Organisational Development in Healthcare: Approaches, Innovations, Achievements

Citation

(2006), "Organisational Development in Healthcare: Approaches, Innovations, Achievements", International Journal of Health Care Quality Assurance, Vol. 19 No. 6. https://doi.org/10.1108/ijhcqa.2006.06219fae.003

Organisational Development in Healthcare: Approaches, Innovations, Achievements

Organisational Development in Healthcare: Approaches, Innovations, AchievementsEdited by Edward PeckRadcliffe Publishing2005ISBN 1 85775 896 X

The NHS Modernisation Agency has defined organisational development (OD) as “a comprehensive, connected and systematic organisation-wide development programme designed to enable an organisation to get from where it is to where it wants to be”.

This recent publication, amongst the plethora of a range of similar products, sets itself an impressive challenge in breaking down this definition – one that other publications do not achieve effectively and that is to pull together the different approaches for OD, provide practical examples and in doing so, provide a critical examination which will allow managers, clinicians and others to decide on the best approach for their organisation.

Organisational Development in Healthcare has two forewords, written by Nigel Edwards and David Fillingham, both of whom at the time were key strategic players in the NHS. The messages they promote are that it is imperative that OD theory and practical experience are brought together to effect change; that organisations should be concentrating their efforts towards long-term OD implementation as opposed to short-term meddling with the latest management fads; and that there has been a tendency to invest in US techniques which don’t always transplant easily in the UK because OD is largely about culture change.

Organisational Development in Healthcare has many contributors and experts on OD including those from research, management, independent consultancy, general management, higher education and crucially, clinical backgrounds to describe and assess their own particular slant on OD practice and implementation. There is indeed no “right answer” in developing an OD programme: the only requirement it appears is to ensure a blended approach and one which is led from within – OD is everyone’s business, not just the remit of external consultants.

The book is divided into four parts. Part 1 provides the context, definitions, and context for OD programmes within healthcare, and particularly the NHS. Much of this relates to the work of the Modernisation Agency and explores the relationships between leadership and OD. The very fact that the Modernisation Agency no longer exists in this remit at this time bears witness to the fast-changing pace of healthcare in the NHS, and ergo the need for robust long-term OD programmes is essential. This chapter brings together the background for OD interventions, which are then explored in Part 2.

Part 2 is the heart of the publication’s initial challenge in filling the gap left by other similar books. It provides eight models or “schools of thought”:

1. 1.

   service development;

2. 2.

   psychodynamics;

3. 3.

   complexity;

4. 4.

   structure;

5. 5.

   systems;

6. 6.

   culture;

7. 7.

   critical appreciative inquiry; and

8. 8.

   narrative and storytelling.

For example, the last model does not claim that storytelling alone is an OD process in its own right, but how it contributes to the OD agenda in health and social care and can ensure that the critical “human element” of ideas are considered.

The eight models are all produced in a standard format for comparison and understanding, including the following sections:

• •

  outlines;

• •

  interventions in practice;

• •

  case studies;

• •

  evaluation;

• •

  limitations; and

• •

  further reading.

Each expert, as one would expect, extols the virtues of their particular preference in their final conclusions, and indeed as the editor highlights, “each intervention contains part of the truth and all of them have their own particular strengths in particular local circumstances.” It is therefore left for the reader to assess each intervention in terms of their particular organisational needs and requirements before making decisions for designing a programme.

Part 3 seeks to examine the claims of OD, the evidence that these interventions will bring about benefits. The key message being that this evidence is in short supply.

Part 4 is the conclusion, written by the editor to challenge his original challenge of filling the gaps and clearing the way for OD to happen. Indeed he admits that it was impossible to provide all the approaches to OD in such a publication, as new ways are being developed all the time.

However, this publication does fulfil the links between theory and practice and provides the reader with a rich source of information. In addition the publication does not promise any easy solutions, it highlights the limitations of a variety of interventions and is honest about the lack of clear evidence to connect OD practices with organisational transformation.