Making sense of change management in healthcare

Il caso dell’AO e dell’AUSL di Ferrara

Principal investigator: Valeria D. Tozzi (CeRGAS)

Team UB/Cergas: Lucia Ferrara, Alberto Ricci, Giovanni Fosti

Partners: AO e AUSL Ferrara

Sponsor: Roche S.p.A.

Duration: November 2023-December 2024

Abstract:

The Italian National Health Service (SSN) is currently undergoing diverse changes, encompassing institutional changes such as mergers between Local Health Authorities (LHA) or LHAs and Hospital Trusts (AO), changes in delivery models influenced by the National Recovery and Resilience Plan (PNRR) "Mission 6," and Decree Law 77/2022, as well as technological changes affecting information systems (e.g., AI) and care delivery models (e.g., telemedicine). While these changes do not capture all the ongoing transformations, they demonstrate diverse content, actors, and change logics.

 

The project, "Making Sense of Change Management in Healthcare," aims to comprehend and represent the change processes within AUSL and AOU of Ferrara, with a particular emphasis on the developed leadership model. The case of AUSL and AOU of Ferrara is noteworthy as it provides a context where all described change types coexist under the guidance of the same strategic direction.

 

The study employs Cameron & Green's 2019 investigation framework, tailored to the nuances of public healthcare organizations, highlighting the synchronous relationship between leadership and change processes. The leadership of the top manager is examined in connection with the development of activities, including provided services (outcomes), promotion of interest in change (interests), and the instigation of a change-ready culture (emotions).

 

To explore the dynamics of change, the research project identifies three representative units of analysis (projects), each embodying different types of initiated change: 

  • the transformation of institutional structures of LHAs and AOs, 

  • the management of oncological activities in non-hospital settings, 

  • and the digital transition. 

The research methodology includes desk research for information gathering, semi-structured interviews with approximately 50 key stakeholders and the strategic direction, and workshops to present intermediate evidence for feedback collection.

The anticipated output is the creation of an article for submission to a scientific journal.