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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