Translating strategy into practice: A tool to understand organizational change in a Spanish university hospital. An in-depth analysis in Hospital Clinic

Purpose: The progressive patient care (PPC) model, the patient-centered approach, and the lean philosophy are key ‘pillars of change’ in hospital settings. This work aims at providing a clear methodological guidance in evaluating a hospital’s positioning in reference to the main pillars of change, as well as on the effectiveness of how enablers of change are concretely enhanced. Methodology/approach: A mixture of qualitative methods such as semi-structured interviews, ethnographic observations, and informal conversations has been used. The most valuable source of data consists of six interviews to key figures within the hospital. Findings: The PPC organizational model is detected to be Non-strategic. Although highly innovative, the new organizational features do not respond to the typical PPC approach. Patient-centeredness assumes a Developed/Advanced position. ‘Units’ are the major response to the hospital’s strategy of introducing patient centeredness. Finally, the implementation of lean reaches a Starting/Developed positioning. The approach followed is responsive to staff’s engagement and commitment, but implementation is isolated and ‘one-shot’. Its positioning on the scales of three pillars of change seems extremely coherent with the hospital’s strategic priorities. The highest position is reached for patient-centered care, which is the prior objective of the hospital’s main pressures for change. Originality/value: The approach’s major potential is in comparing the hospitals’ current position with its strategy, as well as detecting differences with similar settings. This approach provides hospitals’ management with an effective support in ranking priorities through insights on which enabling tools should urgently be further developed.