Linical Leads in the NHS  They Do Have a Positive Impact on the Adoption Of Best Practice Among Their Peers

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MSc in Organisational Change

A Research Proposal


Clinical Champions in the NHS  They Do Have a Positive Impact on the Adoption of Best Practice Among Their Peers.


Contents



Research Aims & Objectives 3
Rationale 3
Theoretical underpinning 4
Methodology 5
References 7
Appendices 1  Ethics Release Form 9
Appendices 2  Timetable 11




Title

Clinical Champions in the NHS  They Do Have a Positive Impact on the Adoption Of Best Practice Among Their Peers.

Research Aims & Objectives

The aim of the research is to understand how Clinical Champions enable the effective and efficient transfer of best practices across a number of separate organisations within the National Health Service.

To demonstrate that by focusing on their area of expertise, the Clinical Champions are effective in increasing adoption of best practice among their peers.

To demonstrate that change will be more effective if an individual who is an expert in the field and has the respect and trust of their Peers champions the change.

Rationale

Best practice is a modern buzzword and while there has been a rise in the number of studies in best practices, there has been little attention given to considering whether the methods used to encourage their spread are effective. This study will focus on the important role of  Champions as major factors in the successful transfer of best practice.

The reform and modernisation of the National Health Service (NHS) is at the centre of domestic government thinking, (The New NHS, Modern and Dependable, 1997, The NHS Plan). Nowhere has the drive for improvement, been more visible than in the area of Cancer Care, and specifically at the services delivered to those patients suspected with or diagnosed with cancer.

The NHS faces a number of challenging targets that must be achieved by 2005, (The Cancer Plan, Sep 2000).

The Cancer Services Collaborative (CSC) programme is a key implementation strategy for the National Cancer Plan and is designed to support local clinical teams to look at their own services and make significant improvements in the services provided to patients, (Cancer Services Collaborative, December 2001).

From April 2003, Phase 3 (2003-2006) of the project commenced. Its main aim is to roll out those improvements (best practice) to other Trusts within the network. However, each Hospital Trust within the network is its own separate organisation complete with different cultures, management styles, systems and processes

Networks incorporate elements of meeting and sharing of experiences between individuals from different organisations. Since its emergence in academic literature in the 1970s, the concept of  networks has steadily grown in popularity. The work of Conway, Alter, Hage, has attempted to understand the value of  networking as a mechanism for spreading innovation, (Conway, 1995; Alter & Hage 1993). These elements are generally seen to be an important part of effective dissemination strategies, (Ollerearnshaw et al 2000). The effectiveness of networks and their ability to transfer best practice will depend on several other factors, including levels of involvement of key stakeholders, leadership, support and commitment in participating organisations and relationships. The network is an ideal environment, for a Champion, to diffuse best practice, as he/she is well placed to influence his/her peers from a number of various organisations.

This research will be helpful to a number of NHS organisations, Improvement Leads and managers that are involved in modernising the services that are delivered to patients and carers.


Theoretical underpinning

What is Best Practice?

The American Productivity and Quality Centre (1997) best practices are those practices that have been shown to produce superior results selected by a systematic process and judged as exemplary, good or successfully demonstrated.

Jarrar and Zairi (2000) used a Chevron approach to defining best practice that resulted in a multi level definition;

a) Good idea  unproven but makes sense intuitively. It could have a positive impact on business performance but requires further review and analysis.

b) Good practice  technique, methodology or process that has been implemented and has improved business results. This is substantiated by data collected at the organisation.

c) Proven best practice a good practice that has been determined to be the best approach for many organisations based on analysis of process performance data.

The interest in identifying best practice has become popular among many practitioners of various disciplines and is widely regarded as a  corporate miracle , (Jarrar and Zairi 2000). Flynn et al (1995) describes,  best practice as  approaches used by managers and workers with the goal of achieving certain types of performance . Best practice has become a buzzword used by both academics and industrialists alike, (Davis and Kochar 2002).
Fitz-enz (1993, 1997) suggest that many of the references to best practice in the practitioner literature provide only a partial picture of best practice as they are not based on a solid foundation of research.

Much of the literature relating to best practice is descriptive, and relates more to those practices and processes that successful organisations have in place, (Davis and Kochar 2002). The evidence for describing the implementation and success of practices in improving performance are most commonly individual case studies. There have been relatively few large-scale studies that empirically link best practices with improved performance and the studies that have been carried out are within manufacturing and industry and not in a Health Care setting. Regularly, the relationship between best practices and improved performance are assumed to be self evident, (Voss et al 1997,Davies and Kochar, 2002).

Ashton (1997) advocates the identification, management, and transfer of best practice as being more useful for  revolutionising performance and that recently the focus of attention has moved towards the diffusion of best practice.

Transferring Best Practice

Zairi and Whymark (2000) describe the  5Rs process of transferring best practice: Research, Resource, Recording, Roll out, Review. Nancy Dixon (2000) and O Dell and Grayson (1998) provide examples of checklists that can be used to enable the transfer of best practice.

Simply providing information is not the most important element of effective dissemination, (Ollerearnshaw et al 2000). The goals of these separate organisations may well be the same but how each organisation gets there may be very different. Transfer, is identifying and learning from best practices and applying them in a new configuration or location, (O Dell and Grayson, 1997).


 Whether practices are exemplary, best or good they are rarely the ultimate that can be achieved since best practice is always contextual , (Manager quoted in Ashton 1998) and according to Davis and Kochar (2002), caution must be used when using the word  best as  best is context specific. Hiebler et al. (1998), states  no single practice works for everyone in any given situation. Best is a contextual term. It means best for you in the context of your business and its company culture, use of technology and competitive strategies .

Gladwell, (2000) compares the adoption of change to an epidemic and, like epidemics, is sensitive to the conditions and circumstances of the time and place they occur. Ollerearnshaw et al (2000) states  people are more inclined to adopt or develop best practice if they can identify for themselves what will work best in their own circumstances . Galliers R, Newell S (2001) argued,  best practices almost always have to be adapted to local conditions . The literature has shown that best practi