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Abstract
Methods It draws on a series of 20 interviews with key protagonists and employs a Bakhtinian approach to narrative analysis, which explores the interplay between individual accounts and larger sociocultural themes.
Conclusions It concludes that the success in managing the complexity of this project can largely be attributed to a systems leader approach that draws on the power of an agile network to be replenished and redeployed against rapidly evolving strategic objectives. This effectively constitutes a parallel operating structure, which is devoted to the design and implementation of strategy based on a continual assessment of the organisation and serves to strengthen rather than supersede established hierarchical structures of authority.
- clinical leadership
- improvement
- integration
- organisational effectiveness
- communication
Data availability statement
Data are available on reasonable request. All data have been gathered from colleagues employed by the NHS and is recorded in the form of Microsoft Word files. If required, data can be accessed via the innovation and improvement manager at the Cardiff and Vale Health Board. No patient data have been collected.
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Data availability statement
Data are available on reasonable request. All data have been gathered from colleagues employed by the NHS and is recorded in the form of Microsoft Word files. If required, data can be accessed via the innovation and improvement manager at the Cardiff and Vale Health Board. No patient data have been collected.
Footnotes
Collaborators The Dragon’s Heart Hospital Leadership Team.
Contributors As the first author, I have drafted this work with the supervision of the CEO, senior responsible officer and executive director for organisational development; I have offered it to them for comment and have sought to include their feedback where possible. I have therefore included them in the authorship. WB planned, conducted and reported the work described in this article under the supervision of JG (innovation and improvement), and with guidance and agreement from MD (organisational development) and LR (CEO). All are employees of the Cardiff & Vale University Health Board.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.