Publications
185 results found
Tucker D, Hendy J, Barlow J, 2012, Sensemaking and Social Accounts of Middle Managers, Academy of Management Annual Meeting
ABSTRACT:Literature on sensemaking has largely focused on the content and patterning of interpretative schemata. We identify the mechanisms which determine how schemata are newly formed. Our longitudinal real-time analysis of a complex change provides an explanation of the evolution of this phenomenon. Using social accounts as a cognitive tool for schemata change, we focus on the interaction between middle managers and other members, during the process of moving from one large hospital facility to another. We elucidate how group consensus and the alignment of a social account with existing schemata, mediates sensemaking. Our findings expand theory regarding the processes and mechanisms through which middle managers incorporate or reject new information into their existing schemata. We also show the extent to which the resulting sensemaking contributes to organizational outcomes.
Steventon A, Bardsley M, Billings J, et al., 2012, Effect of telehealth on use of secondary care and mortality: findings from the Whole System Demonstrator cluster randomised trial., BMJ, Vol: 344
OBJECTIVE: To assess the effect of home based telehealth interventions on the use of secondary healthcare and mortality. DESIGN: Pragmatic, multisite, cluster randomised trial comparing telehealth with usual care, using data from routine administrative datasets. General practice was the unit of randomisation. We allocated practices using a minimisation algorithm, and did analyses by intention to treat. SETTING: 179 general practices in three areas in England. PARTICIPANTS: 3230 people with diabetes, chronic obstructive pulmonary disease, or heart failure recruited from practices between May 2008 and November 2009. INTERVENTIONS: Telehealth involved remote exchange of data between patients and healthcare professionals as part of patients' diagnosis and management. Usual care reflected the range of services available in the trial sites, excluding telehealth. MAIN OUTCOME MEASURE: Proportion of patients admitted to hospital during 12 month trial period. RESULTS: Patient characteristics were similar at baseline. Compared with controls, the intervention group had a lower admission proportion within 12 month follow-up (odds ratio 0.82, 95% confidence interval 0.70 to 0.97, P = 0.017). Mortality at 12 months was also lower for intervention patients than for controls (4.6% v 8.3%; odds ratio 0.54, 0.39 to 0.75, P < 0.001). These differences in admissions and mortality remained significant after adjustment. The mean number of emergency admissions per head also differed between groups (crude rates, intervention 0.54 v control 0.68); these changes were significant in unadjusted comparisons (incidence rate ratio 0.81, 0.65 to 1.00, P = 0.046) and after adjusting for a predictive risk score, but not after adjusting for baseline characteristics. Length of hospital stay was shorter for intervention patients than for controls (mean bed days per head 4.87 v 5.68; geometric mean difference -0.64 days, -1.14 to -0.10, P = 0.023, which remained significant after adjustment). Observe
Hendy J, Barlow J, 2012, The adoption of telecare in the community., Community Practitioner, Vol: 85, Pages: 41-43
Hendy J, Barlow J, 2012, The adoption of telecare in the community., Community Pract, Vol: 85, Pages: 41-43, ISSN: 1462-2815
Barlow J, Koberle-Gaiser M, Moss R, et al., 2012, Delivering innovation in hospital design: Finance, contracts, and the institutional context, Procuring Complex Performance: Studies of Innovation in Product-Service Management, Pages: 159-173, ISBN: 9780203842058
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Barlow JG, Hendy J, Chrysanthaki T, 2012, Scaling-‐up remote care in the United Kingdom: Lessons from a decade of policy intervention., Essential Lessons for the Success of Telehomecare. Why it's not plug and play., Editors: Glascock, Kutzik, Publisher: IOS Press Inc, ISBN: 9781607509936
Hendy J, Barlow J, 2012, The role of the organizational champion in achieving health system change, Social Science & Medicine, Vol: 5, Pages: 348-355
► We use ethnographic longitudinal case studies to study the role of the champion in implementing organizational change. ► We show that champions are highly effective in the first phase of adoption but less effective in later stages. ► Champions highly identified with their work and were threatened when asked to share their work with other stakeholders. ► Our findings caution against allowing change to become positioned within the remit of a few individuals. ► Whilst champions may initially be beneficial they can be detrimental to progress, in the later stages of implementation.
Howitt P, Darzi A, Yang GZ, et al., 2012, Technologies for global health, The Lancet, Vol: 380, Pages: 507-535
For the Whole System Demonstrator team, Steventon A, Bardsley M, et al., 2012, Effect of telehealth on use of secondary care and mortality: findings from the Whole SystemDemonstrator cluster randomised trial, BMJ: British Medical Journal, Vol: 344
Barlow J, Gray C, Wright S, 2011, Fix the system to find the finances., Health Serv J, Vol: 121, Pages: 18-19, ISSN: 0952-2271
Bower PCMHSBJGHJKMHCRASCCMBMSAFRDHNS, 2011, A comprehensive evaluation of the impact of telemonitoring in patients with long-term conditions and social care needs: protocol for the Whole Systems Demonstrator cluster randomised trial, BMC Health Services Research, Vol: 11, ISSN: 1472-6963
BackgroundIt is expected that increased demands on services will result from expanding numbers of older people with long-term conditions and social care needs. There is significant interest in the potential for technology to reduce utilisation of health services in these patient populations, including telecare (the remote, automatic and passive monitoring of changes in an individual's condition or lifestyle) and telehealth (the remote exchange of data between a patient and health care professional). The potential of telehealth and telecare technology to improve care and reduce costs is limited by a lack of rigorous evidence of actual impact.Methods/DesignWe are conducting a large scale, multi-site study of the implementation, impact and acceptability of these new technologies. A major part of the evaluation is a cluster-randomised controlled trial of telehealth and telecare versus usual care in patients with long-term conditions or social care needs. The trial involves a number of outcomes, including health care utilisation and quality of life. We describe the broad evaluation and the methods of the cluster randomised trialDiscussionIf telehealth and telecare technology proves effective, it will provide additional options for health services worldwide to deliver care for populations with high levels of need.
Barlow J, Bayer S, 2011, Raising the profile of simulation and modelling in health services planning and implementation, JOURNAL OF HEALTH SERVICES RESEARCH & POLICY, Vol: 16, Pages: 129-130, ISSN: 1355-8196
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- Citations: 3
Hendy J, Barlow J, Chrysanthaki T, 2011, Implementing remote care in the UK: an update of progress, Eurohealth, Vol: 2-3
Barlow JG, Bayer S, Cravo Oliveira T, 2011, Remote care: Health at home, The Connected Home, Editors: Harper, Publisher: Springer, ISBN: 9780857294760
Hendy J, Barlow J, 2011, Managerial interpretations of evidence and the adoption of a healthcare innovation
Our work explores the gap between evidence, management practices and the adoption of innovations. The article draws on the results of a longitudinal study examining the adoption of remote care (telecare) services. Five UK non-profit organisations form purposively chosen case studies. In the process of adoption, we explore how managers interpret and construct evidence to inform practice. Our results demonstrate that managerial interpretations of evidence are negotiated through a series of interlinked frames of reference. These frames align evidence with existing professional practices and needs, and mobilise collective decision-making and strategic action. The degree to which the resulting adapted managerial practice is consistent with aims and objectives of the recipient organisation serves to mediate innovation spread.
Barlow J, Childerhouse P, Gann D, et al., 2010, Choice and delivery in housebuilding: lessons from Japan for UK housebuilders, BUILDING RESEARCH AND INFORMATION, Vol: 31, Pages: 134-145, ISSN: 0961-3218
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- Citations: 116
Hertin J, Berkhout F, Gann DM, et al., 2010, Climate change and the UK house building sector: perceptions, impacts and adaptive capacity, BUILDING RESEARCH AND INFORMATION, Vol: 31, Pages: 278-290, ISSN: 0961-3218
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- Citations: 69
Hendy J, Barlow J, Chrysanthaki T, 2010, FROM PILOT PROJECT TO MAINSTREAM SERVICES: LESSONS FROM THE WORLD'S LARGEST REMOTE CARE PROGRAMME, GERONTOLOGIST, Vol: 50, Pages: 548-548, ISSN: 0016-9013
Barlow JG, 2010, Delivering Innovation in Hospital Design: Finance, Contracts & the Institutional Context, Procuring Complex Performance, Editors: Caldwell, Publisher: Routledge, Pages: 159-173, ISBN: 9780415800051
Barlow J, Bayer S, Curry R, et al., 2010, From care closer to home to care in the home: the potential impact of telecare on the built environment, Improving Healthcare Through Built Environment Infrastructure, Editors: Kagioglou, Tzortzopoulos, Publisher: Wiley-Blackwell, ISBN: 9781405158657
Barlow J, Roehrich JK, Wright S, 2010, De facto privatization or a renewed role for the EU? Paying for Europe's healthcare infrastructure in a recession., J R Soc Med, Vol: 103, Pages: 51-55, ISSN: 1758-1095
Rechel B, Wright S, Barlow JG, et al., 2010, Hospital capacity planning: from measuring stocks to modeling flows? Bulletin of the WHO, Bulletin of the World Health Organization, Vol: 88, Pages: 632-636, ISSN: 0042-9686
Barlow JG, Bayer S, Curry R, et al., 2010, From care closer to home to care in the home: the potential impact of telecare on the built environment, Improving Healthcare Through The Built Environment, Editors: Kagioglou, Tzortzopoulos, Publisher: Wiley-Blackwell, Pages: 131-138
Bayer S, Petsoulas C, Cox B, et al., 2010, Facilitating stroke care planning through simulation modelling, Health Informatics Journal, Vol: 16, Pages: 129-143
Stroke is a leading cause of death and long-term severe disability. A major difficulty facing stroke care provision in the UK is the lack of service integration between the many authorities, professionals and stakeholdersinvolved in the process. The objective of this article is to describe a prototype model to support integrative planning for local stroke care services. The model maps the flow of care in the acute and community segments of the care pathway for stroke patients and allows xploring alternatives for care provision. Simulationmodelling can help to develop an understanding of the systemic impact of service change and improve the design and targeting of future services.
Dattée B, Barlow JG, 2010, Complexity and whole-system change programmes, Journal of Health Services Research and Policy, Vol: 15 (S2), Pages: 12-18
Objective: There has been growing interest in applying complexity theory to health care systems, both in policyand academic research discourses. However, its application often lacks rigour – authors discuss the propertiesof complex systems, state that they apply to health care and draw conclusions anchored around the idea of ‘wholesystem change’. This paper explores the use of whole systems change in a programme to improve the delivery ofunscheduled health care in Scotland.Methods: Qualitative case-studies of five health boards in Scotland reflecting different demographics, initialperformance data and progress towards meeting programme targets.Results: The programme’s collaborative approach was successful in moving to a culture of mutualunderstanding and greater awareness of the interdependencies between different functions within thehospitals. There was whole system working at the acute hospital level, leading to improved patient flows. Butdespite recognizing the need for whole system change overall, it proved hard to address relationships withstakeholders influencing wider out-of-hospital patient flows. This was exacerbated by the structure of theprogramme, which was designed much more around acute patient flows.Conclusions: The programme worked well to improve performance by focusing on interdependencies within alarge part of the acute care subsystem but did not have the same impact at the overall health care system level.This has important implications for the design of policy and associated programmes which seek to effectwhole system reform, or at least are realistic about the magnitude of change they can achieve.
Barlow J, Hendy J, 2009, The challenges of adopting integrated mainstream telecare services: lessons from the UK., Eurohealth, Vol: 15, Pages: 8-10, ISSN: 1356-1030
Barlow JG, Koberle-Gaiser M, Moss R, et al., 2009, Adaptability and innovation in healthcare facilities. Lessons from the past for future developments, Publisher: HaCIRIC
Picard J, Ward S, Zumpe R, et al., 2009, Guidelines and the adoption of ‘lipid rescue’ therapy for local anaesthetic toxicity, Anaesthesia, Vol: 64, Pages: 122-125
Gathering evidence from animal experiments, an editorial in this journal and published human case reports culminated in the Association of Anaesthetists of Great Britain and Ireland recommending in August 2007 that lipid emulsion be immediately available to all patients given potentially cardiotoxic doses of local anaesthetic drugs. This development offered an opportunity to track the adoption of an innovation by anaesthetists in the UK and to gauge the effects of guidelines. Two surveys, each of 66 NHS hospitals delivering acute care within London and its penumbra,examined the adoption of lipid emulsion therapy. After the publication of the editorial in autumn 2006, the spread of ‘lipid rescue’ was rapid. The timing of the adoption and the impetus for innovation varied substantially between the sampled hospitals. When the formal guidelines were published, approximately half of the hospitals surveyed did not have lipid rescue. Of those that subsequently adopted it, half attributed their decision to the guidelines. At the end of 2007, there remained a small number of hospitals that had yet to adopt lipid rescue. Lipid rescue’s adoption by anaesthetists in the UK offers a rare example of swift uptake of an innovation. National guidelines accelerated the adoption of innovation by some hospitals.
Barlow J, Koberle-Gaiser M, 2009, Delivering innovation in hospital construction: Contracts and collaboration in the UK’s Private Finance Initiative hospitals program, California Management Review, Vol: 51, Pages: 126-143, ISSN: 0008-1256
Barlow J, Burn J, Lockhart G, 2008, All Change Please., All Change Please. Spreading Innovation and Best Practice in the NHS, London, Publisher: Policy Exchange
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