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Organizational Failure in an Nhs Hospital Trust: A Qualitative Study Publisher Pubmed



Ravaghi H1 ; Mannion R2 ; Sajadi HS3
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Authors Affiliations
  1. 1. Health Policy and Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, No. 6, Rashid Yasemi St, Valie Asr Ave, Tehran, 1996713883, Iran
  2. 2. Economics and Social Policy, School of Social Policy, University of Birmingham, United Kingdom
  3. 3. National Institute of Health Research, Tehran University of Medical Sciences, Tehran, Iran

Source: Health Care Manager Published:2015


Abstract

The objective was to explore the key factors associated with organizational failure in an NHS Hospital Trust. This case study adopted a qualitative design. Fifty-seven semistructured interviews and document analyses were conducted as well. Data were analyzed using a framework analysis method. A range of symptoms of organizational performance failure was identified. These relate to a financial deficit, lack of good external relationships, inability to meet core targets, a lack of clear management systems, and low staff morale. These markers had not been taken seriously by the previous senior management team. Symptoms of failure were the reflection of presence of secondary and primary causes of failure. Poor managerial leadership, poor financial control and performance management, lack of open culture, distraction by 2 large projects, and the lack of clinician engagement were perceived as internal causes of failure and the high level of policy changes within the NHS as the key external cause. The level of deprivation in the area was also thought to have had a negative impact on performance. The findings reinforce and expand on those of recent studies across the public sector. Tracking an organization's performance and early diagnosis of performance problems, focusing on performance management systems, and taking into account contextual factors are issues that should be considered. Copyright © 2015 Wolters Kluwer Health, Inc.
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