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Large System Transformation report released

Large System Transformation report released

The Agency for Clinical Innovation (ACI) is working with many people and organisations to bring about large-scale transformation of aspects of the health system in NSW. But are we doing it as well as we could be?

To answer this question, we examined closely three projects involving hip fracture care, delirium and dementia in older patients, and acute stroke care.

We wanted to compare the differences in implementation approaches in the three projects, and what aspects of the different approaches were deemed successful. We wanted to understand more deeply the importance of contextual factors, and what constraints they imposed, and what opportunities they offered.

The research found that:

  • clinicians are central to the adaptation of large-scale transformations to the particular situations
  • complexity is sometimes not considered enough in their early stages, and may not always be apparent even when it is considered
  • explicit and ongoing communication throughout implementation was vital
  • chance and serendipity played a part – perhaps more than commonly realised.

Download the report here or read a summary of the recommendations.