Situational Change Engineering in Healthcare

Many developed countries are confronted with continuously increasing healthcare costs. Most administrations believe that a fundamental reorganization of the healthcare sector is inevitable. Transformation processes are often enabled by information and communication technologies. For healthcare, a plethora of eHealth strategies have been proposed, many of them being aimed at reducing healthcare costs by optimizing administrative processes. Although lots of strategies have been proposed, there is a lack of clear guideline for setting up transformation projects successfully. Since many healthcare systems are characterized by a high degree auf autonomy and many local regulations, a situational approach for setting up transformation projects is necessary. In change management as well as in method engineering, situational approaches have been proposed. But there are few publications on how to combine situational change management with situational method engineering. Regarding applying such an approach to healthcare, there is no work at all. Therefore the aim of this paper is to propose a ‘situational change engineering’ framework for the healthcare sector. Three steps are essential: (1) to classify change projects in the healthcare sector with regard to certain transformation attributes, (2) to identify reusable method fragments that have been deployed in change projects of a certain type, and (3) to develop a procedure which creates a situational method from appropriate method fragments for the respective type of change. In addition to outlining this approach, a hypothesis for the first step is presented, i.e. a scheme is developed to classify change projects in the healthcare sector. The paper ends with a recommendation for implementing the ‘situational change engineering’ framework in the healthcare sector.