IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v19y2022i3p1246-d731200.html
   My bibliography  Save this article

A Case Study of a Whole System Approach to Improvement in an Acute Hospital Setting

Author

Listed:
  • Marie E. Ward

    (Centre for Innovative Human Systems, School of Psychology, Trinity College, The University of Dublin, D02 PN40 Dublin, Ireland)

  • Ailish Daly

    (Beacon Hospital, Sandyford, D18 AK68 Dublin, Ireland)

  • Martin McNamara

    (UCD Centre for Interdisciplinary Research, Education & Innovation in Health Systems, School of Nursing, Midwifery & Health Systems, UCD Health Sciences Centre, University College Dublin, D04 V1W8 Dublin, Ireland)

  • Suzanne Garvey

    (Beacon Hospital, Sandyford, D18 AK68 Dublin, Ireland)

  • Sean Paul Teeling

    (UCD Centre for Interdisciplinary Research, Education & Innovation in Health Systems, School of Nursing, Midwifery & Health Systems, UCD Health Sciences Centre, University College Dublin, D04 V1W8 Dublin, Ireland
    Centre for Person-Centred Practice Research Division of Nursing, School of Health Sciences, Queen Margaret University, Queen Margaret University Drive, Musselburgh EH21 6UU, UK)

Abstract

Changes in healthcare tend to be project-based with whole system change, which acknowledges the interconnectedness of socio-technical factors, not the norm. This paper attempts to address the question of whole system change posed by the special issue and brings together other research presented in this special issue. A case study approach was adopted to understand the deployment of a whole system change in the acute hospital setting along four dimensions of a socio-technical systems framework: culture, system functioning, action, and sense-making. The case study demonstrates evidence of whole system improvement. The approach to change was co-designed by staff and management, projects involving staff from all specialities and levels of seniority were linked to each other and to the strategic objectives of the organisation, and learnings from first-generation projects have been passed to second and third-generation process improvements. The socio-technical systems framework was used retrospectively to assess the system change but could also be used prospectively to help healthcare organisations develop approaches to whole system improvement.

Suggested Citation

  • Marie E. Ward & Ailish Daly & Martin McNamara & Suzanne Garvey & Sean Paul Teeling, 2022. "A Case Study of a Whole System Approach to Improvement in an Acute Hospital Setting," IJERPH, MDPI, vol. 19(3), pages 1-22, January.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:3:p:1246-:d:731200
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/19/3/1246/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/19/3/1246/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Rachel Flynn & Stephanie P. Brooks & Denise Thomson & Gabrielle L. Zimmermann & David Johnson & Tracy Wasylak, 2021. "An Implementation Science Laboratory as One Approach to Whole System Improvement: A Canadian Healthcare Perspective," IJERPH, MDPI, vol. 18(23), pages 1-14, December.
    2. Nick McDonald & Lucy McKenna & Rebecca Vining & Brian Doyle & Junli Liang & Marie E. Ward & Pernilla Ulfvengren & Una Geary & John Guilfoyle & Arwa Shuhaiber & Julio Hernandez & Mary Fogarty & Una Hea, 2021. "Evaluation of an Access-Risk-Knowledge (ARK) Platform for Governance of Risk and Change in Complex Socio-Technical Systems," IJERPH, MDPI, vol. 18(23), pages 1-33, November.
    3. Lisa O’Mahony & Kerrie McCarthy & Josephine O’Donoghue & Seán Paul Teeling & Marie Ward & Martin McNamara, 2021. "Using Lean Six Sigma to Redesign the Supply Chain to the Operating Room Department of a Private Hospital to Reduce Associated Costs and Release Nursing Time to Care," IJERPH, MDPI, vol. 18(21), pages 1-14, October.
    4. Ailish Daly & Seán Paul Teeling & Marie Ward & Martin McNamara & Ciara Robinson, 2021. "The Use of Lean Six Sigma for Improving Availability of and Access to Emergency Department Data to Facilitate Patient Flow," IJERPH, MDPI, vol. 18(21), pages 1-15, October.
    5. Nicola Wolfe & Seán Paul Teeling & Marie Ward & Martin McNamara & Liby Koshy, 2021. "Operation Note Transformation: The Application of Lean Six Sigma to Improve the Process of Documenting the Operation Note in a Private Hospital Setting," IJERPH, MDPI, vol. 18(22), pages 1-16, November.
    6. Ailish Daly & Nicola Wolfe & Seán Paul Teeling & Marie Ward & Martin McNamara, 2021. "Redesigning the Process for Scheduling Elective Orthopaedic Surgery: A Combined Lean Six Sigma and Person-Centred Approach," IJERPH, MDPI, vol. 18(22), pages 1-15, November.
    7. Seán Paul Teeling & Jan Dewing & Deborah Baldie, 2021. "A Realist Inquiry to Identify the Contribution of Lean Six Sigma to Person-Centred Care and Cultures," IJERPH, MDPI, vol. 18(19), pages 1-21, October.
    8. Patricia Egan & Anthony Pierce & Audrey Flynn & Sean Paul Teeling & Marie Ward & Martin McNamara, 2021. "Releasing Operating Room Nursing Time to Care through the Reduction of Surgical Case Preparation Time: A Lean Six Sigma Pilot Study," IJERPH, MDPI, vol. 18(22), pages 1-15, November.
    9. Michael Gibbert & Winfried Ruigrok & Barbara Wicki, 2008. "What passes as a rigorous case study?," Strategic Management Journal, Wiley Blackwell, vol. 29(13), pages 1465-1474, December.
    10. D’Andreamatteo, Antonio & Ianni, Luca & Lega, Federico & Sargiacomo, Massimo, 2015. "Lean in healthcare: A comprehensive review," Health Policy, Elsevier, vol. 119(9), pages 1197-1209.
    11. Anne Dempsey & Ciara Robinson & Niamh Moffatt & Therese Hennessy & Annmarie Bradshaw & Sean Paul Teeling & Marie Ward & Martin McNamara, 2021. "Lean Six Sigma Redesign of a Process for Healthcare Mandatory Education in Basic Life Support—A Pilot Study," IJERPH, MDPI, vol. 18(21), pages 1-18, November.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Elaine Shelford Mead & Seán Paul Teeling & Martin McNamara, 2024. "A Realist Review Protocol into the Contexts and Mechanisms That Enable the Inclusion of Environmental Sustainability Outcomes in the Design of Lean Healthcare Improvement Interventions," IJERPH, MDPI, vol. 21(7), pages 1-16, July.
    2. Ailish Daly & Sean Paul Teeling & Suzanne Garvey & Marie Ward & Martin McNamara, 2022. "Using a Combined Lean and Person-Centred Approach to Support the Resumption of Routine Hospital Activity following the First Wave of COVID-19," IJERPH, MDPI, vol. 19(5), pages 1-20, February.
    3. Sinead Moffatt & Catherine Garry & Hannah McCann & Sean Paul Teeling & Marie Ward & Martin McNamara, 2022. "The Use of Lean Six Sigma Methodology in the Reduction of Patient Length of Stay Following Anterior Cruciate Ligament Reconstruction Surgery," IJERPH, MDPI, vol. 19(3), pages 1-18, January.
    4. Martin McNamara & Marie Ward & Seán Paul Teeling, 2023. "Making a Sustainable Difference to People, Processes and Systems: Whole-Systems Approaches to Process Improvement in Health Systems," IJERPH, MDPI, vol. 20(7), pages 1-5, March.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Martin McNamara & Marie Ward & Seán Paul Teeling, 2023. "Making a Sustainable Difference to People, Processes and Systems: Whole-Systems Approaches to Process Improvement in Health Systems," IJERPH, MDPI, vol. 20(7), pages 1-5, March.
    2. Ailish Daly & Sean Paul Teeling & Suzanne Garvey & Marie Ward & Martin McNamara, 2022. "Using a Combined Lean and Person-Centred Approach to Support the Resumption of Routine Hospital Activity following the First Wave of COVID-19," IJERPH, MDPI, vol. 19(5), pages 1-20, February.
    3. Sinead Moffatt & Catherine Garry & Hannah McCann & Sean Paul Teeling & Marie Ward & Martin McNamara, 2022. "The Use of Lean Six Sigma Methodology in the Reduction of Patient Length of Stay Following Anterior Cruciate Ligament Reconstruction Surgery," IJERPH, MDPI, vol. 19(3), pages 1-18, January.
    4. Seán Paul Teeling & Jan Dewing & Deborah Baldie, 2022. "Developing New Methods for Person-Centred Approaches to Adjudicate Context–Mechanism–Outcome Configurations in Realist Evaluation," IJERPH, MDPI, vol. 19(4), pages 1-17, February.
    5. Diego Tlapa & Ignacio Franco-Alucano & Jorge Limon-Romero & Yolanda Baez-Lopez & Guilherme Tortorella, 2022. "Lean, Six Sigma, and Simulation: Evidence from Healthcare Interventions," Sustainability, MDPI, vol. 14(24), pages 1-25, December.
    6. Anne Dempsey & Ciara Robinson & Niamh Moffatt & Therese Hennessy & Annmarie Bradshaw & Sean Paul Teeling & Marie Ward & Martin McNamara, 2021. "Lean Six Sigma Redesign of a Process for Healthcare Mandatory Education in Basic Life Support—A Pilot Study," IJERPH, MDPI, vol. 18(21), pages 1-18, November.
    7. Lepore, Dominique & Frontoni, Emanuele & Micozzi, Alessandra & Moccia, Sara & Romeo, Luca & Spigarelli, Francesca, 2023. "Uncovering the potential of innovation ecosystems in the healthcare sector after the COVID-19 crisis," Health Policy, Elsevier, vol. 127(C), pages 80-86.
    8. Camelia Ilie & Gaston Fornes & Guillermo Cardoza & Juan Carlos Mondragón Quintana, 2020. "Development of Business Schools in Emerging Markets: Learning through Adoption and Adaptation," Sustainability, MDPI, vol. 12(20), pages 1-28, October.
    9. Thuy Séran & Anne-Sophie Fernandez & Hervé Chappert, 2024. "Managing coopetition in multi-unit organizations: a management-control perspective," Review of Managerial Science, Springer, vol. 18(10), pages 2889-2924, October.
    10. Liu, Yipeng & Meyer, Klaus E., 2020. "Boundary spanners, HRM practices, and reverse knowledge transfer: The case of Chinese cross-border acquisitions," Journal of World Business, Elsevier, vol. 55(2).
    11. Lydia Bals & Jon F. Kirchoff & Kai Foerstl, 2016. "Exploring the reshoring and insourcing decision making process: toward an agenda for future research," Operations Management Research, Springer, vol. 9(3), pages 102-116, December.
    12. Barmeyer, Christoph & Davoine, Eric, 2019. "Facilitating intercultural negotiated practices in joint ventures: The case of a French–German railway organization," International Business Review, Elsevier, vol. 28(1), pages 1-11.
    13. Christina Theodoraki & Alexis Catanzaro, 2022. "Widening the borders of entrepreneurial ecosystem through the international lens," The Journal of Technology Transfer, Springer, vol. 47(2), pages 383-406, April.
    14. Jorge Coque & Pilar L. González-Torre, 2017. "Adapting Nonprofit Resources to New Social Demands: The Food Banks in Spain," Sustainability, MDPI, vol. 9(4), pages 1-16, April.
    15. Gaston Fornes & Abel Monfort & Camelia Ilie & Chun Kwong (Tony) Koo & Guillermo Cardoza, 2019. "Ethics, Responsibility, and Sustainability in MBAs. Understanding the Motivations for the Incorporation of ERS in Less Traditional Markets," Sustainability, MDPI, vol. 11(24), pages 1-22, December.
    16. Ailish Daly & Nicola Wolfe & Seán Paul Teeling & Marie Ward & Martin McNamara, 2021. "Redesigning the Process for Scheduling Elective Orthopaedic Surgery: A Combined Lean Six Sigma and Person-Centred Approach," IJERPH, MDPI, vol. 18(22), pages 1-15, November.
    17. Rabetino, Rodrigo & Kohtamäki, Marko & Gebauer, Heiko, 2017. "Strategy map of servitization," International Journal of Production Economics, Elsevier, vol. 192(C), pages 144-156.
    18. Cheng Mei Tung, 2018. "Vertical integration for smart manufacturing-The dynamic capability perspective," Journal of Advances in Technology and Engineering Research, A/Professor Akbar A. Khatibi, vol. 4(2), pages 70-78.
    19. Carland, Corinne & Goentzel, Jarrod & Montibeller, Gilberto, 2018. "Modeling the values of private sector agents in multi-echelon humanitarian supply chains," European Journal of Operational Research, Elsevier, vol. 269(2), pages 532-543.
    20. Marie-José Avenier & Catherine Thomas, 2015. "Finding one's way around various methodological guidelines for doing rigorous case studies: A comparison of four epistemological frameworks [Se frayer un chemin parmi les différentes recommandation," Post-Print halshs-01491454, HAL.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:19:y:2022:i:3:p:1246-:d:731200. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.