for transient loss of consciousness of suspected syncopal cause, which is still unexplained after the initial evaluation. The risk stratification enables the physician to admit, discharge or monitor shortly the patient in the intensive short-stay Syncope Observation Unit (SOU). There are three risk levels of life-threatening events or serious complications (low, moderate, high). Low risk patients can be discharged, while high risk ones should be monitored and treated properly in case of worsening. Moderate risk patients should undergo clinical and instrumental monitoring in SOU, inside the ED. In all these three cases, patients can be subsequently referred to the Syncope Unit for further diagnostic investigations.

scholarly journals Project managers’ and change managers’ contribution to success

2016 ◽  
Vol 9 (2) ◽  
pp. 451-465 ◽  
Author(s):  
Julien Pollack ◽  
Chivonne Algeo
Keyword(s):  
Critical Success Factors ◽  
Online Survey ◽  
Success Factors ◽  
Organisational Change ◽  
Project Managers ◽  
Content Type ◽  
Critical Success ◽  
Project Risks ◽  
Change Projects ◽  
Specific Project

Purpose – Many projects involve an organisational change component. Project management (PM) and change management (CM) have the potential to jointly contribute to the delivery of organisational changes. However, there is a lack of clarity in the literature about the boundary and relationship between these disciplines. The purpose of this paper is to explore the contribution these disciplines make to a set of project critical success factors, to understand the ways that these disciplines can most effectively work together. Design/methodology/approach – This paper analyses data collected through an online survey, examining project managers’ and change managers’ perception of each disciplines’ contribution to critical success factors. The survey received 455 responses. Findings – This paper identifies the success factors that are most clearly influenced by PM and CM, and areas where practitioners of these disciplines hold significantly different perceptions of their contributions. The results have been used to rank and categorise success factors based on the influence of each discipline. This has been used to develop a risk-based questionnaire to guide the contribution of PM and CM to the mitigation of specific project risks. Originality/value – These findings will be of use to practitioners managing organisational change projects, or projects with a significant change component. The findings will be of assistance in determining the ways in which these disciplines should work together to mitigate risks associated with specific critical success factors.

Effect of an Emergency Department–Based Electronic System for Musculoskeletal Consultation on Facilitating Care for Common Injuries

Orthopedics ◽  
2015 ◽  
Vol 38 (5) ◽  
pp. e407-e410 ◽  
Author(s):  
Simon C. Mears ◽  
Hardin A. Pantle ◽  
Edward S. Bessman ◽  
Scott D. Lifchez
Keyword(s):  
Emergency Department ◽  
Electronic System

Design artefacts as flexible and persuasive tools for customer-centric innovation

2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Jochen SCHWEITZER ◽  
Jacqueline (Jax) WECHSLER
Keyword(s):  
Organisational Change ◽  
Business Value ◽  
The Social ◽  
Innovation Strategies ◽  
Innovation Practices ◽  
Successful Change ◽  
Innovation Processes

More organisations are adopting customer-centric innovation practices to increase business value; however, very little is known about the factors driving customer-centric innovation or the conditions under which innovation succeeds. Similarly, very little is known about the role of design artefacts as inputs in customer-centric innovation processes or as instruments that support the organisational change required for successful change. A practice-led case study was conducted to examine the role of design artefacts and to demonstrate how they are flexible and persuasive tools that mediate the social and intertwined demands of customer-centric innovation strategies. Five distinct roles of design artefacts are proposed and their value in contributing to innovation and organisational change are considered.

scholarly journals Managing people and learning in organisational change projects

2017 ◽  
Vol 30 (6) ◽  
pp. 923-935 ◽  
Author(s):  
David Shaw
Keyword(s):  
Design Methodology ◽  
Management Practices ◽  
Organisational Change ◽  
Organisational Learning ◽  
Sense Making ◽  
Content Type ◽  
Project Outcomes ◽  
New Ideas ◽  
Change Projects ◽  
Internal Sense

Purpose The purpose of this paper is to assess the influence of people management practices on the outcomes of organisational change projects through their contributions to organisational learning. The contributions to their outcomes of particular corporate and project-specific people management practices are considered. Design/methodology/approach Case studies of two organisational change projects undertaken by Arts Council England during 2006-2007 are used to examine how far and in what ways people management practices influence the outcomes of such projects. Organisational change is considered as an instance of organisational learning, which in turn is examined in relation to the twin activities of developing new ideas and internal sense-making. Findings Evidence is presented that certain people management practices, individually and in combination, influence the outcomes of organisational change projects significantly through their contributions to organisational learning. Research limitations/implications Research into the influence of particular people management practices, and the contexts and processes through which it is exerted, is necessary to develop more generalisable conclusions. This influence is liable to be invisible to less granular research into people management as a general construct. Originality/value Research into the use of project management methods specifically to implement organisational change is sparse. The findings of this paper contradict findings from research into the influence of people management on project outcomes in general, which suggest that it does not have a significant effect.

scholarly journals Outcomes of patients with systolic heart failure presenting with sepsis to the emergency department of a tertiary hospital: a retrospective chart review study from Lebanon

BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e022185 ◽  
Author(s):  
Gilbert Abou Dagher ◽  
Karim Hajjar ◽  
Christopher Khoury ◽  
Nadine El Hajj ◽  
Mohammad Kanso ◽  
...  
Keyword(s):  
Heart Failure ◽  
Emergency Department ◽  
Hospital Mortality ◽  
Descriptive Analysis ◽  
Systolic Heart Failure ◽  
Retrospective Chart Review ◽  
Electronic System ◽  
Tertiary Hospital ◽  
Lengths Of Stay ◽  
Secondary Outcomes

ObjectivesPatients with congestive heart failure (CHF) may be at a higher risk of mortality from sepsis than patients without CHF due to insufficient cardiovascular reserves during systemic infections. The aim of this study is to compare sepsis-related mortality between CHF and no CHF in patients presenting to a tertiary medical centre.DesignA single-centre, retrospective, cohort study.SettingConducted in an academic emergency department (ED) between January 2010 and January 2015. Patients’ charts were queried via the hospital’s electronic system. Patients with a diagnosis of sepsis were included. Descriptive analysis was performed on the demographics, characteristics and outcomes of patients with sepsis of the study population.ParticipantsA total of 174 patients, of which 87 (50%) were patients with CHF.Primary and secondary outcomesThe primary outcome of the study was in-hospital mortality. Secondary outcomes included intensive care unit (ICU) and hospital lengths of stay, and differences in interventions between the two groups.ResultsPatients with CHF had a higher in-hospital mortality (57.5% vs 34.5%). Patients with sepsis and CHF had higher odds of death compared with the control population (OR 2.45; 95% CI 1.22 to 4.88). Secondary analyses showed that patients with CHF had lower instances of bacteraemia on presentation to the ED (31.8% vs 46.4%). They had less intravenous fluid requirements in first 24 hours (2.75±2.28 L vs 3.67±2.82 L, p =0.038), had a higher rate of intubation in the ED (24.2% vs 10.6%, p=0.025) and required more dobutamine in the first 24 hours (16.1% vs 1.1%, p<0.001). ED length of stay was found to be lower in patients with CHF (15.12±24.45 hours vs 18.17±26.13 hours, p=0.418) and they were more likely to be admitted to the ICU (59.8% vs 48.8%, p=0.149).ConclusionPatients with sepsis and CHF experienced an increased hospital mortality compared with patients without CHF.

scholarly journals Leadership reflections a year on from the rapid roll-out of virtual clinics due to COVID-19: a commentary

BMJ Leader ◽  
2021 ◽  
pp. leader-2020-000363
Author(s):  
Anthony W Gilbert ◽  
Lucy Davies ◽  
John Doyle ◽  
Saroj Patel ◽  
Luke Martin ◽  
...  
Keyword(s):  
Success Factors ◽  
Communication Effectiveness ◽  
Skills Gap ◽  
Implementation Team ◽  
New Ways Of Working ◽  
Willingness To Change ◽  
Change Projects ◽  
Successful Change ◽  
Leadership Lessons ◽  
Roll Out

COVID-19 changed the way we delivered care to our patients at our Hospital. Prior to the pandemic, no patient facing video clinics and only a small number of telephone clinics were held. In this paper, we share our experience of rapidly implementing virtual clinics (VCs) due to COVID-19. This commentary is based on focused discussions between hospital leaders and provides a reflective account and commentary on leadership lessons learnt from our experience of deploying VCs. We outline success factors (being able to capitalise on existing strategy, having time and space to establish VCs, using an agreed improvement framework, empowering a diverse and expert implementation team with a flat hierarchy, using efficient decision pathways, communication and staff willingness to change), technical challenges (patient capability and skills to use technology, patient connectivity and platform capacity) and considerations for the future (sustaining new ways of working, platform selection, integration, business continuity and commissioning considerations, barriers regarding capability and communication, effectiveness and clinical outcomes). Finally, we provide an overview of the leadership lessons from this project and identify key areas of focus for delivering successful change projects in future (the vision, allocation of resources, methodology selection and managing the skills gap).

scholarly journals The march of time and the "evolution" of change

2004 ◽  
Vol 30 (3) ◽  
Author(s):  
C. L. Van Tonder
Keyword(s):  
Change Management ◽  
Systems Thinking ◽  
Management Practices ◽  
Organisational Change ◽  
Success Rates ◽  
Change Initiatives ◽  
The Past

Change and organisational change are some of the most discussed topics of our time. Yet despite this, reported success rates for major organisational change initiatives remain exceptionally poor. Part of the problem is that contemporary change management practices assume a stable, unidimensional concept of organisational change. By contrast an analysis of organisational and systems thinking over the past five decades or so reveals an evolving concept of organisation and consequently invalidates the assumption of organisational change as a stable unidimensional concept. The evolving character of organisational change and its implications for change management practices are briefly indicated. Opsomming Verandering en organisasieverandering is van die mees besproke onderwerpe van ons tyd. Ten spyte hiervan bly die gerapporteerde sukseskoers vir primêre organisasieveranderingsinisiatiewe buitengewoon swak. Deel van die probleem is daarin geleë dat kontemporêre veranderingsbestuurspraktyke die aanname maak dat organisasieverandering ’n stabiele, een-dimensionele konsep is. In stryd hiermee toon ’n ontleding van organisasieen sisteemdenke oor die afgelope vyf of so dekades egter ’n ontwikkelende konsep van organisasie wat gevolglik die aanname van ’n stabiele en een-dimensionele organisasieveranderingskonsep ongeldig verklaar. Die ontwikkelende karakter van organisasieverandering en die implikasies daarvan vir veranderingsbestuurspraktyke word kortliks aangedui.

scholarly journals A Systems Thinking Approach to Designing Clinical Models and Healthcare Services

Systems ◽  
2019 ◽  
Vol 7 (1) ◽  
pp. 18 ◽  
Author(s):  
Inas Khayal
Keyword(s):  
Chronic Diseases ◽  
Systems Thinking ◽  
Chronic Conditions ◽  
Healthcare Delivery ◽  
Healthcare Services ◽  
Healthcare Delivery System ◽  
Clinical Model ◽  
Organ Systems ◽  
Clinical Models ◽  
High Level

Chronic diseases are on the rise, increasing in number and treatment regimen complexity. Consequently, the needs of patients with chronic diseases are increasing and becoming more complex and multi-faceted. Such chronic conditions require addressing not only the physical body, but also psychosocial and spiritual health. The healthcare delivery system, however, organically organized into departments based on physical organ systems. Such a configuration makes it ill-suited to provide comprehensive multi-faceted healthcare services that span multiple departments and specialties (e.g., podiatry and endocrinology for diabetes; primary care and psychiatry for behavioral health; and palliative care physicians, chaplains, and social workers for end-of-life care). To deliver new services, the medical field typically designs new clinical models to base its new services on. Several challenges arise from typical approaches to designing healthcare services and clinical models, including addressing only single conditions, describing models only at a high-level of abstraction, and using primarily narrative documents called text-based toolkits for implementation. This paper presents and uses systems thinking as an alternative strategy to designing clinical system models and healthcare services to alleviate many of the current design challenges in designing integrated services for chronic conditions. An illustrative example taking a clinical model and describing it as a system model is presented.

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