What Happened to the No-Wait Hospital? A Case Study of Implementation of Operational Plans for Reduced Waits

Hansson, Johan; Tolf, Sara; Øvretveit, John; Carlsson, Jan; Brommels, Mats

doi:10.1097/qmh.0b013e3182418113

Cited by 12 publications

(12 citation statements)

References 76 publications

(98 reference statements)

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“…The identified factors in this review strongly relate to and cover Pettigrew and Whipp’s three original core elements of change [31]. However, the subcategories and especially their labeling sometimes had to be adapted as the original model was more often applied within organizational instead of community settings.…”

Section: Discussionmentioning

confidence: 99%

“…We draw on Pettigrew and Whipp’s classic model of strategic management of change [26], which has been widely applied in comparative case study research across many sectors and organizational contexts [27-29], as well as in studies on the implementation of innovations in healthcare [30,31]. This model generates insight by analyzing three interactive elements; “context”, “process”, and “content” that together shape any strategic change.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Implementation factors and their effect on e-Health service adoption in rural communities: a systematic literature review

Hage

Roo

Offenbeek

et al. 2013

BMC Health Serv Res

113

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BackgroundAn ageing population is seen as a threat to the quality of life and health in rural communities, and it is often assumed that e-Health services can address this issue. As successful e-Health implementation in organizations has proven difficult, this systematic literature review considers whether this is so for rural communities. This review identifies the critical implementation factors and, following the change model of Pettigrew and Whipp, classifies them in terms of “context”, “process”, and “content”. Through this lens, we analyze the empirical findings found in the literature to address the question: How do context, process, and content factors of e-Health implementation influence its adoption in rural communities?MethodsWe conducted a systematic literature review. This review included papers that met six inclusion and exclusion criteria and had sufficient methodological quality. Findings were categorized in a classification matrix to identify promoting and restraining implementation factors and to explore whether any interactions between context, process, and content affect adoption.ResultsOf the 5,896 abstracts initially identified, only 51 papers met all our criteria and were included in the review. We distinguished five different perspectives on rural e-Health implementation in these papers. Further, we list the context, process, and content implementation factors found to either promote or restrain rural e-Health adoption. Many implementation factors appear repeatedly, but there are also some contradictory results. Based on a further analysis of the papers’ findings, we argue that interaction effects between context, process, and content elements of change may explain these contradictory results. More specifically, three themes that appear crucial in e-Health implementation in rural communities surfaced: the dual effects of geographical isolation, the targeting of underprivileged groups, and the changes in ownership required for sustainable e-Health adoption.ConclusionsRural e-Health implementation is an emerging, rapidly developing, field. Too often, e-Health adoption fails due to underestimating implementation factors and their interactions. We argue that rural e-Health implementation only leads to sustainable adoption (i.e. it “sticks”) when the implementation carefully considers and aligns the e-Health content (the “clicks”), the pre-existing structures in the context (the “bricks”), and the interventions in the implementation process (the “tricks”).

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Implementation factors and their effect on e-Health service adoption in rural communities: a systematic literature review

Hage

Roo

Offenbeek

et al. 2013

BMC Health Serv Res

113

View full text Add to dashboard Cite

show abstract

“…Over the past 2 decades, different management strategies including Total Quality Management and Balanced Score Cards had been applied across the hospital to improve care. 18,20 This study was designed according to the view of Lean in health care proposed by Holden 10 (Figure). This model identifies several aspects of Lean application, including the role of context, work design with changes 50 QUALITY MANAGEMENT IN HEALTH CARE/VOLUME 22, ISSUE 1, JANUARY-MARCH 2013 made both in work structure and in work process, and its impact on performance and employee outcomes.…”

Section: Study Setting Design and Theoretical Backgroundmentioning

confidence: 99%

“…16,17 An organization's earlier experience of change efforts can be of help when implementing a new change strategy. 18 Presumably, organizations with a history of quality improvement (QI) efforts may apply Lean in a different way than organizations with limited QI experience. The links between institutions' QI history and their adoption of Lean and its further fate are, however, not sufficiently understood.…”

mentioning

confidence: 99%

Antecedents and Characteristics of Lean Thinking Implementation in a Swedish Hospital

Ulhassan

Sandahl

Westerlund

et al. 2013

Quality Management in Health Care

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Despite the reported success of Lean in health care settings, it is unclear why and how organizations adopt Lean and how Lean transforms work design and, in turn, affects employees' work. This study investigated a cardiology department's journey to adopt and adapt Lean. The investigation was focused on the rationale and evolution of the Lean adoption to illuminate how a department with a long quality improvement history arrived at the decision to introduce Lean, and how Lean influenced employees' daily work. This is an explanatory single case study based on semistructured interviews, nonparticipant observations, and document studies. Guided by a Lean model, we undertook manifest content analysis of the data. We found that previous improvement efforts may facilitate the introduction of Lean but may be less important when forecasting whether Lean will be sustained over time. Contextual factors seemed to influence both what Lean tools were implemented and how well the changes were sustained. For example, adoption of Lean varied with the degree to which staff saw a need for change. Work redesign and teamwork were found helpful to improve patient care whereas problem solving was found helpful in keeping the staff engaged and sustaining the results over time.

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“…15,16 It has been linked to inefficiencies in the health system, public disaffection and prolonged suffering of patients. 17,18 Imbalances between demand and supply have been cited as the reason why patients wait. If demand outweighs supply, queues form and hence patients wait.…”

Section: Discussionmentioning

confidence: 99%

Impact of battery-powered orthopedic drills on the practice of orthopedic surgery in a resource limited country

et al. 2018

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Background: The study aimed at assessing the impact of the availability of battery-powered drills on the management of orthopedic cases presenting to the orthopedic unit of the department of surgery at a major teaching hospital serving the southern part of Ghana.Methods: This study was a single center retrospective study. Authors examined the total number of cases, average time spent on cases in the operating room, and the average patient waiting time for surgery between January 2012 and December 2014. A paired sample t-test was used to evaluate the effectiveness of the orthopedic drills for the pre-and post-intervention periods.Results: There were statistical significant differences in the total number of cases (p<0.01), the average time spent on cases in the operating room (p<0.01), and the average waiting time for surgery (p<0.05) between January 2012 to June 2013 when manual hand drills were in use and July 2013 to December 2014 when the battery-powered drills were introduced.Conclusions: The introduction of the battery-powered drills led to a significant improvement in the total number of cases done. There was a reduction in time spent per case in the operating room as well as the average waiting time to having surgery.

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What Happened to the No-Wait Hospital? A Case Study of Implementation of Operational Plans for Reduced Waits

Cited by 12 publications

References 76 publications

Implementation factors and their effect on e-Health service adoption in rural communities: a systematic literature review

Implementation factors and their effect on e-Health service adoption in rural communities: a systematic literature review

Antecedents and Characteristics of Lean Thinking Implementation in a Swedish Hospital

Impact of battery-powered orthopedic drills on the practice of orthopedic surgery in a resource limited country

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