Analysis complementing the paper "Evaluating an AI-supported serious game in digital health management education: Mixed-Methods Approach" (Hering et al., 2026).
| Feedback area | Feedback function | Coded quotes (n) |
|---|---|---|
| Validation of students’ own work | ||
| Confirmation | 119 | |
| Extension and refinement of students’ analyses | ||
| Extension and concretization of analysis | 108 | |
| Identification of omissions and blind spots | 27 | |
| Critical reflection and contextual adaptation | ||
| Alternative perspective | 59 | |
| Critical comparison | 30 | |
| Total | 343 | |
Note: group rating per case summarized over the management methods across HSO and MSH; HSO = Osnabrück University of Applied Sciences ; MSH = Medical School Hamburg; the free-text reflections were divided into individual quotes, each with distinct content, and coded accordingly. Each segment comprises a single, clearly definable statement. Where bullet points or sentences contained several distinct pieces of content, they were divided into several quotes and coded separately.
| Feedback area | Feedback function | Coded quotes (n) | Quotes |
|---|---|---|---|
| Validation of students’ own work | |||
| Confirmation | 119 | "Empathy map: Complete consistency in content with the model answer." (MSH, Empathy map) "Areas of conflict: Broad agreement" (MSH, Empathy map) "Many points are the same. In particular, the levels of thinking/feeling and saying/doing. The identified pains and gains also showed similarities, although ours were somewhat more detailed. This was also evident in the way we formulated the human root causes." (MSH, Empathy map) "Resource requirements: The patient group in question places a high demand on the healthcare system’s resources." (MSH, Empathy map) "Cooperation between nursing and IT: The need for close coordination of processes between IT and nursing to ensure practical usability in day-to-day work." (MSH, Empathy map) "Structural uncertainty: Identification of unclear roles and a lack of structural anchoring within the nursing profession." (MSH, Empathy map) "Patient perspective: Significant concerns and psychological distress amongst patients regarding their future state of health." (MSH, Empathy map) "Derivation of implications: The results are largely consistent, with almost identical implications being derived." (MSH, Empathy map) "Pains and Gains" (HSO, Empathy map) "The model answer largely covers our work, apart from the aspects described above" (HSO, Empathy map) "The selection of the two most important stakeholders." (HSO, Empathy map) "Gains and Pains, as well as the characters’ emotions." (HSO, Empathy map) "The key aspects of what the characters feel, do or say have been confirmed" (HSO, Empathy map) "In the care worker’s Empathy map, everything was broadly the same, or at least followed similar approaches.The specific implications are also very similar." (HSO, Empathy map) "We also selected the IT manager and the head of nursing, as we felt that these two were likely to represent the most relevant personas for this topic. " (MSH, Empathy map) "The two personas were also structured using the canvas with its six key fields and, as a first step, considered separately from one another." (MSH, Empathy map) "In this Empathy map, very similar points were identified regarding the two personas; in particular, we were very successful in identifying their gains and pains." (MSH, Empathy map) "At this stage, we became acutely aware of the discrepancy between their concerns and frustrations and their hopeful outlook. In other words, one of the key findings for us was that there will be not only technical but, above all, emotional challenges. This insight must be taken into account during implementation." (MSH, Empathy map) "Dominant negative emotion & human root cause: Semantic differences whilst the core content remains the same." (MSH, Empathy map) "Our solutions are very similar to the model answer " (MSH, Empathy map) "As there were many overlaps (similar fears, frustrations, etc.), the personas’ feelings and observations were summarised and, based on this, consistent implementation measures were developed. […]" (MSH, Empathy map) "Data protection, compliance: GDPR/security " (HSO, IRLM) "Technical solution: middleware, system integration " (HSO, IRLM) "Change management: training " (HSO, IRLM) "User focus: user-friendliness, accessibility" (HSO, IRLM) "Approach: pilot phase, feedback loops" (HSO, IRLM) "the same determinants, the same measures, and very similar target outcomes and KPIs" (HSO, IRLM) "All details have been confirmed." (HSO, IRLM) "There were no further points from the model answer" (HSO, IRLM) "The following were confirmed: e.g. Funding the initiatives of Hospital Future Act , guidelines, budget and cost pressures, training, change management, digital and analogue access channels, system integration, interoperability, scalable IT infrastructure, paper, resource savings, General Data Protection Regulation" (HSO, PESTEL analysis) "Promoting the Hospital Future Act as a key political framework" (HSO, PESTEL analysis) "Economic benefits of digitalisation" (HSO, PESTEL analysis) "The importance of training and change management" (HSO, PESTEL analysis) "Data protection and IT security" (HSO, PESTEL analysis) "The AI mentioned everything we had written down." (HSO, PESTEL analysis) "In all sections, we have more or less the same things" (HSO, PESTEL analysis) "All the points were addressed, and details were adjusted subsequently. However, there was a great deal of agreement - probably because a lot of questions were put to the stakeholders beforehand." (MSH, PESTEL analysis) "The classification into the various categories overlapped to a large extent. The ‘technology’ category, in particular, showed a high degree of consistency. The strategies / measures we formulated in the second step were also very much in line with the model solution" (MSH, PESTEL analysis) "There are just a few points that are handled slightly differently, but essentially everything is the same" (HSO, PESTEL analysis) "Ours is relatively comprehensive. Only one further point is missing from each topic" (HSO, PESTEL analysis) "No, the analysis follows the same line of reasoning." (MSH, PESTEL analysis) "The division into individual areas" (HSO, Process analysis) "Starting point is the same" (HSO, Process analysis) "Weaknesses are clearly identified" (HSO, Process analysis) "Media breaks are identified" (HSO, Process analysis) "The structure and approach to modelling" (HSO, Process analysis) "Step 1 of the approach is virtually identical" (HSO, Process analysis) "All other points, except for the aspects described above, were confirmed" (HSO, Process analysis) "Standardized documentation" (HSO, Process analysis) "Improved communication, digital communication between professional groups" (HSO, Process analysis) "Reduction in workload" (HSO, Process analysis) "The process itself" (HSO, Process analysis) "Real-time synchronization" (HSO, Process analysis) "Consistent orders" (HSO, Process analysis) "Diagram" (HSO, Process analysis) "Elimination of media breaks" (HSO, Process analysis) "Reduction of duplicate work" (HSO, Process analysis) "Real-time data availability" (HSO, Process analysis) "Electronic prescriptions" (HSO, Process analysis) "Role-based access rights and data protection" (HSO, Process analysis) "Integration of all systems" (HSO, Process analysis) "Digital documentation" (HSO, Process analysis) "Automated verification mechanisms" (HSO, Process analysis) "Clear lines of responsibility" (HSO, Process analysis) "Improved interprofessional collaboration" (HSO, Process analysis) "Training and change management" (HSO, Process analysis) "The general procedure, the key steps and the weak points are the same as in the model answer." (HSO, Process analysis) "Communication barriers, implementation" (HSO, Process analysis) "Many fundamental approaches were confirmed" (HSO, Process analysis) "The various stages of the process have been confirmed" (HSO, Process analysis) "The lanes are almost identical to the model solution." (MSH, Process analysis) "The process of patient communication, from the start of a patient’s admission due to illness right through to the end, also follows a similar principle. Many interfaces have been taken into account, as can also be seen in the sample solution." (MSH, Process analysis) "Our solution clearly demonstrates the issue of duplicate data entry across different systems." (MSH, Process analysis) "The analysis of weak points also corresponds to the model solution and has been indicated using symbols." (MSH, Process analysis) "There was a great deal of overlap in the basic structure. Particularly in the processes of analysing weaknesses and root causes, and in deriving the various requirements." (MSH, Process analysis) "Essentially, our fragmentation was clearly highlighted and matches the model solution." (MSH, Process analysis) "high degree of consistency with the model answer" (MSH, Process analysis) "there were no other aspects" (HSO, Stakeholder analysis) "Promotion of the Hospital future act as a strength" (HSO, SWOT analysis) "Experienced team, large number of patients" (HSO, SWOT analysis) "Lack of a clear strategy as the main problem" (HSO, SWOT analysis) "Fragmented IT systems, analogue processes" (HSO, SWOT analysis) "Interoperability" (HSO, SWOT analysis) "Time pressure, risk to funding" (HSO, SWOT analysis) "Acceptance issues" (HSO, SWOT analysis) "Identical strengths: Promotion of the Hospital future act, the existing IT infrastructure and interprofessional collaboration were identified in exactly the same way." (HSO, SWOT analysis) "Identical weaknesses: A heterogeneous system landscape, siloed solutions and paper-based documentation were confirmed as key problems." (HSO, SWOT analysis) "Identical opportunities and risks: Cloud and AI technologies were correctly identified as opportunities, whilst cyber-attacks, budgetary risks and the complexity of integration were identified as the main threats." (HSO, SWOT analysis) "Confirmed SO strategy: linking existing infrastructure with modern AI systems to improve patient safety – is essentially the same." (HSO, SWOT analysis) "Confirmed WO strategy (super-users): Your idea of deploying younger colleagues as ‘super-users’ aligns perfectly with the model solution’s approach of utilising demographic change – towards a workforce more tech-savvy – for training purposes." (HSO, SWOT analysis) "Confirmed ST strategy: Using targeted training as a direct response to acceptance issues and fears of change amongst staff." (HSO, SWOT analysis) "Confirmed WT strategy: The call for ‘external project monitoring’ aligns with the rigorous risk management required in the model solution to safeguard the project." (HSO, SWOT analysis) "Many similarities regarding strengths, weaknesses, opportunities, and risks, as well as significant overlap in the strategic implications derived from them." (HSO, SWOT analysis) "most of the approaches were confirmed" (HSO, SWOT analysis) "We have a lot in common. We were on the same path." (MSH, SWOT analysis) "Almost all of our approaches match the model answer" (MSH, SWOT analysis) "Strengths: largely eliminates transparency bottlenecks (blind spot)" (MSH, SWOT analysis) "Weaknesses: lack of monitoring at weekends and the risk of false alarms" (MSH, SWOT analysis) "Opportunities: digital pioneer and competitive edge + cost reduction by avoiding hospital admissions" (MSH, SWOT analysis) "Risks: failure of change management as a key risk factor, potential technical barriers on the patient side" (MSH, SWOT analysis) "Almost complete agreement was achieved, particularly in the stakeholder analysis – specifically the identification and clustering of stakeholders, as well as the influence-interest matrix." (MSH, Stakeholder analysis) "Bilateral communication and the regular meetings between individual project stakeholders were directly addressed and included. The training programme and the involvement of patients in the flow of information were also included in the concept." (MSH, Stakeholder analysis) "Our list of stakeholders matches the model solution almost 100 %. The clusters we have selected (management vs operational users vs end users) also closely resemble those in the model solution." (MSH, Stakeholder analysis) "The categorisation of stakeholders by influence and interest also corresponds to our assessment." (MSH, Stakeholder analysis) "We have also identified many of the communication channels in exactly the same way. In particular, the different types (whether face-to-face discussions or more general information via newsletters or intranet updates)." (MSH, Stakeholder analysis) "The key findings of the stakeholder analysis also correspond very closely to our assessment. In particular, acceptance amongst operational users is an issue that we have also identified as a major challenge." (MSH, Stakeholder analysis) "Proactive communication with users to address their concerns was also a key point for us, and this was highlighted again in the empathy map. Ensuring buy-in from the operational level was also one of the most important points in our discussions." (MSH, Stakeholder analysis) "Significant overlap between the identified stakeholders, the engagement and communication strategies, and the short-term measures" (MSH, Stakeholder analysis) "Internal project management and medical and nursing staff identified as key stakeholders" (MSH, Stakeholder analysis) "No, specifically with regard to the stakeholder map, our assessment is very similar to that in the sample solution." (MSH, Stakeholder analysis) "Division into internal and external. Many similar stakeholders from different groups. Many similar connections: who supports whom and who works with whom." (HSO, Stakeholder analysis) "All internal stakeholders were included" (HSO, Stakeholder analysis) "Similar external stakeholders" (HSO, Stakeholder analysis) "The same grouping of stakeholders" (HSO, Stakeholder analysis) "The supportive relationships were the same" (HSO, Stakeholder analysis) "The classification in the matrix was also largely the same" (HSO, Stakeholder analysis) "The internal and external classifications were the same" (HSO, Stakeholder analysis) "Training for staff and patients, information leaflets for patients and their relatives, 24/7 on-call services" (HSO, Stakeholder analysis) "there were no differences in any of the points" (HSO, Stakeholder analysis) | |
| Extension and refinement of students’ analyses | |||
| Extension and concretization of analysis | 108 | "Dr Nagelsmann lacks the management perspective: “As a member of the management team, I have a very keen interest in seeing this project through,” he muses on the technical implementation within a fragmented IT landscape without a dedicated project team for planning and roll-out, assesses the risks and coordinates the various departments" (MSH, Empathy map) "In terms of "gains", the targeted increase in efficiency and improved patient satisfaction could also be cited as a competitive advantage. Furthermore, successfully implemented projects should be seen as a catalyst for further IT projects." (MSH, Empathy map) "When drawing specific implications for implementation, it is immediately apparent that it is important for such projects to be piloted initially, for example in different departments or, to begin with, only within a single ward. This should be included as a matter of urgency." (MSH, Empathy map) "The interface between senior management and IT should include structured monitoring of milestones and project implementation. Comprehensive ticketing systems, which also incorporate project planning and automatically integrate generated tasks into users’ day-to-day work, can serve as tools for this purpose. In addition, the focus should also be on establishing an interdisciplinary core team. We had mentioned this point initially, but had not included it here." (MSH, Empathy map) "Deriving implications: Patients section: Comprehensive coverage of all relevant aspects, Pilot phase (limited number of patients): A useful addition to quality assurance and staff training, but it does lead to a delay in the final roll-out." (MSH, Empathy map) "In Sabine Banse’s Empathy map, we did not include the point about assigning blame under ‘Thoughts’" (HSO, Empathy map) "In Nagelsmann’s case, this underlying anxiety was perceived as pressure stemming from the high level of responsibility." (HSO, Empathy map) "Verena has listed some other points to consider; for example, she hasn’t mentioned that new data flows need to be interleaved." (HSO, Empathy map) "The characters’ thoughts were more detailed" (HSO, Empathy map) "Furthermore, the model solution had more negative aspects, particularly with regard to the carer Maria Sandell. The AI went on to elaborate further on the carer’s needs" (HSO, Empathy map) "With regard to the human root cause, there were a number of insights emerged, as the cultural component was disregarded or both components were treated as a single entity (see also under ‘Deviations’ and ‘Individual Approaches’)." (MSH, Empathy map) "The responsibility to protect nursing staff from being overworked was not taken into account." (MSH, Empathy map) "The details from the sample solution regarding Step #8 (deriving specific implementation implications per persona) and Step #9 (integration into the implementation plan) provide us with additional strategies and information which we had not yet formulated in such detail, but which will play a major role in the process definition." (MSH Empathy map) "Regulatory pressure: we lack the 18-month deadline set by the KHZG as a firm deadline; risk of having to repay funds" (HSO, IRLM) "Description of technical issues: manual media breaks" (HSO, IRLM) "Resource factors: limited training capacity due to staff shortages" (HSO, IRLM) "More detailed mechanisms of action of the measures, Outcomes broken down by category" (HSO, IRLM) "We were able to identify the following aspects from the solution: Political: Opportunities for future funding, positioning as a digital pioneer … Economic: Cost-benefit analysis, long-term funding after the project ends… Sociocultural: Early involvement of all stakeholders, communication strategy… Technological: Accessibility… Environmental: sustainability strategy, enhanced reputation… Legal: data protection impact assessment" (HSO, PESTEL analysis) "Telematics infrastructure as part of the national digitalisation strategy, compliance strategy and technology strategy" (HSO, PESTEL analysis) "And the AI has also listed overarching strategic areas of action" (HSO, PESTEL analysis) "Furthermore, sustainability was not described quite so explicitly in relation to the economic factors." (MSH, PESTEL analysis) "Political factors: Review of available funding schemes + political support helps in negotiations with health insurance funds Sociocultural factors: Clear communication strategies are necessary to distinguish this service from 24/7 emergency monitoring Legal factors: Liability issues arising from delayed responses to critical readings outside staff working hours (no night-time on-call service) + Escalation procedures via the medical emergency service 116-117 must be established + Clear communication regarding emergency contacts for patients" (MSH, PESTEL analysis) "The model solution is much more detailed." (MSH, PESTEL analysis) "Administrative staff check availability in isolated, standalone systems." (HSO, Process analysis) "Patients have to wait whilst data is entered multiple times" (HSO, Process analysis) "Support from Peter Reincke in the event of problems" (HSO, Process analysis) "Billing system" (HSO, Process analysis) "Unclear responsibilities in the event of system failures" (HSO, Process analysis) "When action was required, we failed to take into account the need to minimise the use of staff resources." (HSO, Process analysis) "Questions regarding the medication status raised by nursing staff" (HSO, Process analysis) "Documentation of medication administered" (HSO, Process analysis) "Manual verification of prescriptions by the pharmacy" (HSO, Process analysis) "The entire IT system is missing as a workflow" (HSO, Process analysis) "Lack of transparency regarding medication status" (HSO, Process analysis) "Organisational and functional requirements" (HSO, Process analysis) "Manual verification of prescriptions by the pharmacy" (HSO, Process analysis) "Lack of transparency regarding current medication" (HSO, Process analysis) "Documentation of medication administration" (HSO, Process analysis) "Preparation using barcodes" (HSO, Process analysis) "System failure / backups" (HSO, Process analysis) "We have considered many things, but have not written them down" (HSO, Process analysis) "Training and change management" (HSO, Process analysis) "Automatic allergy checks" (HSO, Process analysis) "Automatic quality and safety checks" (HSO, Process analysis) "Standardised digital workflows" (HSO, Process analysis) "The model answer is much more detailed, and they’ve even gone into the specifics of communication, noting that it takes place over the telephone." (HSO, Process analysis) "A few vulnerabilities and requirements, the actual 10-step process" (HSO, Process analysis) "Another aspect we can add to our diagram is direct or recurring communication channels – i.e. the patient has to pick up the phone several times. This process is already shown in the diagram, but it is not immediately clear that certain processes (such as communication) on the patient’s part are often duplicated or repeated." (MSH, Process analysis) "The IT systems have only been included in the diagram in a superficial manner." (MSH, Process analysis) "Concerns on the part of the pharmacy that medicines have not arrived, due to a lack of integration of logistics" (MSH, Process analysis) "Disposal of medicines (cost driver)" (MSH, Process analysis) "Detailed breakdown of the problems into categories (technical, resource-related, etc.)" (MSH, Process analysis) "Key area for action: shift from proactive to reactive care" (MSH, Process analysis) "Option for telephone contact with Hirden" (MSH, Process analysis) "Dealing with false-negative results" (MSH, Process analysis) "Target process: communication platform, secure exchange of messages" (MSH, Process analysis) "Option for active follow-up by nursing staff → patients" (MSH, Process analysis) "Specific requirements: an app with offline capability and an interface to the patient management system (PVS)" (MSH, Process analysis) "Consent process as part of patient training" (MSH, Process analysis) "Implications for implementation: define selection criteria for patients; revise the job description for nursing staff" (MSH, Process analysis) "Project management, structure: lack of milestone planning, systemic risk management" (HSO, SWOT analysis) "Roll-out strategy: pilot phase with selected patient groups, testing and optimisation cycles" (HSO, SWOT analysis) "Patient perspective: care extending beyond the hospital stay, data protection, data protection impact assessments" (HSO, SWOT analysis) "Future-proof technology: scalable IT infrastructure" (HSO, SWOT analysis) "Academic status & size: Utilising the hospital’s status as a university hospital with high case volumes for research collaborations and innovative pilot projects (SO strategy)."(HSO, SWOT analysis) "Support from senior management: Leveraging the management team’s strong commitment as a strategic strength for more streamlined project management (ST strategy)." (HSO, SWOT analysis) "Sustainability in recruitment: Targeted marketing of paper reduction as a sustainability strategy to attract staff in a competitive labour market (SO strategy)." (HSO, SWOT analysis) "Lack of a project concept: Identification of the previous failure to establish a concrete implementation plan as a critical internal weakness." (HSO, SWOT analysis) "Dependence on external parties: A lack of in-house IT expertise leads to heavy reliance on service providers and carries cost risks (weakness)." (HSO, SWOT analysis) "Risk of KHZG clawback claims: Delays in the 18-month timetable threaten the funding, which in the worst-case scenario could lead to the repayment of 3.2 million euros (risk)." (HSO, SWOT analysis) "Specific IT standard (FHIR): Focus on the FHIR interoperability standard for a phased, modular system integration rather than a risky complete replacement (WO strategy)." (HSO, SWOT analysis) "Under ‘Strengths’, two additional points were listed: ‘Competent software partner’ and ‘Motivation of care staff’; under ‘Weaknesses’" (HSO, SWOT analysis) "Use of established data protection frameworks to minimise compliance risks" (MSH, SWOT analysis) "Unstructured stakeholder involvement was not taken into account" (MSH, SWOT analysis) "AI-supported decision-making tools" (MSH, SWOT analysis) "Technical integration issues" (MSH, SWOT analysis) "Financial risks" (MSH, SWOT analysis) "Work packages are very similar" (MSH, SWOT analysis) "Strengths: specialised cardiological expertise, adequate project budget, established cooperation structures with health insurance providers are generally in place, experienced nursing team, clear strategic focus" (MSH, SWOT analysis) "Weaknesses: limited staffing capacity, legal uncertainties / liability issues, lack of clarity regarding billing" (MSH, SWOT analysis) "Opportunities: Demographic change and rising patient numbers, government support for digitalisation in healthcare" (MSH, SWOT analysis) "Risks: False alarms and system overload, regulatory hurdles, competition from other providers" (MSH, SWOT analysis) "SO: Development of selective contracts with health insurance providers" (MSH, SWOT analysis) "WO: Gradual increase in staffing levels through additional revenue" (MSH, SWOT analysis) "ST: Collaboration with a software provider for a 24/7 helpline and weekend support" (MSH, SWOT analysis) "We were able to remove social services, ward management and the "promotional agency of the Hospital future act" from the model solution" (HSO, Stakeholder analysis) "Procurement department" (HSO, Stakeholder analysis) "Institutional/regulatory stakeholders" (HSO, Stakeholder analysis) "Strategies and measures were not described in detail" (HSO, Stakeholder analysis) "Internal stakeholders: operational staff, works council, data centre" (HSO, Stakeholder analysis) "Institutional/regulatory stakeholders: funding bodies (KHZG), BfArM (Federal Institute for Medicines and Medical Devices), BSI (Federal Office for Information Security), State Medical Association" (HSO, Stakeholder analysis) "Regulatory bodies: funding bodies, supervisory authorities, standardisation organisations" (HSO, Stakeholder analysis) "High influence, high interest (manage closely): Management: budgetary responsibility for a 3.2 million euro project; Nursing Management: operational implementation for 90,000 patients annually; IT Management: technical implementation in a heterogeneous IT landscape" (HSO, Stakeholder analysis) "High influence, low interest (meet requirements): Funding bodies: control over a €3.2 million budget, but primarily interested in the achievement of objectives; regulatory authorities: compliance requirements, but not involved in operational success" (HSO, Stakeholder analysis) "Direct escalation channels in the event of conflicts or delays" (HSO, Stakeholder analysis) "Satisfy: Quarterly reporting to funding bodies on milestones; proactive coordination with supervisory authorities regarding compliance requirements; early integration of regulatory requirements into project planning" (HSO, Stakeholder analysis) "Monitor: Half-yearly updates on interfaces and integration options; monitoring of market developments and technical standards" (HSO, Stakeholder analysis) "various communication measures and tips on technical integration" (HSO, Stakeholder analysis) "Health insurance funds, the IT department at the medical centre, other patients" (HSO, Stakeholder analysis) "Jana’s interpretation of the matrix is different" (HSO, Stakeholder analysis) "IT management is ranked much higher than we had anticipated" (HSO, Stakeholder analysis) "Potential resistance: none (nursing staff vs medical staff; older patients vs digital portal; operational staff vs project management)" (MSH, Stakeholder analysis) "Position on the influence-interest matrix: medical service providers tend to be in the middle ground between high influence and high interest, and low influence and high interest – the project will only be successful if these very stakeholders are more closely involved; Software providers are also in the middle ground with low interest: although they primarily have an implementing role once the contract has been awarded, they have a high level of influence on the course of the project" (MSH, Stakeholder analysis) "Engagement and communication strategies: there is a lack of cross-functional meetings (e.g. monthly project team meetings comprising key users, medical and nursing management, IT staff, data protection officers); Software providers and service providers for the primary system are not involved, meaning there are no direct escalation channels; newsletters or information sessions (e.g. a group-wide 15-minute meeting) to provide updates on the current status and milestones achieved" (MSH, Stakeholder analysis) "Stakeholders: Data protection (high influence, low interest), competitors (low influence, low interest), maintenance (position slightly adjusted)" (MSH, Stakeholder analysis) "Stakeholder matrix: Management / Administration: Administration / Controlling and Data Protection Officer added; Others: Competitors added" (MSH, Stakeholder analysis) "Engagement and communication strategy: Competitors: passive provision of information via general channels added" (MSH, Stakeholder analysis) "Measures for the first 6 months: Feedback channels for patients added (MSH, Stakeholder analysis) | |
| Identification of omissions and blind spots | 27 | The classification of toxic emotions could have been more detailed if these points had been elaborated on further. (MSH, Empathy map) "Deriving implications: […] Nursing Care: Increase in staff numbers: Listed as a lever in the model solution; not listed in the solution due to its high resource intensity and complexity" (MSH, Empathy map) "We have also covered several points under other headings" (HSO, Empathy map) "We have not provided a detailed answer to Step 4" (HSO, Empathy map) "We have not described the measures taken to recognise IT" (HSO, Empathy map) "Other classification" (HSO, Empathy map) "And there is no consideration of the fragmented IT landscape…" (HSO, Empathy map) "The model solution selected different stakeholders, which partly led to different results." (HSO, Empathy map) "We did not analyse the implementation implications on a case-by-case basis." (MSH, Empathy map) "We initially found the political factors somewhat difficult to analyse, which is why the measures to be derived from them were not entirely clear. However, the interviews with the various stakeholders provided a clear picture, which ensured that the results were consistent" (MSH, PESTEL analysis) "We first carried out the PESTEL analysis without going into the specific strategies or measures. These were added in the second step. " (MSH, PESTEL analysis) "We had categorised patient safety as a social issue rather than a political one" (MSH, PESTEL analysis) "Generational differences, sustainability issues and the patient portal were not taken into account" (MSH, PESTEL analysis) "We have not divided the target process into phases (step 2)" (HSO, Process analysis) "We are missing mobile optimisation for smartphone and tablet use in step 5." (HSO, Process analysis) We have not identified any key findings. (MSH, Process analysis) "Implementation measures initially drawn up for the first 6 months; no complete project plan yet (to follow)" (MSH, Stakeholder analysis) "under ‘Weaknesses’ the point ‘Lack of a concrete implementation plan and unclear stakeholder acceptance’ was missing" (HSO, SWOT analysis) "Under ‘Opportunities’, ‘Scaling potential’ was missing" (HSO, SWOT analysis) "Under ‘Risks’, ‘Legal compliance issues’ was missing" (HSO, SWOT analysis) "The same basis as in the SWOT analysis but different conclusions in the SO/ST/WT analysis" (MSH, SWOT analysis) "We discussed the analysis of stakeholder relationships verbally (particularly potential resistance), but the breakdown into the different categories (supportive, neutral, resistant) could have been included in the overview." (MSH, Stakeholder analysis) "We did not document the areas of tension amongst stakeholders." (MSH, Stakeholder analysis) "We outlined the engagement and communication strategies in rather general terms (e.g. face-to-face meetings vs. newsletters), but did not specify them in detail for the respective stakeholders. This additional level of detail can help to identify or improve specific communication channels." (MSH, Stakeholder analysis) "The patients were missing because we had grouped them under ‘patient representation’. There were different categorisations and links. The measures were not as detailed as the workshops, which we had not categorised into short-term, medium-term and long-term measures." (HSO, Stakeholder analysis) "We did not work out steps 5 and 6 in such detail" (HSO, Stakeholder analysis) "We were actually quite stuck" (HSO, Stakeholder analysis) | |
| Critical reflection and contextual adaptation | |||
| Alternative perspective | 59 | "Expanding the Empathy map to include the ‘hearing’ and ‘seeing’ dimensions, in order to incorporate the current state of affairs in day-to-day working life." (MSH, Empathy map) " We have chosen a different stakeholder; […] For us, this was the more appropriate choice in order to gain two different perspectives." (HSO, Empathy map) "Our focus was on identifying the specific concerns of the workforce and considering ways to address them, e.g.: Frustration due to a delayed roll-out -> address this with understanding and offer opportunities for feedback in small groups." (MSH, Empathy map) "Hybrid communication: with a greater focus on inclusion and user groups" (HSO, IRLM) "Change management: for example we cover this in a bit more detail in training courses" (HSO, IRLM) "User-centred approach: e.g. focus on accessibility" (HSO, IRLM) "We have tried to involve stakeholders" (HSO, IRLM) "We have set different priorities… Differences: e.g. Environmental: greater emphasis on hardware and energy consumption Technological: focus on cloud backup and cyber security Legal: focus on technical security measures Political: focus on political risks and funding conditions" (HSO, PESTEL analysis) "Involvement of IT management and data protection officers" (HSO, PESTEL analysis) "Other aspects, because the thinking was different" (HSO, Process analysis) "The target process was outlined across the various departments, and we focused more on the individuals involved." (HSO, Process analysis) "In the sample solution, the processes are viewed in relative isolation. In our approach, the steps flow seamlessly between the individual lanes. As a result, it is not immediately apparent in our approach that key interfaces between roles are missing or have not been indicated." (MSH, Process analysis) "In the sample solution, the processes are viewed in relative isolation. In our approach, the steps flow seamlessly between the individual lanes. As a result, it is not immediately apparent in our approach that key interfaces between roles are missing or have not been indicated." (MSH, Process analysis) "Unlike in the model answer, we didn’t stop at the end of treatment, but at the point concerning data protection. So our patient had already been discharged" (HSO, Process analysis) "Some requirements differ" (HSO, Process analysis) "We have taken data protection into account. There should be no data protection gaps in the future system" (HSO, Process analysis) "We involved more staff in the modelling process (more levels)" (HSO, Process analysis) "We divided Step 2 up according to the stakeholders." (HSO, Process analysis) "In our view, pharmacies do not dispense medicines (that is the doctors’ responsibility)" (HSO, Process analysis) "For us, the problem is not organisational shortcomings, but the fact that the system is not working" (HSO, Process analysis) "Comply with the General Data Protection Regulation" (HSO, Process analysis) "Digital notifications" (HSO, Process analysis) "Electronic approvals" (HSO, Process analysis) "Centralised communication platform" (HSO, Process analysis) "Automatic logging" (HSO, Process analysis) "GDPR compliance" (HSO, Process analysis) "Real-time synchronisation" (HSO, Process analysis) "Role-based access control" (HSO, Process analysis) "Another department at Swinlane, a smaller or general department e.g. medical care centre, cardiologist, medical assistant" (HSO, Process analysis) "We tended to think in terms of people rather than institutions." (HSO, Process analysis) "The process is not shown in the swim-lane diagram in the solution." (HSO, Process analysis) "We have a similar output, although the path to it is presented in a slightly more complex manner. This has made the issues at various interfaces clearer, as many different connections have been illustrated. Rather than considering the various lanes in isolation, they have been viewed holistically. This allows specific issues between the interfaces to be identified." (MSH, Process analysis) "digital medication management via an app, including information on side effects and drug interactions" (MSH, Process analysis) "Focus of the solutions: specific process improvements" (HSO, SWOT analysis) "Approach to implementation: direct ideas for improvement" (HSO, SWOT analysis) "The ‘super-user’ approach. Rather than relying solely on theoretical training, you involve younger staff in practical ways to provide direct support to the team in their day-to-day work." (HSO, SWOT analysis) "A different IT strategy: the solution is opting for a radical overhaul through the implementation of an integrated system" (HSO, SWOT analysis) "Strengths: a greater sense of security through direct feedback" (MSH, SWOT analysis) "Weaknesses: alarm fatigue amongst patients and the risk of ‘scaremongering’ due to constant monitoring of the status (traffic light system)" (MSH, SWOT analysis) "Opportunities: reduction in paper and postage costs" (MSH, SWOT analysis) "Risks: a new role for staff; if the change fails, acceptance of the software will decline" (MSH, SWOT analysis) "SO: Patient retention through a sense of security" (MSH, SWOT analysis) "WO: Reduced telephone workload through digital channels" (MSH, SWOT analysis) "ST: Quality assurance to combat alarm fatigue: regular medical review of threshold values" (MSH, SWOT analysis) "WT: Emergency algorithm: if a patient does not transmit any data for an extended period, switch to the telephone helpline" (MSH, SWOT analysis) "We had also listed the external stakeholder landscape, but classified it as a group with little impact on this issue." (MSH, Stakeholder analysis) "The engagement and communication strategies are notably lacking in cross-functional meetings within the project team, as well as group-wide meetings, to ensure a constant flow of information regarding the project’s progress." (MSH, Stakeholder analysis) "In the influence-interest matrix, two stakeholders were classified as being in the middle ground between low and high influence: the software provider/primary system (low interest) and medical service providers (high interest)" (MSH, Stakeholder analysis) "We plan to introduce regular fortnightly ‘Jour Fixes’ with the software provider to discuss tests, escalation issues and further development in a targeted manner. Close coordination between external service providers and clinical staff (IT, medical and nursing management) is crucial here, as otherwise delays and miscommunication may occur." (MSH, Stakeholder analysis) "During the roll-out, the focus should be on face-to-face meetings. It makes sense to deploy key users who are particularly tech-savvy and trained in using the software. They can act as direct on-site contacts, helping to resolve any issues that arise quickly and providing the team with optimal support." (MSH, Stakeholder analysis) "Further key stakeholders identified: patients, IT/software providers and payers (holistic approach)" (MSH, Stakeholder analysis) "Minor discrepancies in the categorisation within the stakeholder matrix: e.g. payers have a high level of interest in the project’s success (e.g. for internal care and cost management); internal IT has been added to the matrix" (MSH, Stakeholder analysis) "Actions for the first 6 months: training sessions not yet carried out; following consultation with the software provider, training sessions can be planned from around the halfway point of the project; prior to this, contract negotiations must be finalised and requirements (medical and patient-related) must be gathered" (MSH, Stakeholder analysis) "We also had fewer than 20 stakeholders, rather than more than 20 as envisaged in the model solution." (HSO, Stakeholder analysis) "We identified who the key players are and who is less important, and drew up fundamental, concrete measures" (HSO, Stakeholder analysis) "We have brought the five main stakeholders closer together, so that they collaborate more closely than envisaged in the model solution." (HSO, Stakeholder analysis) "We had the idea of putting up information leaflets and posters to get patients and their relatives involved as well" (HSO, Stakeholder analysis) "When clustering the stakeholders, we used different criteria" (HSO, Stakeholder analysis) "We have not given IT management such a high priority; in our view, it is only responsible for data protection and not directly for the welfare of children. We do not regard schools and counselling centres as part of the resistance, as we believe they too should prioritise the child’s welfare and not focus primarily on the additional workload" (HSO, Stakeholder analysis) | |
| Critical comparison | 30 | "Our own analysis reveals further, more in-depth areas of tension." (MSH, Empathy map) "in some cases, more points were awarded for the wording of the human root cause" (HSO, Empathy map) "It has been recognised that Nagelsmann’s high level of responsibility leads him to fear failure." (HSO, Empathy map) "Ms Hecht’s toxic emotions were portrayed more concrete" (HSO, Empathy map) "Our presentation differs slightly from the model answer and we have explained the concept of ‘feeling’ in more detail" (HSO, Empathy map) "We have more KPIs, a table with SMART criteria" (HSO, IRLM) "We have identified a few more aspects" (HSO, IRLM) " We have also produced a diagram illustrating the SWOT analysis" (HSO, IRLM) "And the AI has also listed overarching strategic areas of action; we have incorporated these directly into the strategic implications" (HSO, PESTEL analysis) "Generally speaking, we find our solution more suitable, as it is slightly more detailed; this is because we have broken down the effects into positive and negative ones." (HSO, PESTEL analysis) "We have presented the diagram at the end differently from the model answer" (HSO, PESTEL analysis) "When planning the measures, we went into greater detail and identified more specific actions. For example: BI dashboard, measures relating to the survey, transparent documentation platforms and promotion of the cause" (MSH, PESTEL analysis) "We have worked out many details in greater depth, but these are not necessarily entirely new approaches" (MSH, PESTEL analysis) "We subsequently adjusted our process, as it was not as clear as in the model solution. In addition, the checklist was very helpful in guiding us and improving the outcome." (MSH, Process analysis) "we have paid more attention to pharmacies (restricted access)" (HSO, Process analysis) "we have paid more attention to changes in the medication plan" (HSO, Process analysis) "the sample solution states that the administration department plans the rounds; this is incorrect, as the care service management team is responsible for this task. Our solution is more appropriate in this respect. Furthermore, our end point is the preparation of the invoice by the administration department, which is missing from the sample solution." (HSO, Process analysis) "In some cases, the wording is very tough – for example, that all funding will be withdrawn." (MSH, Porcess analysis) "It was generally difficult to compare the results with the model answers, as these, unlike the students’ own work, were not shown visually. Consequently, it wasn’t possible to compare the different paths directly; instead, one had to think a little more creatively." (MSH, Process analysis) "The model solution opts for the more cautious approach of gradual, modular integration via interfaces (FHIR)." (HSO, SWOT analysis) "We have set out the strategies in much greater detail" (HSO, SWOT analysis) "We have included more aspects than in the sample answer and have presented the SWOT analysis in a summary table" (HSO, SWOT analysis) "Our visual presentation makes our solution much clearer" (MSH, SWOT analysis) "Our work packages are even more comprehensive and also include marketing, monitoring and digitalisation as an employer benefit" (MSH, SWOT analysis) "the sample solution was more detailed than our draft" (HSO, Stakeholder analysis) "We had a different view of the potential resistance from the schools; in that regard, we were more focused on the child’s welfare" (HSO, Stakeholder analysis) "the model answer is more detailed" (HSO, Stakeholder analysis) "We had other ideas that differed from the model solution" (HSO, Stakeholder analysis) "for the influence-interest matrix, we sometimes opted for different solutions that suited us better" (HSO, Stakeholder analysis) "in almost everything except steps 5 and 6, where the model solution is much more detailed and thorough" (HSO, Stakeholder analysis) | |
| Total | 343 | ||
Note: group rating per case summarized over the management methods across HSO and MSH; HSO = Osnabrück University of Applied Sciences ; MSH = Medical School Hamburg; the free-text reflections were divided into individual quotes, each with distinct content, and coded accordingly. Each segment comprises a single, clearly definable statement. Where bullet points or sentences contained several distinct pieces of content, they were divided into several quotes and coded separately.