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Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
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Using systems thinking to support clinical system transformation.

Allan Best1, Alex Berland1, Carol Herbert1

  • 1InSource Research Group, Coquitlam, Canada.

Journal of Health Organization and Management
|April 28, 2016
PubMed
Summary
This summary is machine-generated.

Implementing large-scale change (LSC) in healthcare requires preparing clinicians, fostering leadership, and improving communication. Strategies include engaging local champions and adapting guidelines to clinical settings for successful health system transformation.

Keywords:
Clinical guidelinesComplex adaptive systemsImplementationKnowledge translationLarge-scale changeSystems thinking

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Area of Science:

  • Health Services Research
  • Organizational Change Management
  • Complex Systems Theory

Background:

  • Large-scale change (LSC) initiatives in healthcare systems face significant implementation challenges.
  • Understanding the mechanisms enabling and constraining clinical guideline implementation is crucial for health system transformation.

Purpose of the Study:

  • To examine the enablers and constraints of implementing clinical guidelines within the British Columbia Ministry of Health's Clinical Care Management initiative.
  • To apply a complex adaptive systems framework to analyze large-scale change in a health system.

Main Methods:

  • Utilized a complex adaptive systems model, realist evaluation, and system dynamics mapping.
  • Conducted focus groups and interviews with diverse healthcare stakeholders, validated by an online survey.

Main Results:

  • Key themes for managing LSC included preparing clinicians, promoting shared leadership, strengthening knowledge management and communication, and navigating system complexity.
  • Practical strategies involved engaging local champions, supporting guideline adaptation, empowering local teams, and ensuring adequate resources and consistent communication.

Conclusions:

  • A complex systems perspective provides valuable insights into the challenges of LSC in healthcare.
  • Effective implementation hinges on multi-level engagement, adaptive strategies, and clear communication to support clinical guideline adoption.