scholarly journals Leading implementation of the management innovation value-based healthcare at a Swedish University Hospital

2017 ◽  
Vol 6 (1) ◽  
pp. 51 ◽  
Author(s):  
Kerstin Nilsson ◽  
Mette Sandoff
Keyword(s):  
Medical Staff ◽  
Role Model ◽  
Implementation Process ◽  
Leadership Role ◽  
University Hospital ◽  
Leadership Strategies ◽  
Management Innovation ◽  
Implementation Processes ◽  
Everyday Work ◽  
Control Implementation

Objective: The aim of this study is to explore medical and care staff’s experiences of leading the implementation of the management innovation, named value-based healthcare (VBHC) at a large Swedish University Hospital.Methods: In this study an explorative design was used. Data was collected with individual open-ended repeated interviews with 20 members of four teams leading the implementation of VBHC. The interviews were transcribed verbatim and qualitatively analysed.Results: Findings from this interview study showed that not all participants were comfortable with being appointed as leaders for the VBHC implementation process. Some found it rather too challenging instead. Participants described characteristics such as openness, visibility, approachability, and the ability to be a role model as necessary when leading implementation work. Leadership strategies emphasized were participation and involvement but also the ability to control implementation processes. Anchoring was effectuated by means of a pedagogical approach including dialogues and feedback before making step-by-step changes in everyday work itself.Conclusions: This study shows that leadership is a challenging experience in the context of a team responsible for implementing VBHC, however commendable the management innovation in itself may be. The expectations connected to the leadership role in the context of VBHC implementation must be clarified. Awareness is needed of the extent of the mandates accorded to the care and medical staff appointed as leaders of VBHC teams, especially since care and medical staff are formally speaking not as managers.

scholarly journals Leadership assumptions on implementation of patient involvement methods

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kathrine Håland Jeppesen ◽  
Kirsten Frederiksen ◽  
Marianne Johansson Joergensen ◽  
Kirsten Beedholm
Keyword(s):  
Health Care ◽  
Organizational Learning ◽  
Health Care Professionals ◽  
Large Scale ◽  
Patient Involvement ◽  
Hospital Setting ◽  
Implementation Process ◽  
University Hospital ◽  
Structured Interviews ◽  
Implementation Processes

Abstract Background From 2014 to 17, a large-scale project, ‘The User-involving Hospital’, was implemented at a Danish university hospital. Research highlights leadership as crucial for the outcome of change processes in general and for implementation processes in particular. According to the theory on organizational learning by Agyris and Schön, successful change requires organizational learning. Argyris and Schön consider that the assumptions of involved participants play an important role in organizational learning and processes. The purpose was to explore leaders’ assumptions concerning implementation of patient involvement methods in a hospital setting. Methods Qualitative explorative interview study with the six top leaders in the implementation project. The semi-structured interviews were conducted and analyzed in accordance with Kvale and Brinkmanns’ seven stages of interview research. Result The main leadership assumptions on what is needed in the implementation process are in line with the perceived elements in organizational learning according to the theory of Argyris and Schön. Hence, they argued that implementation of patient involvement requires a culture change among health care professionals. Two aspects on how to obtain success in the implementation process were identified based on leadership assumptions: “The health care professionals’ roles in the implementation process” and “The leaders’ own roles in the implementation process”. Conclusion The top leaders considered implementation of patient involvement a change process that necessitates a change in culture with health care professionals as crucial actors. Furthermore, the top leaders considered themselves important facilitators of this implementation process.

scholarly journals Navigating change – managers’ experience of implementation processes in disability health care: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anette Granberg ◽  
Marie Matérne ◽  
Lars-Olov Lundqvist ◽  
Anna Duberg
Keyword(s):  
Health Care ◽  
Health Care Organizations ◽  
Contextual Factors ◽  
Implementation Process ◽  
Public And Private ◽  
Implementation Processes ◽  
Telephone Interviews ◽  
External Conditions ◽  
The Many ◽  
Dance Intervention

Abstract Background Effective implementation processes play a central role in health care organizations and affect the care of patients. Managers are pivotal in facilitating the use of new practices, but their experience and how it affects the implementation outcome are still largely unknown. In the field of disability health care in particular, managers experiences have scarcely been investigated. Therefore, the aim of this study is to explore managers’ experiences of the implementation process when transferring new practices into disability health care settings. Methods Semi-structured individual telephone interviews were conducted with managers at disability health care organizations in four administrative regions in central Sweden. A total of 23 managers with formal managerial responsibility from both public and private health care were strategically selected to be interviewed. The interviews were analysed using reflexive thematic analysis with an inductive approach. Results The analysis resulted in two themes about factors influencing the implementation process: firstly, Contextual factors set the agenda for what can be achieved, which highlighted aspects that hinder or enable the implementation process, such as internal and external conditions, the workplace culture, the employees and managers’ attitudes and openness to change: secondly, Leadership in the winds of change, which described the challenges of balancing managerial tasks with leading the change, and the importance of a leadership that involves the participation of the employees. Conclusions This study explored how and to what extent managers address and manage the implementation process and the many associated challenges. The findings highlight the importance of leadership support and organizational structure in order to transfer new practices into the work setting, and to encourage an organizational culture for leading change that promotes positive outcomes. We suggest that identifying strategies by focusing on contextual factors and on aspects of leadership will facilitate implementation processes. Trial registration The SWAN (Structured Water Dance Intervention) study was retrospectively registered on April 9, 2019 and is available online at ClinicalTrials.gov (ID: NCT03908801).

Managers’ silent whisper innovation involvement and role-modeling in service firms

2018 ◽  
Vol 21 (1) ◽  
pp. 2-19 ◽  
Author(s):  
Ingela Sölvell
Keyword(s):  
Role Model ◽  
Leadership Behavior ◽  
Innovation Management ◽  
Service Innovation ◽  
Role Modeling ◽  
Leadership Role ◽  
Service Firms ◽  
Actual Behavior ◽  
Leadership Roles ◽  
Content Type

Purpose The task of leading innovation is predominantly pictured as a supportive role vis-à-vis employees. Motivation is a crucial aspect of this task. To better understand the practice of this change-oriented leadership task, the actual behavior and activities of managers are investigated. The purpose of this paper is to reflect through practice and self-reports how this leadership challenge is executed. Design/methodology/approach In this longitudinal multi-method investigation, the service innovation literature constitutes the main theoretical framework. The investigation draws additionally on leadership literature about how to understand leadership through practice. The methodological design facilitated the drawing of causal inferences in the dynamics of service innovation. Findings The investigation enhances our understanding of managers’ particular context of innovation, and particularly the initiation context. It provides empirically grounded descriptions of what managers identify as potential opportunities, and how they take them further in the ideation stage. The results develop the suggestion that leadership roles, and specifically change-oriented roles, are not restricted to initiating or enabling activities related to the employees. Instead the much downplayed leadership role, i.e. the active practice-based involvement in innovation, is theorized as a role that is continuously activated, but tends to be set aside for contingency reasons. Research limitations/implications Further research is needed to assess the importance of managers’ involvement in the practice of innovation, both through systematic mapping of ideas on a larger scale, and through the employee perspective. This paper provides useful insights on managers’ cognition and involvement in innovation for further investigations of innovation management. Practical implications The results provide awareness for managers regarding their diverse leadership roles related to innovation. First, the study embraces heterogeneous ideas that are useful to evaluate and constitute role-modeling. Second, it highlights how managers’ execution of innovation creates awareness about the challenges involved. Finally, but maybe most important, the results alert managers of the discontinuity, even in strategically anchored intentional innovation. Social implications In a changing innovation landscape, individual firms need to draw on other firms to achieve their innovation strategies. In pursuit of this goal, this paper enhances the understanding of the role-modeling leadership task. It is a novel way of guiding individuals that are exposed to new and uncertain innovation contexts, and rethinking how innovation eventually can be achieved. Originality/value While earlier research has identified the multifaceted leadership behavior to support innovation, this paper outlines the contextual conditions and the practice of executing the suggested powerful role of being a role-model for others.

scholarly journals Understanding the implementation of evidence-informed policies and practices from a policy perspective: a critical interpretive synthesis

2020 ◽  
Author(s):  
Heather L Bullock ◽  
John N Lavis ◽  
Michael G Wilson ◽  
Gillian Mulvale ◽  
Ashleigh Miatello
Keyword(s):  
Grey Literature ◽  
Synthesis Method ◽  
Empirical Work ◽  
Implementation Process ◽  
Empirical Literature ◽  
Implementation Theory ◽  
Policy Perspective ◽  
Implementation Processes ◽  
Critical Interpretive Synthesis ◽  
Way Of Thinking

Abstract Background: The fields of implementation science and knowledge translation have evolved somewhat independently from the field of policy implementation research, despite calls for better integration. As a result, implementation theory and empirical work do not often reflect the implementation experience from a policy lens nor benefit from the scholarship in all three fields. This means policymakers, researchers and practitioners may find it challenging to draw from theory that adequately reflects their implementation efforts.Methods: We developed an integrated theoretical framework of the implementation process from a policy perspective by combining findings from these fields using the critical interpretive synthesis method. We began with the compass question: how is policy currently described in implementation theory and processes and what aspects of policy are important for implementation success? We then searched 12 databases as well as grey literature and supplemented these documents with other sources to fill conceptual gaps. Using a grounded and interpretive approach to analysis, we built the framework constructs, drawing largely from the theoretical literature and then tested and refined the framework using empirical literature.Results: A total of 11,434 documents were retrieved and assessed for eligibility and 35 additional documents were identified through other sources. Eighty-six unique documents were ultimately included in the analysis. Our findings indicate that policy is described as: 1) the context; 2) a focusing lens; 3) the innovation itself; 4) a lever of influence; 5) an enabler/facilitator or barrier; or 6) an outcome. Policy actors were also identified as important participants or leaders of implementation. Our analysis led to the development of a two-part conceptual framework, including process and determinant components. Conclusions: This framework begins to bridge the divide between disciplines and offers a new way of thinking about implementation processes at the systems level. It offers researchers, policymakers and implementers with a new way of thinking about implementation and can be used for planning or evaluating implementation efforts.

scholarly journals Rate and causes of discharge against medical advice from a university hospital emergency department in Iran: an ethical perspective

2020 ◽  
Author(s):  
Sanaz Rouhbakhsh Halvaei ◽  
Hojat Sheikh Motahar Vahedi ◽  
Ayat Ahmadi ◽  
Maryam Sadat Mousavi ◽  
Alireza Parsapoor ◽  
...  
Keyword(s):  
Emergency Department ◽  
Medical Staff ◽  
Medical Advice ◽  
University Hospital ◽  
P Value ◽  
Emergency Ward ◽  
Ethical Perspective ◽  
Against Medical Advice ◽  
Discharge Against Medical Advice ◽  
Clinical Records

Discharge against medical advice (DAMA) is a common problem in the health-care system. It imposes risks to both patients and medical staff and could be the subject of ethical deliberation. This cross-sectional study was conducted in 2017 on 400 patients who were discharged against medical advice from the emergency ward of Shariati Hospital, Tehran, Iran. Patients’ information was collected using clinical records and telephone calls. The collected data were analyzed using STATA software. DAMA rate was 12% in the emergency department of Shariati Hospital. Male gender was found to be a risk factor for DAMA (OR: 1.90; CI (95%): 1.44 - 2.52; P < 0.0001). In addition, younger patients were more likely to leave hospital against medical advice (p-value: 0.04). The more common reasons for DAMA were feeling better, long delay in diagnostic and therapeutic procedures and the hectic ambience of the emergency ward. Patients’ self-discharge is a multi-dimensional phenomenon that is affected by patients’ characteristics, medical conditions and hospital circumstances. It raises some ethical concerns, mainly due to a conflict between patients’ autonomy and beneficence. It is helpful for the medical staff to create an effective relationship with patients who are at higher risk of DAMA, in order to increase their compliance and prevent the consequences of leaving hospital against medical advice.

scholarly journals Understanding Low-value Care and Associated De-implementation Processes: A Qualitative Study of Choosing Wisely Interventions Across Canadian Hospitals

2021 ◽  
Author(s):  
Gillian Parker ◽  
Monika Kastner ◽  
Karen Born ◽  
Nida Shahid ◽  
Whitney Berta
Keyword(s):  
Process Model ◽  
Healthcare Providers ◽  
Implementation Process ◽  
Choosing Wisely ◽  
Structured Interviews ◽  
Team Members ◽  
Implementation Processes ◽  
Healthcare Settings ◽  
National Campaigns ◽  
The Impact

Abstract Background:Choosing Wisely (CW) is an international movement comprised of national campaigns in more than 20 countries to reduce low-value care (LVC). Hospitals and healthcare providers are examining existing practices and putting interventions in place to reduce practices that offer little to no benefit to patients or may cause them harm. De-implementation, the reduction or removal of a healthcare practice is an emerging field of research. Little is known about the factors which (i) sustain LVC; and (ii) the magnitude of the problem of LVC. In addition, little is known about the processes of de-implementation, and if and how these processes differ from implementation endeavours. The objective of this study was to explicate the myriad factors which impact the processes and outcomes of de-implementation initiatives that are designed to address national Choosing Wisely campaign recommendations.Methods:Semi-structured interviews were conducted with individuals implementing Choosing Wisely Canada recommendations in healthcare settings in four provinces. The interview guide was developed using concepts from the literature and the Implementation Process Model (IPM) as a framework. All interviews were conducted virtually, recorded, and transcribed verbatim. Data were analysed using thematic analysis.Results:Seventeen Choosing Wisely team members were interviewed. Participants identified numerous provider factors, most notably habit, which sustain LVC. Contrary to reporting in recent studies, the majority of LVC in the sample was not ‘patient facing’; therefore, patients were not a significant driver for the LVC, nor a barrier to reducing it. Participants detailed aspects of the magnitude of the problems of LVC, specifically the impact of harm and resources. Unique factors influencing the processes of de-implementation reported were: influence of Choosing Wisely campaigns, availability of data, lack of targets and hard-coded interventions.Conclusions: This study explicates factors ranging from those which impact the maintenance of LVC to factors that impact the success of de-implementation interventions intended to reduce them. The findings draw attention to the significance of unintentional factors, highlight the importance of understanding the impact of harm and resources to reduce LVC and illuminate the overstated impact of patients in de-implementation literature. These findings illustrate the complexities of de-implementation.

Re-AbilityLab

2022 ◽  
pp. 34-55
Author(s):  
Linamara Rizzo Battistella ◽  
Lilian Aparecida Treff
Keyword(s):  
Implementation Process ◽  
Exponential Model ◽  
Lessons Learned ◽  
Incremental Innovation ◽  
Management Innovation ◽  
Current Scenario ◽  
Definition Of ◽  
The University ◽  
Patient Performance

This study aims to show the methodology of implementation of the Skills Laboratories (Re-AbilityLab) at the Institute of Physical Medicine and Rehabilitation of the Hospital das Clínicas of the Faculty of Medicine of the University of São Paulo. These Skill Labs offer activities to maximize patient performance by promoting specific functional outcomes, which are described in the International Classification of Functionality. The activities are dynamic and carried out by a multidisciplinary team in the areas of health, education, and management. Innovation and strategic aspects of the knowledge economy are structured in the management of this project to enhance the achievement of purposes and results. The implementation process includes solutions adopted, definition of responsibilities, difficulties faced, benefits, functionality of the methods applied, and lessons learned. Mapping the process from the current scenario to the desired contributes to the transition from a care model (linear, refractory, obsolete) to an exponential model of care (intangibles, incremental innovation).

Using social networking applications to facilitate change implementation processes: insights from organizational change stakeholders

2020 ◽  
Vol 26 (7) ◽  
pp. 1979-1998 ◽  
Author(s):  
Muhammad Naeem
Keyword(s):  
Social Media ◽  
Organizational Change ◽  
Social Networking ◽  
Knowledge Sharing ◽  
Change Process ◽  
Implementation Process ◽  
Change Implementation ◽  
Content Type ◽  
Implementation Processes ◽  
Insurance Sector

PurposeThe failure rate of change is high amongst countries and cultures where collectivism, destructive politics and resistance are high. Therefore, change leaders are more focused on exploring how they can create networking and socialization amongst major organizational stakeholders that can minimize detrimental cynicism and lobbying during change implementation. This study is an attempt to shed light on how Social Networking Applications (henceforth SNAs) can facilitate change implementation processes in the insurance sector.Design/methodology/approachThe individual reaction and interaction realities during the change process cannot be discovered once and for all as there are varied perspectives on the same subjects. Therefore, a social constructionist position was used to understand the different realties of change managers and change recipients using the context of insurance sector.FindingsThe study documented how SNAs can play an active role in addressing the concerns of employees as well as managing and protecting knowledge sharing to facilitate the change implementation process. The collaborative and interactive nature of SNAs can enhance richness in knowledge sharing and can facilitate the participation of employees. Therefore, management should monitor these platforms as a means to improve the change process and to address the concerns of employees. These networking channels which include WhatsApp and Facebook can enhance social interactions, support and acceptance at individual and organizational levels.Research limitations/implicationsSocial media has become a familiar tool for employees to use to discuss internal changes and policies within their organizations. Social media enhances the richness, reach, knowledge exchange and effective internal communication potential amongst organizational change stakeholders. Using social media, change recipients are now more empowered and connected with their leadership that ever before. It is now easier to facilitate decision making during the change formulation and implementation process.Practical implicationsSocial media applications have become necessary to ensure incremental and radical changes to the survival of dynamic businesses. The findings of this study are beneficial for change leaders and recipients of change to implement successful organizational change using social media tools. The effective and efficient use of social media applications helps organizations to foster knowledge amongst employees and they can address various critical issues, that is resistance to change, lower levels of knowledge sharing and support for change acceptance and lack of employee participation in decision making.Originality/valueThere is an inadequate understanding regarding how SNAs play a role in facilitating the change process in both public and private sector organizations. This study offers a social mchange facilitation model with the help of social learning, social networking and social behaviourism theories.

Strategies for Successful Implementation of Innovation

2017 ◽  
Vol 8 (2) ◽  
pp. 16-28 ◽  
Author(s):  
Neeta Baporikar
Keyword(s):  
Grounded Theory ◽  
Literature Review ◽  
Implementation Process ◽  
Successful Implementation ◽  
Innovation Implementation ◽  
Implementation Processes ◽  
Innovation Processes ◽  
Multiple Causes

Innovations are vital to most organizations especially in this competitive and globalized scenario. Nevertheless, the results of innovations are in many cases far from satisfactory. Several studies have shown that an organization's failure to benefit from an adopted innovation can often be attributed to a deficient implementation process rather than to the innovation itself. Thus, the implementation process is a critical interface between the decision to adopt and the routine usage of an innovation. Ways and methods to implement innovation effectively have been under scholarship for some time now. Despite the number of studies which identify multiple causes of unsuccessful implementation processes, literature is lacking regarding the crucial aspects of innovation implementation. Building on the derived knowledge of the underlying dynamics of innovation processes, through grounded theory and in-depth literature review, the present study aims to contribute to existing implementation literature by examining the strategic facets of innovation implementation.

scholarly journals Psychosocial emergency care in times of COVID-19: the Essen University Hospital concept for corona-infected patients, their relatives, and medical staff

2020 ◽  
Author(s):  
Vanessa Rentrop ◽  
Johanna Sophie Schneider ◽  
Alexander Bäuerle ◽  
Florian Junne ◽  
Nora Dörrie ◽  
...  
Keyword(s):  
Medical Staff ◽  
Online Training ◽  
University Hospital ◽  
High Psychological Distress ◽  
Increased Risk ◽  
Psychosocial Emergency ◽  
Low Threshold ◽  
Long Term Consequences ◽  
The University

Abstract Due to the SARS CoV-2-virus (COVID-19), anxiety, distress, and insecurity occur more frequently. In particular, infected individuals, their relatives, and medical staff face an increased risk of high psychological distress as a result of the ongoing pandemic. Thus, structured psychosocial emergency concepts are needed. The University hospital of Essen has taken up this challenge by creating the PEC concept to reduce psychosocial long-term consequences for infected patients, relatives, and medical staff at the university hospital. The concept includes professional medical as well as psychological support to convey constructive coping strategies and the provision of adequate tools such as the low-threshold online training program (CoPE It), which is accessible via the webpage www.cope-corona.de.

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