Domain 6: Responding to complexity in the external environment

Try to align your project with current policy priorities. If the technology is actively supported in policy, it will be easier to introduce. If priorities are elsewhere, it may be worth trying to ‘rebrand’ the work to fit these.

Address regulatory issues and challenges. Consider which regulations (from which regulatory bodies) are relevant to the introduction of this technology. Are all approvals already in place? If not, who do you need to work with to make progress in this regard? See ‘Due diligence’ section on page 12.

Get the professions on board.  If clinicians or social workers believe that the technology compromises the care of their patients or clients, or if they view it as demeaning to their role or a threat to their professional jurisdiction or income, their professional bodies may oppose it. Early dialogue with such bodies may avert such a situation.

Establish inter-organisational networks or collaboratives. Complex, organisation-wide change is a lot easier if change agents in one organisation can network with their opposite numbers in comparable organisations – for example in quality improvement collaboratives or learning sets. Here’s a resource for that:

Improvement collaboratives in health care – A guide from the Health Foundation.

Keep a close eye on the outer context. External shocks to an organisation (such as economic turbulence) make change precarious. Whist such shocks are often hard to predict, it is a good idea to see what’s on the horizon.  The following questions may help you:

• Does the new technology and the proposed changes to services align with the strategic priorities for the wider health system e.g. in terms of current health policy, national priorities for action and improvement?
• Are there incentives in the wider health system that reinforce the proposed change e.g. pay for performance schemes, regulatory requirements etc.?
• Are there existing inter-organisational networks (e.g. specialised clinical networks) that will be helpful in terms of supporting the proposed changes?
• How much stability/instability is there in the wider health system – and how might this likely influence the implementation project?