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Appreciative Inquiry


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Summary of the article 'If we can't do more, let's do it differently!': using appreciative inquiry to promote innovative ideas for better health care work environments.
As seen in the Journal of Nursing Management, 2009
Richer MC, Ritchie J, Marchionni C

Published in: Business
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Appreciative Inquiry

  1. 1. Journal Article Review Andrea Dvorak‘If we can’t do more, let’s do it differently!’: Using appreciative inquiry to promote innovative ideas for better health care work environments .-Richer, M., Ritchie, J. & Marchionni, C. (2009)
  2. 2. Class Readings: What is Appreciative Inquiry Scherer and Alban  Rothwell and Sullivan  Uses interviewing and storytelling to  Requires a paradigm shift from focusing explore the past while looking at the on what is going wrong to what is going positive aspects of ‘what is working’ right and then trying to leverage what is in the organization as a basis to ‘what going right into new, higher level visions of a positive future might be’  A way of being, a model, a conceptual  Combines data collection with a framework, and a process to guide change large-group meeting where the stories gathered are used as building  Search for the best in people, their blocks to design new initiatives for organizations, and the world around the future them  Aim is to generate new knowledge  Focuses on what is going right, what is that expands the realm of the motivating, what is energizing, and what possible and helps members of an are the key strengths of a setting organization to envision together a desired future  The most exciting development in thinking about change in recent years
  3. 3. Class Readings: The 4-D Model of Appreciative Inquiry Rothwell and Sullivan  Discovery—people talk to one another, often via structured interviews, to discover the times when the organization is at its best. These stories are told as richly as possible.  Dream—the dream phase is often run as a large group conference where people are encouraged to envision the organization as if the peak moments discovered in the ‘discovery’ phase were the norm rather than exceptional.  Design—a small team is empowered to go away and design ways of creating the organization dreamed in the meetings.  Destiny—the final phase is to implement the changes.
  4. 4. Article: Background Background  Increase in pressures in healthcare system led to a negative impact on the current work environment and shortage in personnel  Hospital closures  Mergers  Ageing population  Increase in people living with chronic diseases  Persistent employee dissatisfaction  need for change in health care environments  Based on the literature review by the authors, AI was chosen as the framework for the transformational change process
  5. 5. Article: Purpose Purpose  To examine the use of Appreciative Inquiry (AI) to promote the emergence of innovative ideas regarding the reorganization of health care services  Break through old boundaries and promote the emergence of new ideas
  6. 6. Method Research Strategy  Case Study Participants  52 participants  3 teams  2 health care teams  1 management team
  7. 7. Method cont’d Procedure  Health care teams  AI process (4-D) led to development of an action plan  Evaluated for innovativeness using ‘Innovative Ideas Grid’  Action plan was presented to the management team Evaluation  Participant observation  During interviews with health care teams  Interviews  With management team gauge responsiveness  Direct Observation  During management meetings to observe responsiveness  Documentation  of reports to determine if action plans were implemented
  8. 8. Major Findings Emergence of innovative ideas  13 of the 15 ideas in the action plans were found to be ‘innovative’ therefore:  AI promoted emergence and adoption of innovative ideas  Innovative ideas were incremental in nature  Initiated by nurses  More fully developed by members from all disciplines  Discovery phase: Group discussed the importance of collaboration and teamwork in relationship to staffing, time efficiency, and patient care  Dream phase: Proposition that the organization should create a vision for cancer care  Design Phase: Group took ownership of idea and decided to propose a vision to all members of the interdisciplinary team  Destiny phase: member of team had contacted other disciplines and organized a meeting to present the vision/goals that were developed through the AI process  Ideas rejected then brought back
  9. 9. Major Findings cont’d Organizational Responsiveness and Idea Implementation  Implementation involved action of those who were part of the AI process  Formal meetings held to elicit organizational response to ideas  Management team did not respond to health care teams’ expectation to support the implementation of most ideas  External context issues and new emerging pressures took precedent over discussions of ideas proposed in the action plan
  10. 10. Conclusion Using a process that builds on positives such as AI may be the first step towards promoting the emergence of innovation in health care but…. The organization must respond and take action to support change  Importance of follow through on proposed ideas AI is a way to create organizational change by building on its most important asset, its people
  11. 11. Limitations and Future Research Limitations  Short post-AI observation period Future Research  Use of multilevel interventions involving middle and upper management to better understand the factors that influence the implementation of ideas and the key role of management in this process
  12. 12. Discussion Question Assuming that the development of innovative ideas is not unique to AI, what other change models could have been used to promote the development of innovative ideas and how would these processes differ from the 4D method of AI?  Critical Research Model?  Traditional Action Research Model?
  13. 13. The Critical Research Model
  14. 14. Traditional Action Research Model
  15. 15. Appendix 1• A YES answer at item #1 or 2 and a NO answer at item 3 classify the idea as innovative
  16. 16. References Rothwell, W. J., Sullivan, R. (2005). Practicing Organization Development: A guide for consultants. San Fransisco, CA: Pfeiffer. Richer, M., Ritchie, J., & Marchionni, C. (2009). ‘If we can’t do more, let’s do it differently!’: Using appreciative inquiry to promote innovative ideas for better health care work environments. Journal of Nursing Management, 17, 947- 955.
  17. 17. Article Rating