Link to thesis - Concept - NTNU

A project such as the new St. Olavs hospital has a need for specific and detailed knowledge oftoday’s activities and capacities, as well as possible avenues towards improving conditions forthe future. Obtaining such knowledge requires involvement of employees and specialists fromdifferent levels and places in the organization. This argues for a bottom-up approach tocreating an enterprise map and to identifying areas for improvement.On the other hand there is also a need to make decisions and priorities that trigger the relevantchanges and ensure that the project is working towards common goals. Moreover,construction projects of the size of the St Olavs project (200.000 m2) involve importantdiscussions on policy and strategy regarding e.g. the distribution of resources, implying theneed for elements of a top-down approach.In the process analysis of each of the clinical centres at St Olavs Hospital, differentapproaches were used. Initially, process analysis was largely along the lines of a bottom-upapproach, where individuals from the higher organizational levels in the centres were engagedmainly at the early and the latest stages (stage 1 and 5 in Figure 2).Figure 2 illustrates the plan for process analyses. As we see there were intensive group-worksessions where employees and experts on the relevant patient groups or patient pathways werethe main resources.Figure 2. Process analyses bottom-up1Modellingconference- Vision- Goals- Common”processpicture”2Group work(patientpathways)- Todaysprocesses andactivities- Resources- Bottlenecks3Group work(patientpathways)- Opportunities- Constraints- Alternativeprosesses4Group work(patientpathways)- New futureprocesses- Future activity- Changes- Requirements- Futureresources5Priorityconference- Collocation- Prioritizing- GoalachievementThe modelling conference was a session assembling both leadership and employees atdifferent levels in the organization aiming to get a common overall picture of the processes inthe centre. Ambitions and goals related to the process analyses, and to some extenttraining/guiding in process approach, is also a part of the modelling conference.The stages 2-4 represent much of “the traditional” BPR activities and produces much of thefacts/basis for decisions in the future project work. In this model, the priority conference isthe most important arena for decision making regarding new and/or improved processesOur case was one of the first process analyses in the second phase and represented importantlearning for everybody involved. In the process analyses in this particular centre there werecontinuous discussions regarding the HFP that was under revision. The consequence of thiswas that the HFP was not regarded as an absolute constraint. The HFP 2 is regarded as the