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

Marie E. Ward, Ailish Daly, Martin McNamara, Suzanne Garvey and Sean Paul Teeling
Additional contact information
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

IJERPH, 2022, vol. 19, issue 3, 1-22

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.

Keywords: whole system improvement; socio-technical systems; Lean Six Sigma; person-centred care; acute hospital; implementation science (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (4)

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