Organizational Failure in an NHS Hospital Trust: A Qualitative Study.
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.
Author Affiliations: Health Policy and Management, Health Management and Economics Research Center, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran (Dr Ravaghi); Economics and Social Policy, School of Social Policy, Health Services Management Centre, University of Birmingham, UK (Dr Mannion); and National Institute of Health Research, Tehran University of Medical Sciences, Tehran, Iran (Dr Sajadi).
Hamid
H
Ravaghi
Russell
R
Mannion
Haniye Sadat
HS
Sajadi
D001291:Attitude of Health Personnel; D003695:Delivery of Health Care / Q000458:organization & administration*; D006779:Hospitals, Public / Q000458:organization & administration*; D006801:Humans; D007400:Interprofessional Relations; D007407:Interviews as Topic; D007857:Leadership; D019982:Organizational Case Studies; D036301:Qualitative Research