1. Dr. Maria Kapsali HaCIRIC Research Associate
Work: European Policy and Operational Change
Research theme Policy design and healthcare innovation projects:
4. Policy problems and related
priorities for research the design of implementation policy instruments
The research problem The theory The method The results
• 12 healthcare technology deployment projects (adoption
Problem: Literature says: • The first case (EARSS) shows that by
and use of telemedicine) grouped into 2 embedded multiple
• The evaluation of healthcare innovation case studies: the EARSS case and the eTEN case. using an open systems approach a project
projects is difficult to achieve accurately • CLOSED systems control complexity in achieves most of its targets, attributed to:
and out of the system – project through • Each case was run under a different policy programme with
• A lot of resource is going to unsuccessful a different set of implementation instruments in place. 1. The flexibility in decision making to
procedures to monitor process
projects that do not achieve their target compliance adjust plans and activities
outcomes • OPEN systems adjust to complexity 2. Managing the internal and external
with internal management mechanisms boundaries.
Question: WHY? and boundary management
The findings 3. The alignment of policy goals with
• Policy implementation instruments, such 1. Policy design of instruments and project activities.
as evaluation procedures and metrics and project management practices mostly
follow a closed systems approach
• 3 projects (EARSS case) were successful and 9
participation rules, are not suitable for (eTEN case) were not. • The second case (eTEN) shows that under
managing healthcare innovation projects . , • Successful projects were managed and
2. The application of open systems a closed system approach a project:
(as they were initially made to control evaluated through critical minimum specifications
thinking in empirical studies is inhibited 1. Does not have the flexibility to manage
processes in engineering / construction by the lack of constructs-metrics that based on outcomes – the others were managed
projects) are easily operationalisable and
change due to the focus on controlling
through traditional top down review procedures
WHY? measurable. the activities in the project process.
• Because the design of policy 2. This leads to weak leadership and in-
Open systems thinking was practiced in project group problems.
implementation instruments presupposes 3. Different perspectives on the theories
of implementation of innovation policy management through minimum critical
that process change can be tightly specifications and boundary management. 3. Because of buffering the system and
have not generated a common
controlled through bureaucratic generalizable theory and suffer from Implementation standardizing boundary management,
procedures and compliance to lack of consensus on measures, Causal connectedness between policy instruments the project managers could not deal
bureaucratic rules factors of success and research implementation instruments and confine with operational complexity.
analysis units. project management practices was managerial action
the reason why projects failed.. and choice
An open systems approach is more useful
for projects of high complexity and
Conclusions Unrealistic
Implementation instruments focused on
controlling-evaluating project activities
unpredictability like innovation projects.
Priorities for future health policy research expectations (not outcomes) in terms of time, cost and
quality, and interfered with project
Tension between management practices..
1. Develop metrics that link managerial / project metrics (time, policy goals and
cost and quality) to minimum critical outcomes and implementation The successful projects established the
boundary management (rather than the project process) instruments minimum critical outcomes in each phase in Contact details:
and embed flexibility in them. terms of time, cost and quality (not the Dr Maria Kapsali
outputs of workpackages) and allowed m.kapsali@imperial.ac.uk
2. Base the design of implementation instruments flexibility in changing formal plans through +44 (0)20 7594 6491
managerial autonomy..
(evaluation and participation rules) on these metrics www.haciric.org
www.imperial.ac.uk/business-school