CONSTRUCCIONES E INSTALACIONES

Table 7.27: A table to show the framework concept, theme and sub-theme for ‘Evolution’ – ‘External Boundary Spanning’

2.11 Transition

2.11.1 Mandated spread and timeliness

There are three distinct aspects that drive the process forward from ‘activity’. These are the inclusion of a CLAHRC member within the group, a mandated timeline for the delivery of outcomes and the mandated deliverable to include the wider teams of which each group member is a representative. I unpack each of these aspects further below. However, in essence it ensures the knowledge transfer boundary network moves forward from the ‘activity’ stage because these three aspects combine to prevent the network from either becoming or remaining bonded in a sealed manner.

A project had an 18 month timeframe in which to deliver its outcomes. This was an absolute deadline and created a drive to keep moving the project forward. The quote below highlights an interviewee’s view of the time period available for the process. There was a sense of urgency and continued pressure to keep the project moving

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and this prevented the group from remaining in a cohesive, inward looking state I delineated in ‘activity’.

‘… I almost feel that 18 months is too short for, to learn improvement methodology within a busy’. (10153)

Whilst I highlighted in the commentary surrounding ‘activity’ that CLAHRC’s involvement had reduced it was still present and importantly from the very beginning of the process it was clear that there was a timeframe in which the team had to deliver the outcomes. I observed this requirement throughout the process and the reason the group remained cognisant of this was due to the inclusion of a CLAHRC member to the project team (UoA). In other words the inclusion of a CLAHRC member into the project team prevented the team becoming too tightly sealed and separated from the wider environment. The quote below demonstrates the level of contact a project member states that they have with their CLAHRC project team member.

‘I’ve got one person in my mind [CLAHRC project member] immediately who I just think I lost hours and hours’ (10096)

Another aspect that was a strong part of CLAHRC’s requirements surrounded sustainability. For a project’s outcome to deliver on sustainability there was a strong focus on including the other members of the team from which the participant was representing. In other words there was a drive to embed a new process or action into the wider care pathway network. This was an important part of the success of a project and as such it enabled the group to move forward from becoming too insular and looking only inward.

‘I mean, the project’s really been centred… with all the talks we were having, is

centred on sustainability… I would hope to think that the project we do allows it to be embedded.’ (10153)

As a result the project team worked to embed the new process within the care pathway. The key aspect was to move the project from being done by those who were part of the project team to those in the wider care pathway. As the quote below highlights the challenge is to get it to run smoothly when the project team is not present.

‘And it’s, that’s the challenge, trying to get things in place that when we’re [the project team] not there, things still tick along’. (10134)

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This engagement and spread to the other individuals within the care pathway and the professional and/or organisational areas the individuals were representative of had a certain amount of difficulty.

This difficulty resulted from a number of different reasons. For example, there was a need to clarify the need for the change. The team often met with views that they were already doing whatever the change was supposed to instigate.

‘had the view that for him it doesn’t work, it’s a tick box exercise, because he does this anyway in his practice’. (10113)

Equally, there was the problem surrounding the constant change of personnel. This depended to some extent on the level the change was targeted at. Within a care environment there is a working rotation for trainee level doctors, for example. For those projects where the change was at a trainee level as the training cycle came round there was an on-going need to keep training and embedding the process.

‘just even within my, like, rotation, you know, [person A] has taken it over and she’s now involved’. (10139)

The methods that the projects utilised with regard to engagement varied. A project member even commented on how random the approaches that they as a team utilised.

‘Well everyone tells me, there are magic formulas about spending time and making them feel like everyone’s doing it, but actually I find it’s quite random’. (10159)

It was suggested by some that in order to instigate change ‘you need high-level

support’ (10153), you need ‘repetition’ (10154), and making it clear the value they

would gain from doing it, for example, less waste would equal greater efficiency. The view was then that ‘people sort of think, oh yes, I see, maybe it is a point; I will do it

now’. (10159)

Summary

The network has the momentum to move forward from the ‘activity’ phase due to three reasons, which combine to create a network that does not become completely sealed and stagnant. The core network itself has a CLAHRC member in it, there is an aggressive timeframe in which to deliver the project and there is a requirement for the project to be embedded with a wider sphere of people than just those in the

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project team. This leads the group to move forward to being able to look outwards from the group itself and become ‘self-organising’ as I outline in the following sections of the process framework - termed ‘reiteration’.

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