Network Alignment in Healthcare: A Socio-Technical Approach to System-Wide Improvement and Patient Safety.

Abstract

Local process improvement efforts have permeated the healthcare industry, yet the ability to extend these improvements across the system continues to be a challenge. Coordinating services, or patient care, across organizational boundaries can be difficult and can impact leadership’s ability to enable widespread organizational change. This research presents a socio-technical approach to cross-unit coordination and system-wide improvement by forwarding a network alignment methodology that can aid in the identification of gaps throughout a system. The proposed model examines the alignment of patient or diagnostic information flow, the technical flow network, with the ability to clearly define customer requirements and problem solve with suppliers, the safety control network. This research uses a case study approach to assess the current situation and demonstrate an improvement approach to coordinate across organizational boundaries for improved quality in health care. Using both qualitative and quantitative data, we observe empirically a relationship between unit coordination and quality, safety culture, and process improvement efforts. This work provides a method for analyzing value streams that differ from the linear, sequential value stream mapping techniques commonly employed in manufacturing and introduces a coordination assessment measurement approach to quantify mismatches between technical flow and organizational structure. The ability of leadership to understand where breakdowns occur and develop countermeasures can impact the effectiveness of system-wide problem solving which, in turn, becomes the basis for continuous organizational learning and improvement.