ArticleAnnals of family medicine
Increasing capacity for innovation in bureaucratic primary care organizations: a whole system participatory action research project.
Article in Annals of family medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed, 35 citations in OpenAlex.
- Health managers and community representatives' views of a system-wide intervention to strengthen public healthcare in the Free State, South Africa.African health sciences · 2023Article
- Factors contributing to innovation readiness in health care organizations: a scoping review.BMC health services research · 2022Article
- A participatory action research approach to strengthening health managers' capacity at district level in Eastern Uganda.Health research policy and systems · 2017Article
- The use of case studies to drive bottom-up leadership in community-oriented integrated care and health promotion (COIC).London journal of primary care · 2017Article
- A realist review of interventions and strategies to promote evidence-informed healthcare: a focus on change agency.Implementation science : IS · 2013Review
- Using routinely gathered data to empower locally led health improvements.London journal of primary care · 2013Article
- Recipes for collaborative practice improvement and community development for health.London journal of primary care · 2013Article
- Using routinely gathered data to empower locally led health improvements.London journal of primary care · 2012Article
- Recipes for collaborative practice improvement and community development for health.London journal of primary care · 2012Article
- Inter-organisational communication for patients being case managed by community matrons.London journal of primary care · 2010Article
- Primary care practice development: a relationship-centered approach.Annals of family medicine · 2010Article
- Inter-organisation communication for end of life care.London journal of primary care · 2009Article
- A group randomized trial of a complexity-based organizational intervention to improve risk factors for diabetes complications in primary care settings: study protocol.Implementation science : IS · 2008Article
- Comprehensive Primary Health Care: a new phase?London journal of primary care · 2008Article
- Antenatal screening for haemoglobinopathies in primary care: a whole system participatory action research project.The British journal of general practice : the journal of the Royal College of General Practitioners · 2005Article
- Natural history of practice transformation: development and initial testing of an outcomes-based model.Annals of family medicineArticle
- General medical practitioners need to be aware of the theories on which our work depend.Annals of family medicineArticle
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeWe wanted to identify what organizational features support innovation in Primary Care Groups (PCGs).
methodsOur study used a whole system participatory action research model. Four research teams provided complementary insights. Four case study PCGs were analyzed. Two had an intervention to help local facilitators reflect on their work. Data included 70 key informant interviews, observations of clinical governance interventions and committee meetings, analysis of written materials, surveys and telephone interviews of London Primary Care Organizations, interviews with 20 nurses, and interviews with 6 finance directors. A broad range of stakeholders reviewed data at annual conferences and formed conclusions about trustworthy principles. Sequential research phases were refocused in the light of these conclusions and in response to the changing political context.
resultsFive features were associated with increased organizational capacity for innovation: (1) clear structures and a vision for corporate and clinical governance; (2) multiple opportunities for people to reflect and learn at all levels of the organization, and connections between these "learning spaces"; (3) both clinicians and managers in leadership roles that encourage participation; (4) the right timing for an initiative and its adaptation to the local context; and (5) external facilitation that provides opportunities for people to make sense of their experiences. Low morale was commonly attributed to 3 features: (1) overwhelming pace of reform, (2) inadequate staff experience and supportive infrastructure, and (3) financial deficits.
conclusionsThese features together may support innovation in other primary care bureaucracies. The research methodology enabled people from different backgrounds to make sense of diverse research insights.
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