The Hospital of Tomorrow Case Study: Multidisciplinarity, Inclusiveness and Holistic Approaches to Foster Innovation in Complex Organizations

Document Type : Original Article

Authors

1 World Health Organization, Headquarters, Geneva, Switzerland

2 IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico di Sant’Orsola, Bologna, Italy

3 World Health Organization, Regional Office for Europe, Copenhagen, Denmark

4 James Lind Institute, Geneva, Switzerland

Abstract

Background 
This case study describes and analyses an action research initiative undertaken by management, staff and World Health Organization (WHO) at the IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico di Sant’Orsola, Italy. The initiative utilised staff engagement approaches developed during the COVID-19 pandemic to rethink and reshape future development plans. The initiative provides a ‘how-to’ case study for complex health facilities on ways to create similar multisectoral, inclusive and holistic processes in planning structural, functional and organizational solutions for their ‘hospitals of tomorrow.’

Methods 
The case study utilised an action research approach coordinated by a team of WHO facilitators in close collaboration with the Board of Hospital Directors. Heterogeneous and multidisciplinary working groups were created, with members from different levels of the hospital staff. In the context of facilitated group meetings held weekly over a one-year period, participants were asked to review topics of interest to future plans of the hospital and make recommendations on effective/innovative ways of addressing these in the short and long term. Working groups focused on different challenges.

Results 
The initiative was successful in creating and sustaining broad staff engagement in the future planning processes. 80% groups maintained high staff participation throughout the entire project year. Participating staff reported enhanced communication and cooperation between departments represented in different groups. 87% of the proposed plans suggested by the working groups were approved by the Board for implementation.

Conclusion 
Key factors contributing to the high approval rate of plans, strong engagement record of staff and enhanced cooperation between involved departments; included: multisectoral/cross hierarchal staff involvement, group attention to defining time-bound contextual goals, flexible implementation monitoring approaches, personnel skills and profiles of participants, direct and open communication at all levels and times, member commitment and clear exit strategy. The case study is presented as a model to stimulate similar actions in other complex healthcare facilities.

Keywords

References

  1. Istituto Superiore di Sanità (ISS). Characteristics of COVID-19 Patients Dying in Italy. ISS; 2022.
  2. Dipartimento della protezione civile. Coronavirus. La situazione in Italia. https://mappe.protezionecivile.gov.it/it/mappe-emergenze/mappe-coronavirus/situazione-desktop. Accessed January 11, 2021.
  3. Gazzetta Ufficiale della Repubblica Italiana. D.L. 19 May 2020 n. 34: Piano straordinario di riorganizzazione della rete ospedaliera in emergenza COVID-19. https://www.gazzettaufficiale.it/eli/id/2020/05/19/20G00052/sg. Accessed August 20, 2021.
  4. Italian Ministry of Health. Circolare 11254 Del 29 Maggio 2020: Trasmissione Linee Di Indirizzo Organizzative per Il Potenziamento Della Rete Ospedaliera per Emergenza Covid-19. 2020. https://www.sicp.it/wp-content/uploads/2020/06/Min-Sal-circolare-11254_potenziamento-rete-ospedaliera_29-mag-20.pdf.
  5. Camera dei Deputati. Misure sanitarie per fronteggiare l’emergenza coronavirus. https://temi.camera.it/leg18/temi/misure-sanitarie-per-fronteggiare-l-emergenza-coronavirus.html. Accessed August 20, 2021.
  6. Emilia Romagna Region. Piano di riorganizzazione per i ricoveri in regime di terapia intensiva e in aree di assistenza ad alta intensità di cura. https://bur.regione.emilia-romagna.it/bur/area-bollettini/bollettini-in-lavorazione/n-220-del-26-06-2020-parte-seconda.2020-06-26.5805590125/emergenza-pandemica-covid-19-disposizioni-in-ordine-al-piano-di-riorganizzazione-dellassistenza-ospedaliera-di-cui. Accessed August 20, 2021.
  7. Gorla F, Silenzi A, Borojevic A, et al. “The hospital of tomorrow’’: a participative, holistic method to innovate health-care facilities during the COVID-19 pandemic, 2020-2021. Wkly Epidemiol Rec. 2022;97(7):41-8.
  8. Orsola-Malpighi Polyclinic. Policlinico di Sant’Orsola. https://www.aosp.bo.it/. Accessed October 13, 2021.
  9. Yin RK. Enhancing the quality of case studies in health services research. Health Serv Res. 1999;34(5 Pt 2):1209-1224.
  10. Yin RK. Case Study Research: Design and Methods. SAGE Publications Inc. https://books.google.it/books?hl=it&lr=&id=FzawIAdilHkC&oi=fnd&pg=PR1&ots=l_2V6akV_x&sig=EZ0YI-qPFtK0vkWSqpdpsJxySeE&redir_esc=y#v=onepage&q&f=false. Accessed July 12, 2021.
  11. Busch-Casler J, Haubner S, Pinkwart A. Employee involvement in innovation activities in hospitals: how perception matters. Health Serv Manage Res. 2021;34(2):70-79. doi:1177/0951484820943600
  12. Länsisalmi H, Kivimäki M, Aalto P, Ruoranen R. Innovation in healthcare: a systematic review of recent research. Nurs Sci Q. 2006;19(1):66-72. doi:1177/0894318405284129
  13. Melo S, De Waele L, Polzer T. The role of Post-New Public Management in shaping innovation: the case of a public hospital. Int Rev Adm Sci. 2022;88(4):1032-1049. doi:1177/0020852320977626
  14. Telljohann V. Employee-driven innovation in the context of Italian industrial relations: the case of a public hospital. Transfer (Bruss). 2010;16(2):227-241. doi:1177/1024258910364308
  15. Schultz C, Graw J, Salomo S, Kock A. How project management and top management involvement affect the innovativeness of professional service organizations—an empirical study on hospitals. Proj Manag J. 2019;50(4):460-475. doi:1177/8756972819857893
  16. Oyebamiji FF. Influence of employees participation in decision making on organization performance: a study of Ladoke Akintola University of technology teaching hospital, Ogbomoso, Oyo State, Nigeria. Int J Innov Soc Sci Humanit Res. 2018;6(3):8-17.
  17. O'Donoghue P, Stanton P, Bartram T. Employee participation in the healthcare industry: the experience of three case studies. Asia Pacific J Hum Resour. 2011;49(2):193-212. doi:1177/1038411111400262
  18. Hudon C, Chouinard MC, Bisson M, et al. Case study with a participatory approach: rethinking pragmatics of stakeholder engagement for implementation research. Ann Fam Med. 2021;19(6):540-546. doi:1370/afm.2717
  19. Schultz C, Salomo S, de Brentani U, Kleinschmidt EJ. How formal control influences decision-making clarity and innovation performance. J Prod Innov Manage. 2013;30(3):430-447. doi:1111/jpim.12009
  20. Mol MJ, Birkinshaw J. The role of external involvement in the creation of management innovations. Organ Stud. 2014;35(9):1287-1312. doi:1177/0170840614539313
  21. Téchne. Who is Téchne? https://www.who.int/groups/techne. Accessed August 18, 2021.
  22. Wang J, Wang Z. Strengths, weaknesses, opportunities and threats (SWOT) analysis of China's prevention and control strategy for the COVID-19 epidemic. Int J Environ Res Public Health. 2020;17(7):2235. doi:3390/ijerph17072235
  23. Gogoi K, Baruah P. Goal setting: its impact on employee outcome. SCMS J Indian Manag. 2021;18(1):75-86.
  24. Stretton A. Responsibilities for “project” successes/failures. PM World J. 2018;7(11):1-17.
  25. Ogbeiwi O. Why written objectives need to be really SMART. Br J Health Care Manag. 2017;23(7):324-336. doi:12968/bjhc.2017.23.7.324
  26. Serrador P. The Importance of the Planning Phase to Project Success. Paper Presented at PMI® Global Congress 2012—North America, Vancouver, British Columbia, Canada. Newtown Square, PA: Project Management Institute 2012. https://www.pmi.org/learning/library/importance-planning-phase-project-success-6021. Accessed July 11, 2021.
  27. Pinto MB, Pinto JK. Project team communication and cross-functional cooperation in new program development. J Prod Innov Manage. 1990;7(3):200-212. doi:1111/1540-5885.730200
  28. Mayrowetz D, Weinstein CS. Sources of leadership for inclusive education: creating schools for all children. Educ Adm Q. 1999;35(3):423-449. doi:1177/00131619921968626
  29. Smylie MA, Wenzel SA. The Chicago Annenberg Challenge: Successes, Failures, and Lessons for the Future. Final Technical Report of the Chicago Annenberg Research Project. 2003. https://eric.ed.gov/?id=ED482425. Accessed July 11, 2022.
  30. Team E. Project Success Criteria: How to Define, Measure with Examples. https://www.projectpractical.com/project-success-criteria/. Accessed July 11, 2022.
  31. Matsumoto A. How to Use Surveys Throughout Your Project Lifecycle. https://www.surveymonkey.com/curiosity/how-to-use-surveys-throughout-your-project-lifecycle/. Accessed October 11, 2021.
  32. Palmer E. Five Factors That Lead to Successful Projects. P.M. Project Management. https://project-management.com/five-factors-that-lead-to-successful-projects/. Accessed August 19, 2021.

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History

  • Receive Date: 12 April 2022
  • Revise Date: 28 December 2022
  • Accept Date: 28 January 2023
  • First Publish Date: 29 January 2023

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