title: A new workforce in the making? A case study of strategic human resource management in a whole-system change effort in healthcare.
abstract: OBJECTIVE
  This paper seeks to describe the exploration of human resource issues in one large-scale program of innovation in healthcare. It is informed by established theories of management in the workplace and a multi-level model of diffusion of innovations.
  
  
  METHODS
  A realist approach was used based on interviews, ethnographic observation and documentary analysis.
  
  
  RESULTS
  Five main approaches ("theories of change") were adopted to develop and support the workforce: recruiting staff with skills in service transformation; redesigning roles and creating new roles; enhancing workforce planning; linking staff development to service needs; creating opportunities for shared learning and knowledge exchange. Each had differing levels of success.
  
  
  CONCLUSIONS
  The paper includes HR implications for the modernisation of a complex service organisation.
  
  
  CONCLUSIONS
  This is the first time a realist evaluation of a complex health modernisation initiative has been undertaken.
authors.affiliation: School of Management, University of Surrey, Guildford, UK. f.macfarlane@surrey.ac.uk
authors.forename: Fraser
authors.initials: F
authors.lastname: Macfarlane
authors.forename: Trish
authors.initials: T
authors.lastname: Greenhalgh
authors.forename: Charlotte
authors.initials: C
authors.lastname: Humphrey
authors.forename: Jane
authors.initials: J
authors.lastname: Hughes
authors.forename: Ceri
authors.initials: C
authors.lastname: Butler
authors.forename: Ray
authors.initials: R
authors.lastname: Pawson
mesh_terms: D004059:Diffusion of Innovation; D058016:Health Facility Administration; D006801:Humans; D007407:Interviews as Topic; D008962:Models, Theoretical; D019370:Observation; D009936:Organizational Innovation; D010559:Personnel Management / Q000379:methods*; D013192:Staff Development