A Practical Note on Transferring Ideas and Methods from Consultancy Practice to the MPA Classroom: A Personal Account from a Danish Case Study.

TL;DR: In this article, the authors present a three-year consultancy/research project in a merging hospital department, and evaluate whether these methods can be transferred to a potential MPA module at CBS.

Abstract: At the lead author’s home institution – Copenhagen Business School (CBS) – the combination of theory and practice is seen as very important in teaching. Research-based teaching is the slogan. In this respect, CBS has the same ambition as other universities. But it seems as if CBS has an advantage at the master’s level, because students come with a lot of experience. The average age of the MPA students is generally over 40. Consequently, they are able to bring practice into the classroom and to confront it with theories and also the experiences of their fellow students. There are, however other ways of bringing practice and theory together. In this note, the author reviews a three-year consultancy/research project in a merging hospital department. The aim of the note is twofold. One is to detail the more exploratory methods used to develop the organization. The second is to evaluate whether these methods can be transferred to a potential MPA module at CBS. It is concluded that for some of the methods such ...

Summary

1. Introduction

• Over 500000 people all over the world suffer from cardiac arrest every year.
• The probability of survival is highly dependent on correct treatment of the patient, which relies on knowledge of the current state of the patient, such as type of rhythm and circulatory information.
• This knowledge is difficult to obtain manually.
• The task of performing the carotid pulse check has for example been shown to be very inaccurate and time consuming [1].
• A simple, objective and noninvasive way of monitoring circulatory parameters is therefore of great interest and may potentially increase survivability of cardiac arrest patients.

2. Methods

• Medicine, Medical University of Vienna from March 2003 to January 2005.
• The impedance measurements were recorded using commercially available self-adhesive electrode defibrillator pads (Heartstart Pads, Philips Medical Systems, Seattle, WA, USA), by passing a 32 kHz, 3 mA peak-to-peak sinusoidal current between them and measuring the resulting voltage difference between the electrodes.
• The blood pressure was measured via an arterial line in the arteria radialis.
• Measurements periods where the patient did not have a pulse were excluded from the study, and 49 episodes therefore had to be discarded.

2.1. Extracting information from the measurements

• Figure 1 shows the electrocardiogram (ECG), the impedance, its first derivative and the blood pressure trace of a measurement from the UN data.
• The mean of the impedance signal was first removed, since the authors are only interested in the temporal changes of the measurement.
• The impedance measurement and its derivative is flipped since the negative peaks of the fluctuations historically have been the parameters used for estimation of SV [2].
• For each heartbeat the authors calculate the magnitude of the negative peak of the impedance fluctuation and its first time derivative (d).
• From the blood pressure measurement the authors extract the systolic (Ps), diastolic (Pd), the pulse pressure (PP) and the mean arterial pressure (MAP).

2.2. Correlation study

• For each patient the authors now have averages of Zpeak and dZpeak per heart beat for which they also have parameters describing the blood pressure.
• The authors now want to see if any of the parameters are correlated over the patient group.
• The sample set of the different parameters are compared by computing their correlation coefficient ρ defined as [7].
• Ρxy = Cxy√ σxσy (2) where x and y are the two random processes with variance σx and σy the authors want to compare.

3. Results

• Table 1 summarizes the results of the correlation study.
• The correlation is generally higher for the CA data than for the UN data.
• There are none of the correlations that are statistically significant for the UN data.
• The distributions of the parameters are plotted in Figure 2, where each point represents one patient.

4. Discussion and conclusions

• It would be valuable for a rescuer to have circulatory information about a patient undergoing resuscitation due to cardiac arrest.
• It has been suggested [3] to measure the thoracic impedance through the defibrillator pads, and thereby acquire information related to blood circulation [2].
• The authors wanted to explore the information that could be drawn from such measurements, and therefore simultaneously recorded the thoracic impedance by using standard defibrillator pads and the blood pressure arterially from 79 patients undergoing resuscitation and 37 hemodynamically stable patients.
• Figure 2(a) shows the parameters with the highest correlation, ρ = 0.4338, and illustrates that even the best relation in terms of correlation appears for the human eye to be close to random.

Full text

A Practical Note on Transferring Ideas and Methods from
Consultancy Practice to the MPA Classroom
A Personal Account from a Danish Case Study
Ry Nielsen, Jens Carl; Quinn, Brid
Document Version
Accepted author manuscript
Published in:
Teaching Public Administration
DOI:
10.1177/0144739415615662
Publication date:
2016
License
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Citation for published version (APA):
Ry Nielsen, J. C., & Quinn, B. (2016). A Practical Note on Transferring Ideas and Methods from Consultancy
Practice to the MPA Classroom: A Personal Account from a Danish Case Study. Teaching Public Administration,
34(1), 83-95. https://doi.org/10.1177/0144739415615662
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Download date: 10. Aug. 2022

A Practical Note on Transferring Ideas and Methods from
Consultancy Practice to the MPA Classroom: A Personal
Account from a Danish Case Study
Jens Carl Ry Nielsen and Brid Quinn
Journal article (Post print version)
This article was originally published in
Teaching Public Administration
. First published
online 01 December 2015.
DOI: 10.1177/0144739415615662
Uploaded to Research@CBS: February 2016

1
October 2015
A Practical Note on Transferring Ideas and Methods from
Consultancy practice to the MPA clasroom: a personal account
from a Danish Case Study
J.C . Ry Nielsen, Copenhagen Business School and Brid Quinn, University of Limerick
Ideas come while you work, not while you wait for them
i
Abstract
At the lead author´s home institution - Copenhagen Business School (CBS) - the combination of
theory and practice is seen as very important in teaching. Research-based teaching is the slogan.
In this respect CBS has the same ambition as other universities. But it seems as if CBS has an
advantage at the master’s level, because students come with a lot of experience. The average age
of the MPA students is generally over 40. Consequently, they are able to bring practice into the
classroom and to confront it with theories and also the experiences of their fellow students. There
are, however other ways of bringing practice and theory together. In this note the author reviews
a 3 year consultancy/research project in a merging hospital department. The aim of the note is
twofold. One is to detail the more exploratory methods used to develop the organization. The
second is to evaluate whether these methods can be transferred to a potential MPA module at
CBS. It is concluded that for some of the methods suchas diary keeping and agenda setting,
transfer is easy. Other methods such as using a cross sectional group or manager role-analysis may
not transfer easily but could be applied in the home organizations of participants. The design of
the module and the non-traditional roles of the teachers are very important for successful
implementation.
Keywords research teaching Copenhagen Business School explorative methods master
programme transfer implementation
Part 1: Introduction
At the author´s home institution, Copenhagen Business School (CBS), the combination of theory
and practice in teaching is given high priority. As in other higher education institutions research-
based teaching is almost a mantra (www.cbs.dk). Combining theory and practice is easier at the

2
masters’ level because participants come with a lot of experience that can be utilized in class and
in assignments. For the MPA programme at CBS we created a motto that expresses the
importance of the theory-practice linkage. Our motto ‘from nearness to distance – and back again’
recognises that
participants come with a lot of knowledge, problems and solutions from their daily life– the
nearness dimension. The teachers and fellow participants provide the helicopter perspective with
theories, cases, discussions, and assignments – the distance and objectivity dimensions. For CBS
graduates the MBA is not just an academic exercise. It enables participants to return to their
organisations and become change agents using the academic and experiential insights developed
during the MPA programme (see www.mpa.dk). The MPA approach used in CBS can thus be seen
to reflect the literature that deals with transfer from the classroom to the real world, see , for
example., Keller et al (2011). This reflective article has a different point of departure. It
investigates the possibility of transferring ideas and methods from an action research/consultancy
project in a hospital department into a module for the Master of Public Administration (MPA)
programme at CBS. The article describes a learning experience in the real world, i.e., a hospital
setting, and looks at transferring ideas from there to the classroom.
Clarification of content
The article has deliberately been labelled ‘A Practical Note’. ‘Practical’ because the article is very
specific and does not focus much on theory, in contrast with, for example, the articles by Quinn
and Oldfield in this volume. It has a narrow focus on the pedagogical content of the specific case
which means that other perspectives such as process consultation, merger theory or team-
building are not dealt with By using the word “note” the intention has been to emphasise the
academic non- pretentious character of the contribution. Rather, the ambition has been to
demonstrate in detail what can be drawn from pedagogical analysis of a real-life issue in order to
design a potential MPA module. Written by the consultant it is an insider perspective with much of
the data coming from memory and notes. Part two outlines the specific context of the case. It
first provides a description of the case organization – a hospital department which is a merger of
three previously independent departments. Then the author’s relationship with the case
organization and the points of departure are outlined. The section ends with a short description of
the overall MPA programme and the specific module design based on the hospital case. In part
three the methods applied in the change project are detailed and the transfer possibilities
discussed before the ideas that can be applied in class are outlined. Part four reflects on the
process and content of the case abefore conclusions are drawn in part five draws conclusions

3
Part 2 Contexts
The case organization and the merger
ii
The case organization, which shall be referred to as the G-case, is the Diagnostic Department of a
large hospital in the Capital Region of Denmark The hospital has 2.500 employees, 350 beds and
250.000 outpatient treatments per year.The Diagnostic Department (DD) has 215 employees and
200.000 patient contacts per year. The DD is the result of a merger inDecember 2012. The merger
process consisted of bringing three previously independent departments together in one
organization, the DD The three departments were Radiology (90 employees), Clinical Physiology
and Nuclear Medicine (40), and Clinical Biochemistry (60). Finally there is a medical research group
of 25 employees.
Mergers are often used as money saving instruments but not in this case. The top management
group of the hospital declared at the outset that the main purpose of the merger was to make
patient-care more effective. The motivation was thus a professional one.
This clarification removed a lot of anxiety in the organization, thereby creating better conditions
for the merger processes and establishing cross sectional collaboration. The new organization was
rather unique in a Danish hospital context and the management structure of the DD was different,
too. The designated management group of the new entity consisted of three people: the chief
physician, the chief radiographer and the chief technologist. They were supported by three chief
physicians from the three new sections. Before long it was decided that the management group
should consist of all six, and they lightheartedly named themselves ‘the Sixpack The group quickly
realized that they had no experience of mergers and agreed to seek outside help. Consequently,
the chief physician ( a graduate of the MPA programme directed by the author) arranged for the
author to act as consultant for the merger process. The group took the task of leading and
managing the organization very seriously and committed to bi-weekly ‘consultant meetings’ to
discuss organisational developments.. In total 42 two-hour meetings were held. From the very
beginning, the group decided to go public with the merger processes and outcomes. They sought
to identify what went well, what went wrong, what was learnt and what others could learn.
Therefore,they also hired a young sociologist, (Line Nicolaisen) who in collaboration with Sixpack
and the author produced a report on the merger processes and life in the organization over the
last three years (Nicolaisen 2015)
The Sixpack were confident about selecting the author as external consultant for the merger
process because of his skill as a process-oriented teacher (as observed by the chief physician), his
consultancy experience and his reputation as an author on organizational change. The author
came to the process with an open mind in the Engelundian mode, ready to work with organization
as it evolved and to work with the ideas that emerged from the merger process. This openness
was coupled with a very broad repertoire of different theories and practical experience that could
be applied during the unprecedented merger process

Frequently asked questions

Q1. What have the authors contributed in "A personal account from a danish case study" ?

At the lead author ́s home institution Copenhagen Business School ( CBS ) the combination of theory and practice is seen as very important in teaching. In this note the author reviews a 3 year consultancy/research project in a merging hospital department. The aim of the note is twofold. The second is to evaluate whether these methods can be transferred to a potential MPA module at CBS. 

Q2. What are the dimensions of the helicopter perspective?

The teachers and fellow participants provide the helicopter perspective with theories, cases, discussions, and assignments – the distance and objectivity dimensions. 

Q3. What were the activities used to increase involvement?

The involvement strategies used included : 10 cross sectional project groups which yielded a 10% improvement in patient care (Nicolaisen:2015); meetings for all staff, in the sections, in the joint committee and with top management ; interactive project days for all staff; a newsletter and an annual report. 

Q4. What did the participants learn from the reflective journalling process?

From the reflective journalling process, managers could see themselves as role models for collaboration across sections in the department. 

Q5. What was the purpose of the seminars?

The seminars provided a forum to discuss the future of the organisation since the Capital Region had just announced a merger of the G-hospital with the much larger and very much prestigious National Hospital. 

Q6. What was the result of the group dialogue?

In the group dialogue afterwards it was obvious that the members had become more conscious about their managerial and leadership roles. 

Q7. What was the key to the development and learning model?

From the start of the consultancy, creating psychological safety for those involved was key, although the development and learning model was not introduced immediately. 

Q8. What was the author's attitude towards the merger process?

The author came to the process with an open mind in the Engelundian mode, ready to work with organization as it evolved and to work with the ideas that emerged from the merger process. 

Q9. What was the main benefit of the merger?

The openness in the organization not only enabled the merger process and Nicolaisen’s constructive evaluation but also facilitated development of this pedagogical perspective, generating new tools and methods and expanding the teaching repertoire for mid-career classrooms.