Leadership and change management in advancing hybrid operating rooms into interventional cardiology in hospitals within the National Health Service
Introduction
Hybrid operating rooms (HORs) constitute a new advancement in cardiology where endovascular surgeons join cardiologists to perform more complex operations in an integrated care system.1 The adoption of this advancement is in line with the 10-year plan of the NHS where more funding is being provided for measurable improvement and commitment for enhanced service.1 Cardiac diseases continue to pose a challenge to the NHS where increased survival of chronically managed conditions continues to be more prevalent.2
Materials and methods
This research would design a model to allow for an efficient introduction of HORs into an existing healthcare service. This is done by analysing leadership theories, leadership domains, challenges of improvement, change management and models of change agency.3,4 A literature review was conducted and it included PubMed, Medline, Embase, Google Scholar, the King's Fund publications website and NHS Evidence. The keywords used were ‘hybrid operating rooms’ or ‘HOR’, ‘leadership’, ‘leading change’, ‘organisational change’, ‘change management’, ‘change theories’, ‘quality improvement’ and ‘NHS change’. The results were reviewed manually to identify key articles for more investigation.
Results and discussion
A plan is devised based on Kanter et al’s theory of change management starting with organisational analysis of cardiology and cardiothoracic surgery departments.5 This is followed by arranged meetings to create a common vision and then creating a separate leadership to head the change with organisational autonomy; such a design would reduce tribalism and allow for better advocacy for HOR implementation within the healthcare service. Afterwards, a cost–benefit analysis and projected morbidity and mortality improvements would be drafted in order to create a sense of urgency for moving forward with the project. At this stage gathering political sponsorship (Fig 1) is vital to secure funding and support as well as constructing an implementation program, which would be of a continuous incremental type.6,7 Assurances to staff and tackling rumours would reduce resistance to new change.8 An audit would be conducted after completion to learn from the process and to incorporate learned lessons in future projects (Fig 2).
Conclusion
The study concludes that a carefully designed strategic plan can ease the transition into adopting HORs through identifying gaps, building a harmonious environment, garnering acceptance and facilitating workflow. Such a plan needs to be flexible and also needs the participation of multidisciplinary team of various specialties to benefit from different perspectives and knowledge bases. Resistance should be expected and addressed. Finally, continuous involvement and collaboration throughout the process is important, and is an essential determinant of success of the project as a whole.
Conflicts of interest
None declared.
- © Royal College of Physicians 2020. All rights reserved.
References
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- Kaneko T
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- Oliver D
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- Mango E
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- Kotter JP
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- Kanter RM
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- Luecke R.
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- Dixon-Woods M
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