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Table 3 Description and underlying assumptions of the SIDSSA intervention

From: Exploring the potential of a multi-level approach to improve capability for continuous organizational improvement and learning in a Swedish healthcare region

Interventions Forms/Means Rationale/Assumptions Intermediate Outcomes Individual Intermediate Outcomes Group/Unit Long-term outcomes
R&D unit – regional development and change facilitators
Exemplify, test, and evaluate the usefulness of the SIDSSA development loop, the systems view and multi-level/multi strategy approach, and the regular use of reflective learning and action-learning loops
- On the R&D unit’s own improvement areas
- On municipality cases A and B, involving participants from several hierarchical levels and phases in the development loop
- Of specific work procedures and instruments on the R&D unit’s own improvement cases and municipality cases
- On the participants’ own learning and change processes
Researcher-led development:
- Workshops
- Seminars
- Group coaching
- Individual coaching
- Test on real cases
- Visualization of process/structure
- Joint collection of data/information
- Joint analyses of learning process and reactions
- Participation in adapting the approach to specific contexts and choices of arenas for testing
- Action-learning loop for double-loop learning
- Shared mental models
- Systems view
- Multiple levels, multiple strategies
- Structured approach
- Flexible and contextualized
- Visualized development process
- Increase complexity gradually
Improved knowledge
- Of the regional system of partner organizations, its levels, and functions
- On change and learning processes
Improved competence, ability
- To act systematically when supporting COIL (map, identify, analyze, plan, execute, evaluate, sustain)
-To analyze and reflect
- To support others trying to change their work approach
-To choose and use various procedures and instruments to aid change processes
- Insights, attitudes, and behavioral changes in line with the new approach
Behavioral strategies, work approach
- Changed, more systematic, and strategic approach to support COIL
- Clarified task, mission, and map of target organization
Group strategies, work approach
- Common, systematic work approach to support and facilitate COIL
Shared knowledge
- Common team mental model of what it takes to change behavior and potential approaches to do so in their function
Capability
- Improved capability as a unit to facilitate and support the development of COIL in the regional partner organization
Municipality A and B participants
Exemplify, test, and evaluate the usefulness of SIDSSA development loop, the systems view and multi-level/multi strategy approach, and the regular use of reflective learning and action-learning loops
- For unit managers with the participating unit’s own choices of improvement areas/projects
- On participants’ own learning and change processes
- For local support functions to test when supporting the participating units in their process
- For division managers to support unit managers in their processes and to reflect on the usefulness of the learning for the whole division
Researcher-led development:
- Workshops
- Meetings
- Follow-ups
- Initial group coaching
Development led by the R&D unit:
- Meetings
- Group coaching
- Individual coaching
- Follow-ups
Local test and development:
- Local development work and support within organization
- Action-learning loop for double-loop learning
- Shared mental models
- Systems view
- Multiple levels, multiple strategies
- Structured approach
- Flexible and contextualized
- Visualized development process
- Increase complexity gradually
Improved knowledge
- Of the organizational system and on-going development initiatives (national, regional, local levels)
- On change and learning processes
Improved competence, ability
- To work systematically to support COIL in division and unit (map, identify, analyze, plan, execute, evaluate, sustain)
- To analyze and reflect
- To support others’ change and learning processes
- To choose and use various procedures and instruments to aid change processes
- Insights, attitudes, and behavioral changes in line with the new approach
Behavioral strategies, work approach
- Changed, more systematic, and strategic approach to support COIL
Division strategy/work approach
- Development towards a common, systematic work approach to facilitate COIL in the participating units
Shared knowledge
- Common team mental model of what it takes to change behavior and potential approaches to do so in their function and in the division
Capability
- Improved capability as a division manager; local support function and unit manager to facilitate and support the development of COIL in their organization
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