'The productive ward round': a critical analysis of organisational change

Grant, Paul
October 2008
International Journal of Clinical Leadership;Oct2008, Vol. 16 Issue 4, p193
Academic Journal
The 'Productive Ward' project is based on an initiative from the USA, 'Transforming Care at the Bedside', which aims to use 'lean' methodology, borrowed from the Toyota corporation, to maximise the efficiency and productivity of patient care in a very pragmatic manner. Our study utilises the McKinsey 7S model to critically analyse the implementation of this type of transformational change. Doctors may agree that their working practices are outmoded and inefficient, but bringing about change will be difficult if the culture and attitudes of doctors are not acknowledged. There are significant areas of non-alignment (structure, shared values and style) that may be barriers to change unless they are appropriately addressed. Ultimately, this will be difficult because the way in which the ward round is currently designed is for the convenience of doctors. The productive ward vision is designed for the convenience of nurses. We perhaps need to find some common ground whereby it is actually modelled on the convenience of patients, but without some stark changes in medical culture this will be hard to bring about.


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