Sharyn Maxwell

Medicine, management, and modernisation: a “danse macabre”?

To break their destructive antagonism over issues of health service modernisation, doctors and managers should engage more directly with nursing and allied health professionals when responding to reform initiatives

Making clinical governance work

The current focus on quality and safety means most doctors have negative views about clinical governance. But done properly, clinical governance has the power to improve NHS performance

The negotiated order of health care.

It is forty years since Anselm Strauss and his colleagues published this seminal paper. In the present day it can be read at two levels. First, for proponents of reform, it provides a benchmark for measuring progress. Second, for students and researchers, it is an enduring contribution to organisation studies. The discussion that follows is in three parts. We open with Strauss’s depiction of clinical work organisation and examine its benchmarking potential. We then canvas the paper’s contribution to organisation studies. We conclude by examining the paper’s implications for current efforts on reform.

Integrated Care e-Pathways Using Formic Fusion for Patients Undergoing Elective Hip and Knee Replacements

The objective of this research is to re-engineer data capture and analyze process of orthopaedic patients, involving multidisciplinary & cross-departmental healthcare records towards a unified Integrated Care e-Pathway (eICP) information system. The project will introduce a homogeneous, consistent and efficient way of capturing and querying of orthopaedic surgical patients’ data across the relevant hospital departments and will complement other NHS (National Health Service)-wide initiatives on electronic health records. The chosen approach is a mix of intelligent re-designs of paper based pathways with an Optical-Character-Recognition (OCR) process via Formic Fusion Software, and a successive move towards routine electronic data capture which will be fully integrated with other hospital-based systems. Reports will be generated using Statistical Process Control (SPC) tools. So, it is a huge change management project involving culture change. A survey is conducted to study the attitude of clinical staff and service users towards implementing technology at the point of care (before and after implementing new technology). It also involves adopting lean principles which is termed as North East Transformation System (NETS). The research tracks the current status of National Program for IT (NPfIT), run by Connecting for Health (CfH).