Process analysis in general practice ‐ a new perspective?

Boaden, Ruth; Zolkiewski, Judy

doi:10.1108/09526869810216034

Cited by 4 publications

(2 citation statements)

References 9 publications

(11 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Esain and Rich 89 focused on improving patient flow through hospitals to reduce waiting times. 90 conducted a process study of the non-clinical aspects of a UK general practice, with particular attention to the relationship between the patient and the managerial and administrative aspects of the organisation. Endsley et al 91 considered process and flow issues in family medical practice in the USA.…”

Section: Fillinghammentioning

confidence: 99%

A mixed-methods evaluation of transformational change in NHS North East

Hunter

Erskine

Hicks

et al. 2014

Health Services and Delivery Research

View full text Add to dashboard Cite

BackgroundThe North East Transformation System (NETS) was conceived as an experiment in adopting large-scale transformational change across a NHS region in England. Although the NHS in the North East performs well, the health of the population ranks among the poorest in the country. The NETS was viewed as a means of addressing this conundrum. It comprised three components: Vision, Compact and Method.ObjectivesThe evaluation study comprised six elements: a literature review; an evaluation of the evolution and impact of the NETS; an identification of the factors facilitating, and/or acting as barriers to, successful change; an assessment of the role of the NETS project team; establishing how far the changes introduced through the NETS became embedded and sustained; and an evaluation of the impact of the NETS on end users.DesignThe research comprised a longitudinal mixed-methods study conducted over 3.5 years. Research methods included 68 semistructured interviews, observation, two focus groups, documentary analysis and interrupted time series (ITS) analysis. The ITS component comprised analysis of five rapid process improvement workshops in two of the sites.SettingThe research setting was the NHS North East region until its abolition in April 2013 following the UK government’s NHS changes. Fourteen sites were selected for the study, comprising primary care trusts as commissioners, and provider trusts including mental health, community, acute care and ambulance services.ParticipantsThe study respondents were members of staff in the 14 sites drawn from different levels of their organisations.InterventionsThe NETS comprised a complex set of interventions aimed at improving the efficiency and effectiveness of care pathways for staff and patients.Main outcome measuresThe ‘receptive contexts for change’ framework was used to evaluate the transformational change process and its outcomes.Data sourcesQualitative parts of the study drew on semistructured interviews, focus groups, observation and documents. Quantitative parts of the study used routinely collected NHS data.ResultsTransformational change in a complex system takes time and demands consistency, constancy of purpose and organisational stability. The NETS was seriously disrupted by the NHS changes announced in July 2010. Progress was sustained at four of the study sites, but slowed or ceased at the other sites. Leadership style was found to be critical to the success of transformational change.ConclusionsThe NETS was a bold and ambitious initiative which succeeded in bringing about real and lasting change in some parts of the North East. However, it was unable to fully realise its vision and purpose partly because of the widespread reorganisation of the NHS by the new coalition government.Future workThere is a need to develop new methods to understand how change occurs, or fails, in complex settings like the NHS. There is a need for more in-depth studies in those sites that were able to implement and sustain change. This would inform future policy and practice. The results of the quantitative analyses were less conclusive than those obtained by qualitative methods. Further development of mixed-methods approaches would provide additional support for evidence-based decision-making.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

show abstract

Section: Fillinghammentioning

confidence: 99%

A mixed-methods evaluation of transformational change in NHS North East

Hunter

Erskine

Hicks

et al. 2014

Health Services and Delivery Research

View full text Add to dashboard Cite

show abstract

“…There are many existing frameworks for increasing firm performance, presented under the umbrella of blueprints (Shostack, 1984(Shostack, , 1987Shapiro, 2002); process analysis (Graham, 1995;Boaden and Zolkiewski, 1998); total cycle time compression pipeline (Towill, 2001), process control (Jones and Dent, 1994), process improvement (Harrington, 1992;Pulat, 1994;Zairi and Hutton, 1995;Povey, 1998); process redesign (Ferguson, 1990;Kaplan and Murdock, 1993) and business process re-engineering (Hammer, 1990;Davenport and Short, 1990;Maull and Childe, 1994;Zairi and Leonard, 1994;Borja et al, 2000). Previous studies provide different methodologies related to inefficiency in the operational process which is due to incorrect design or to poor performance (Deming, 1982;Harrington, 1992;Hammer and Champy, 1993;Mukhopadhyay et al, 1997;Shin and Jemella, 2002).…”

Section: Background Of the Current Studymentioning

confidence: 99%

Re‐engineering service quality process mapping: e‐banking process

Akamavi

2005

International Journal of Bank Marketing

View full text Add to dashboard Cite

Purpose -The paper examines a financial service innovation process, which is referred to as financial product innovation: improvements to existing services. This study conducts a critical analysis of the operational process of opening a Lloyds TSB Student Account at a local branch. Design/methodology/approach -The process of opening a student bank account is documented in a flowchart/flow network, which highlights operational steps and the visibility line between front-end and backroom staff. This process mapping technique/flowchart allows for the diagnosis and identification of both potential and actual bottlenecks in the existing process, which prevented a quality service encounter for the customer. After outlining these problematic areas/non-value added activities, the adopted qualitative triangulated methodological approach yields a redesigned flowchart illustrating these changes. Furthermore, this paper proposes a re-engineered process (i.e. e-process or virtual process), which removes these bottlenecks systematically. Findings -The results show the increased efficiency, productivity and customer satisfaction levels that are the key to innovation process performance. The study concludes with evidence of non-financial performance results of this type of financial service innovation.Research limitations/implications -The study does not quantify the performance of e-process operations, and it does not examine customer concerns related to complexity, trust security and safety issues. However, it provides useful managerial recommendations for improving the process of opening a student account. Numerous key learning points and invaluable insights gathered during this project are practical contributions both to managers involved in innovation process and researchers interested in this domain. Practical implications -This paper provides a re-engineered process which is simpler, more economical and faster than the original process. It presents principles to diagnose appropriate service operation processes for re-engineering using action mapping programmes and review their innovation performances. Managers will learn new frameworks, diagnostic tools and analysis techniques to better understand and improve their firm's service operations. This study is designed to give service innovation managers and e-marketers instantaneous and continuous improvement in the quality of their e-service designs. Originality/value -One of its contributions lies in increasing the ability of managers to improve their knowledge and skills for responding to the e-service innovation process. It adds to the growing literature on the innovation process for financial services. While the study answers a number of salient questions, it also produces a stimulus for further investigation of service innovation through the provision of future research directions in this area.

show abstract