Internal factors that have potential to change in healthcare

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Public management reform: a comparative analysis. Oxford: Oxford University Press; Gadolin C. The logics of healthcare: in quality improvement work. Hogan R. Personality and the fate of organizations. Mahwah: Lawrence Erlbaum; Berry L, Curry P. Nursing workload and patient care. Accessed 10 October Change fatigue: development and initial validation of a new measure. Ead H.

Change fatigue in health care professionals. J Perianesth Nurs. McMillan K, Perron A. Nurses amidst change: the concept of change fatigue offers an alternative perspective on organizational change.

Policy Polit Nurs Pract. Epub Apr 2. Organisational change and employee burnout: the moderating effects of support and job control. Saf Sci. Dahl MS. Organizational change and employee stress. Manag Sci. Miller D. Successful change leaders: what makes them? What do they do that is different? J Change Manage. Why people stay: using job embeddedness to predict voluntary turnover. Acad Manag J.

Hill LA. Managing change. Boston: Harvard Enterprise Faculty Publishing; J Appl Behav Sci. Employee cynicism and resistance to organizational change. J Bus Psychol. Understanding and managing cynicism about organizational change. Acad Manage Perspect. Bouckenooghe D. Three approaches to qualitative content analysis. Qual Health Res.

Grama B. Cynicism in organizational change. Readiness for organizational change: a longitudinal study of workplace, psychological and behavioural correlates. J Occup Organ Psychol. On the receiving end: Sensemaking, emotion, and assessments of an organizational change initiated by others.

Stensmyren H. The challenge of transforming organizations. Transforming organizations. Young GJ. Fernandez S, Rainey HG. Managing successful organizational change in the public sector. Public Admin Rev. Subjective perceptions of organizational change and employee resistance to change: direct and mediated relationships with employee well-being. Br J Manage. Weiner BJ. A theory of organizational readiness for change.

Implement Sci. Implementing performance-based program budgeting: a system-dynamics perspective. Implementation and public policy. Lanham: University Press of America; Statutory coherence policy implementation: the case of family planning.

J Public Policy. Reay T, Hinings CR. Managing the rivalry of competing institutional logics. Organ Stud. The impact of management on medical professionalism: a review. Sociol Health Illn. Freidson E. Professionalism: the third logic.

Cambridge: Polity Press; Gabbay J, LeMay A. Mindlines: making sense of evidence in practice. Br J Gen Pract. Beck M, Melo S. Quality management and managerialism in healthcare: a critical historical survey. Houndmills, Basingstoke: Palgrave Macmillan; Noordegraaf M. Present-day professionalism in ambiguous public domains.

Admin Soc. Wilensky H. The professionalization of everyone? Am J Sociol. Nurs Inq. Halldin J. Socialmedicinsk tidskrift. Freedom to do what you are told: senior management team autonomy in an NHS acute trust. Public Admin. McGivern G, Ferlie E. Playing tick-box games: interrelating defences in professional appraisal. Hum Relat. Zaremba M. Agerberg M. Stockholm: Regeringskansliet; Debate article.

Dagens Nyheter. Sample size in qualitative interview studies: guided by information power. Download references. The authors would like to thank all the participating physicians, registered nurses and assistant nurses who participated in the interviews. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. You can also search for this author in PubMed Google Scholar.

All analysed the data. PN drafted the manuscript, but it was reviewed and critically revised for important intellectual content by all authors. All authors read and gave final approval of the version of the manuscript submitted for publication.

Correspondence to Per Nilsen. All the participants gave their written and oral consent to participate in the interviews. The study was performed according to World Medical Association Declaration of Helsinki ethical principles for medical research involving human subjects.

To maintain the principle of non-maleficence, the participants were guaranteed confidentiality, which was taken into account when reporting the findings through abstracted findings presented at the group level.

In the interviews, the researchers were aware of power issues, in that an interview is not a conversation between two equal individuals. The interview time was taken into careful consideration. The participants were given opportunity to reflect on what they said in the interviews, and time was also available for the participants to ask questions. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Reprints and Permissions. Nilsen, P. Characteristics of successful changes in health care organizations: an interview study with physicians, registered nurses and assistant nurses. Download citation. Received : 19 November Accepted : 14 February Published : 27 February Anyone you share the following link with will be able to read this content:.

Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative. Skip to main content. Search all BMC articles Search. Download PDF. Research article Open Access Published: 27 February Characteristics of successful changes in health care organizations: an interview study with physicians, registered nurses and assistant nurses Per Nilsen 1 , Ida Seing 2 , Carin Ericsson 1 , 3 , Sarah A.

Abstract Background Health care organizations are constantly changing as a result of technological advancements, ageing populations, changing disease patterns, new discoveries for the treatment of diseases and political reforms and policy initiatives. Methods The study was based on semi-structured interviews with 30 health care professionals: 11 physicians, 12 registered nurses and seven assistant nurses employed in the Swedish health care system.

Results The analysis yielded three categories concerning characteristics of successful changes: having the opportunity to influence the change; being prepared for the change; valuing the change. Conclusions Organizational changes in health care are more likely to succeed when health care professionals have the opportunity to influence the change, feel prepared for the change and recognize the value of the change, including perceiving the benefit of the change for patients.

Background The only constant in health care organizations, as the saying goes, is change. Methods Study setting, design and participants Study data come from interviews with Swedish health care professionals physicians, registered nurses, assistant nurses. Table 1 Participant characteristics Full size table.

Having the opportunity to influence the change The health care professionals emphasized the importance of having the opportunity to influence organizational changes that are implemented. Discussion Change is pervasive in modern health care.

Conclusions In conclusion, organizational changes in health care are more likely to succeed when health care professionals have the opportunity to influence the change, feel prepared for the change and recognize the value of the change, including perceiving the benefit of the change for patients.

Availability of data and materials All interview data analysed during the current study are available from the corresponding author on reasonable request. Birken US: United States. Google Scholar SKL. Google Scholar Gray M. Google Scholar Gadolin C. Google Scholar Hogan R. Article Google Scholar Ead H. Article Google Scholar Miller D.

Google Scholar Hill LA. Article Google Scholar Bouckenooghe D. Article Google Scholar Stensmyren H. Google Scholar Young GJ. Another social element is If an organization is deciding between several quality management programs, which would you recommend and why?

The healthcare sector is complex and comprises various subsystems connected to achieve the main goal or objective. According to Aggarwal et al. However, quality is not a physical aspect. It is a combination of various concepts, including assessing, monitoring, and improving the quality and safety of care. The transition in quality management is that it was traditionally perceived as directing the service providers on what to deliver.

Presently, it involves managing the care process and developing strategies that will enhance healthcare delivery. In a position to select a quality management program, I would select the total quality management TQM.

According to Chiarini and Vagnoni , the TQM process involves the management philosophy focusing on work processes and people, promoting organizational performance and customer satisfaction. It further involves the delivery of quality and content quality. The selection of this quality management approach is centered on reducing errors, ensuring the optimization of infrastructure, and controlling the quality of care delivery.

The fundamental tenets of TQM include client focus, obsession with quality, long-term commitment, scientific approach, education, training, autonomy, and collaborative practice. In TQM, the nurses are central and significantly contribute to achieving the implementation process of the principles. TQM is enhanced by a quality management department designed for the purpose.

Notably, several instruments have been designed to evaluate the delivery of quality services and that the approaches are beneficial to the staff. Important to note is that quality benefits all the healthcare stakeholders, from the managers and leaders to physicians to the nurses. Among the benefits of the TQM approach are enhancing patient satisfaction, reducing wastage, mitigating errors, and improving the quality of service delivery Aburayya et al.

The selection of the TQM is further centered Aburayya, A. An empirical examination of the effect of TQM practices on hospital service quality: an assessment study in UAE hospitals. Pharm , 11 9 , Aggarwal, A.

Quality management in healthcare: The pivotal desideratum. Journal of Oral Biology and Craniofacial Research , 9 2 , Almathami, H. Journal of medical Internet research , 22 2 , e Barrett, M. Artificial intelligence supported patient self-care in chronic heart failure: a paradigm shift from reactive to predictive, preventive and personalised care. Epma Journal , 10 4 , Chiarini, A.

TQM implementation for the healthcare sector: The relevance of leadership and possible causes of lack of leadership. Leadership in Health Services.

Fatima, I. Dimensions of service quality in healthcare: a systematic review of the literature. International Journal for Quality in Health Care , 31 1 , Fleming, R. Interprofessional collaborative practice and school nursing: A model for improved health outcomes. Heeringa, J. Horizontal and vertical integration of health care providers: a framework for understanding various provider organizational structures.

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Geneva: World Health Organization; Google Scholar. Stockholm: Sveriges kommuner och landsting SKL ; Gray M. Evidence-based healthcare and public health. Edinburgh: Churchill Livingstone; Pollitt C, Bouckaert G. Public management reform: a comparative analysis.

Oxford: Oxford University Press; Gadolin C. The logics of healthcare: in quality improvement work. Hogan R.

Personality and the fate of organizations. Mahwah: Lawrence Erlbaum; Berry L, Curry P. Nursing workload and patient care. Accessed 10 October Change fatigue: development and initial validation of a new measure. Ead H. Change fatigue in health care professionals. J Perianesth Nurs. McMillan K, Perron A. Nurses amidst change: the concept of change fatigue offers an alternative perspective on organizational change.

Policy Polit Nurs Pract. Epub Apr 2. Organisational change and employee burnout: the moderating effects of support and job control. Saf Sci. Dahl MS. Organizational change and employee stress. Manag Sci. Miller D. Successful change leaders: what makes them?

What do they do that is different? J Change Manage. Why people stay: using job embeddedness to predict voluntary turnover. Acad Manag J. Hill LA. Managing change. Boston: Harvard Enterprise Faculty Publishing; J Appl Behav Sci.

Employee cynicism and resistance to organizational change. J Bus Psychol. Understanding and managing cynicism about organizational change. Acad Manage Perspect. Bouckenooghe D. Three approaches to qualitative content analysis. Qual Health Res. Grama B. Cynicism in organizational change. Readiness for organizational change: a longitudinal study of workplace, psychological and behavioural correlates.

J Occup Organ Psychol. On the receiving end: Sensemaking, emotion, and assessments of an organizational change initiated by others. Stensmyren H. The challenge of transforming organizations. Transforming organizations. Young GJ. Fernandez S, Rainey HG. Managing successful organizational change in the public sector.

Public Admin Rev. Subjective perceptions of organizational change and employee resistance to change: direct and mediated relationships with employee well-being. Br J Manage. Weiner BJ. A theory of organizational readiness for change. Implement Sci. Implementing performance-based program budgeting: a system-dynamics perspective.

Implementation and public policy. Lanham: University Press of America; Statutory coherence policy implementation: the case of family planning. J Public Policy. Reay T, Hinings CR. Managing the rivalry of competing institutional logics.

Organ Stud. The impact of management on medical professionalism: a review. Sociol Health Illn. Freidson E. Professionalism: the third logic. Cambridge: Polity Press; Gabbay J, LeMay A. Mindlines: making sense of evidence in practice. Br J Gen Pract. Beck M, Melo S. Quality management and managerialism in healthcare: a critical historical survey.

Houndmills, Basingstoke: Palgrave Macmillan; Noordegraaf M. Present-day professionalism in ambiguous public domains. Admin Soc. Wilensky H. The professionalization of everyone? Am J Sociol. Nurs Inq. Halldin J. Socialmedicinsk tidskrift. Freedom to do what you are told: senior management team autonomy in an NHS acute trust.

Public Admin. McGivern G, Ferlie E. Playing tick-box games: interrelating defences in professional appraisal. Hum Relat. Zaremba M. Agerberg M. Stockholm: Regeringskansliet; Debate article. Dagens Nyheter. Sample size in qualitative interview studies: guided by information power. Download references. The authors would like to thank all the participating physicians, registered nurses and assistant nurses who participated in the interviews. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

You can also search for this author in PubMed Google Scholar. All analysed the data. PN drafted the manuscript, but it was reviewed and critically revised for important intellectual content by all authors. All authors read and gave final approval of the version of the manuscript submitted for publication. Correspondence to Per Nilsen.

All the participants gave their written and oral consent to participate in the interviews. The study was performed according to World Medical Association Declaration of Helsinki ethical principles for medical research involving human subjects.

To maintain the principle of non-maleficence, the participants were guaranteed confidentiality, which was taken into account when reporting the findings through abstracted findings presented at the group level. In the interviews, the researchers were aware of power issues, in that an interview is not a conversation between two equal individuals.

The interview time was taken into careful consideration. The participants were given opportunity to reflect on what they said in the interviews, and time was also available for the participants to ask questions.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Reprints and Permissions. Nilsen, P. Characteristics of successful changes in health care organizations: an interview study with physicians, registered nurses and assistant nurses. Download citation. Received : 19 November Accepted : 14 February Published : 27 February Anyone you share the following link with will be able to read this content:.

Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative. Skip to main content.

Search all BMC articles Search. Download PDF. Research article Open Access Published: 27 February Characteristics of successful changes in health care organizations: an interview study with physicians, registered nurses and assistant nurses Per Nilsen 1 , Ida Seing 2 , Carin Ericsson 1 , 3 , Sarah A.

Abstract Background Health care organizations are constantly changing as a result of technological advancements, ageing populations, changing disease patterns, new discoveries for the treatment of diseases and political reforms and policy initiatives. Methods The study was based on semi-structured interviews with 30 health care professionals: 11 physicians, 12 registered nurses and seven assistant nurses employed in the Swedish health care system.

Results The analysis yielded three categories concerning characteristics of successful changes: having the opportunity to influence the change; being prepared for the change; valuing the change. Conclusions Organizational changes in health care are more likely to succeed when health care professionals have the opportunity to influence the change, feel prepared for the change and recognize the value of the change, including perceiving the benefit of the change for patients. Background The only constant in health care organizations, as the saying goes, is change.

Methods Study setting, design and participants Study data come from interviews with Swedish health care professionals physicians, registered nurses, assistant nurses. Table 1 Participant characteristics Full size table.

Having the opportunity to influence the change The health care professionals emphasized the importance of having the opportunity to influence organizational changes that are implemented. Discussion Change is pervasive in modern health care. Conclusions In conclusion, organizational changes in health care are more likely to succeed when health care professionals have the opportunity to influence the change, feel prepared for the change and recognize the value of the change, including perceiving the benefit of the change for patients.

Availability of data and materials All interview data analysed during the current study are available from the corresponding author on reasonable request. Birken US: United States. Google Scholar SKL. Google Scholar Gray M. Google Scholar Gadolin C. It has become an important aspect in healthcare and underpins every mission, vision, goal, and objective of the medical practice and service delivery.

These definitions have been drawn from the nationally acknowledged agencies. In the first definition by the Institute of Medicine, there are six tenets of quality in healthcare practice.

These include the effective, equitable, timely, person-centered, safe, and effective. This definition is further asserted by the Agency for Healthcare Research and Quality AHRQ , which notes that quality is doing right for the right individual and at the right instance.

This care is delivered in the right manner to meet the most suitable objectives and goals. Six objectives in quality healthcare delivery exist in this regard.

These include;. This is achieved through engaging and involving the individual in care planning and implementation. What factors can you control, as a manager, for your staff to provide high-quality care? Quality in healthcare is fostered through acknowledging various internal and external factors Almathami et al. The organizational leadership and management should demonstrate an understanding of these elements and integrate them in service delivery.

They comprise the roles, rules, and responsibilities of the individuals. In quality healthcare, the structure is essential as it determines the decision-making process in care delivery. A flat or horizontal structure ensures that all employees are involved in the decision-making process, increasing the quality of informed choices Heeringa et al.

Quality healthcare delivery is characterized by effective values, supportive of the quality practice. Another internal element to consider is the working environment. Notably, aspects such as performance management and employee engagement should be fundamental in providing quality healthcare practice.

Performance management involves Email: info pearlbrill. These include technology, social-cultural, economy, and legal elements.

The healthcare facility should be conscious of the technological advancements in care delivery. This ensures that it remains competitive and that the employees are equipped with skills aligned with these technologies. For instance, there is an increase in using artificial intelligence and machine learning. Aspects such as data analytics are critical in ensuring big data is integrated to deliver effective services.

The healthcare staff should brace themselves to deliver culturally competent care. This ensures quality care to all individuals regardless of their affiliation, such as race, ethnicity, age, and gender. Another social element is If an organization is deciding between several quality management programs, which would you recommend and why?

The healthcare sector is complex and comprises various subsystems connected to achieve the main goal or objective. According to Aggarwal et al. However, quality is not a physical aspect. It is a combination of various concepts, including assessing, monitoring, and improving the quality and safety of care. The transition in quality management is that it was traditionally perceived as directing the service providers on what to deliver.

Presently, it involves managing the care process and developing strategies that will enhance healthcare delivery. In a position to select a quality management program, I would select the total quality management TQM.

According to Chiarini and Vagnoni , the TQM process involves the management philosophy focusing on work processes and people, promoting organizational performance and customer satisfaction.

It further involves the delivery of quality and content quality. The selection of this quality management approach is centered on reducing errors, ensuring the optimization of infrastructure, and controlling the quality of care delivery.

The fundamental tenets of TQM include client focus, obsession with quality, long-term commitment, scientific approach, education, training, autonomy, and collaborative practice.