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The role of leadership in times of systems disruption : a qualitative study of health and social care integration
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Curry, Leslie, Ayedun, Adeola, Cherlin, Emily, Taylor, Beck, Castle-Clarke, Sophie and Linnander, Erika (2022) The role of leadership in times of systems disruption : a qualitative study of health and social care integration. BMJ Open, 12 (5). e054847. doi:10.1136/bmjopen-2021-054847 ISSN 2044-6055.
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Official URL: http://doi.org/10.1136/bmjopen-2021-054847
Abstract
Objectives To understand whether and how effective integration of health and social care might occur in the context of major system disruption (the COVID-19 pandemic), with a focus on how the initiative may overcome past barriers to integration.
Design Rapid, descriptive case study approach with deviant case sampling to gather and analyse key informant interviews and relevant archival documents.
Setting The innovation (‘COVID-19 Protect’) took place in Norfolk and Waveney, UK, and aimed to foster integration across highly diverse organisations, capitalising on existing digital technology to proactively identify and support individuals most at risk of severe illness from COVID-19.
Participants Twenty-six key informants directly involved with project conceptualisation and early implementation. Participants included clinicians, executives, digital/information technology leads, and others. Final sample size was determined by theoretical saturation.
Results Four primary recurrent themes characterised the experiences of diverse team members in the project: (1) ways of working that supported rapid collaboration, (2) leveraging diversity and clinician input for systems change, (3) allowing for both central control and local adaptation and (4) balancing risk taking and accountability.
Conclusions This rapid case study underscores the role of leadership in large systems change efforts, particularly in times of major disruption. Project leadership overcame barriers to integration highlighted by prior studies, including engaging with aversion to clinical/safety risk, fostering distributed leadership and developing shared organisational practices for data sharing and service delivery. These insights offer considerations for future efforts to support strategic integration of health and social care
Item Type: | Journal Article | ||||||||||||
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Subjects: | R Medicine > RA Public aspects of medicine | ||||||||||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School | ||||||||||||
Library of Congress Subject Headings (LCSH): | Integrated delivery of health care , Health services administration, Leadership -- Medicine | ||||||||||||
Journal or Publication Title: | BMJ Open | ||||||||||||
Publisher: | BMJ | ||||||||||||
ISSN: | 2044-6055 | ||||||||||||
Official Date: | 13 May 2022 | ||||||||||||
Dates: |
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Volume: | 12 | ||||||||||||
Number: | 5 | ||||||||||||
Article Number: | e054847 | ||||||||||||
DOI: | 10.1136/bmjopen-2021-054847 | ||||||||||||
Status: | Peer Reviewed | ||||||||||||
Publication Status: | Published | ||||||||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||||||||
Date of first compliant deposit: | 22 May 2023 | ||||||||||||
Date of first compliant Open Access: | 23 May 2023 | ||||||||||||
RIOXX Funder/Project Grant: |
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