Question

Discuss the choice you would expect an organization to make based on this maturity model and the range of possible projects you might expect to see presented in a healthcare organization today. Presuming that a project opportunity will likely rise to the maturity level required for success (a BIG assumption, but let's allow it here), discuss the types of projects or system choices that might be effective enough at each maturity level

Answer 1

Hi,

I would like to explain it. Please be patience. The answer to such generic questions are verbose.

Maturity models (MM) has its root in software engineering. It helps in guiding and monitoring the maturity of software development practices. In recent years, multitude of generic and domain-specific MM models have been developed in order to improve organizational design and learning of healthcare organizations.

The goals of such models are to identify gaps between actual and desired states as well as to demonstrate an evolutionary path to achieve the improvement from a desired to an actual state.

There are three choices:

The well defined top-down approach by fixing a number of maturity stages or levels first and further corroborating it with characteristics support the initial assumptions about the maturity distribution. The other choices are sophisticated data-driven (bottom-up) techniques and algorithms.

There can be three type of projects a mature hospital organization can take. They all will result in a software prototype and further can be used as a MM model.

The first project can be developing a MM for measuring the IT-capability of hospitals; the second MM can be improvement of the supplier relationship management systems of hospitals; the third project can be the development of a MM for improving intra and inter-organizational collaboration of hospitals. The final result of all the three research projects is a software prototype.

Common to all three projects is the adoption of action design research (ADR) as underlying research method.
ADR is used for “generating prescriptive design knowledge through building and evaluating ensemble IT artifacts in an organizational setting”. Research using ADR follows a generic schema or interaction pattern. After a first phase of requirements elicitation (mainly desk research), It used focus group discussions to pre-test a first version of newly developed MM. This commonly served as first basis for refining the MM and getting more specific feedback for the software design (the final prototype).

Hence, design and implementation of MM are interconnected. (see picture below)

MATURITY MODEL DESIGN MATURITY MODEL IMPLEMENTATION Define purpose & Design model Prepare deployment Select model Real need or project opportunity Organizational need Collect Reflect evolution Evaluate model

Each measurement process starts with the questions "what" and "why" something should be measured. Once the question of the need has been answered, the "focus" and the "purpose" of the model have to be defined. The developers of MM also have to define the observation “depth” and “breadth” of their model. After the need has been elicited and both, audience and scope have been set, the model itself has to be designed. One of the first and at the same biggest challenges in this context therefore is to develop a suitable concept of maturity. Three different concepts, notably the process-focused, the object- or technology-focused, and the people-focused concept of maturity do exist.

The MM has to be maintained and further development will be needed given that some model elements will get obsolete, new constructs will emerge, and assumptions on the different levels of maturity will be affirmed or refuted . Therefore, even in an early stage it is important to also reflect on how to handle alterations in model design and deployment.

After having verified that a MM should be used, another important step for the successful use is to select the right and most appropriate model for the given task. As mentioned earlier hospitals are characterized by a high degree of organizational complexity and specific linguistic features.

Additionally, the implementation success also heavily depends on the search and requirement rationales for the maturity model itself. Hence it usually makes little sense to use a MM for unique assessments or doubtful certificates. In the case of hospitals, MM should therefore be primarily used for changing requirements that were previously assessed by various stakeholders tangent by the object of change as relevant and contemporary.

In a first step the model should be tested with people that are dependent – this could for example be the group of people the model has been developed with. In a next step, the model should be tested with practitioners that are independent of the developing and testing process in order to improving the model.

Hence, In hospitals responsibility for MM use and development should therefore be located at the top management level of the organization in order to ensure a sustainable use across professional borders. Furthermore, as the development and use of MM is resource intensive, organizations should strive to develop models that can be used for more than just one opportunity or at least adapted to new domains easily. This reduces the costs of such models and therefore can therefore help to improve acceptance and foster sustainability. Another reason for the localization of responsibility on top management level is the high resource intensity of maturity assessments. Since the budget responsibility for organizational improvements in hospitals is always localized at the top of the organization, resources for assessments, improvements or changes can only be released by management. Furthermore, high staff turnover on department level aggravates a sustainable development of the tool if located on departmental level. However, depending on the type the assessments are performed, and the model is further developed, a close cooperation between the IT department and the hospital management is useful.

Conclusion:

The development and use of maturity models for path-oriented improvements has become more and more common in the recent years.
MM have become an established and major instrument for guiding organizational change initiatives.
However, the fast-growing number of models can not obscure, that hardly any study on the efficacy of initiated change efforts exist.
Contributions focus more on the development process and address the developers of such models. However, developers are often only involved tangentially in the implementation of MM. Besides direct implementation help, try to stimulate the scientific discussion on challenges of the implementation of maturity models than on the construction process itself.
This in turn could not only increase the appropriateness and effectiveness of such models, but at the same time may lead to new knowledge for the proper construction of MM.