Fleur Pawsey, PhD, University of Canterbury; Jennifer HK Wong, PhD, University of Canterbury; Sanna Malinen, PhD, University of Canterbury; Katharina Naswall, PhD, University of Canterbury

This case study explores attitudes and experiences of healthcare workers towards a significant change in workplace facilities and investigates factors that enabled or hindered successful change.

Healthcare facilities are constantly changing in response to challenges related to the health and wellbeing needs of populations, as well as to take advantage of opportunities presented by developments in medical knowledges and advancements in technology (Wutzke, Benton, & Verma, 2016). One response to these challenges and opportunities is the redevelopment or construction of new facilities. Moving into new facilities is as much an ongoing organisational change process as it is a physical shift at a point in time (Pomare et al., 2019a), and one which impacts greatly on healthcare employees, who are at the forefront as they are the people who need to adjust from existing processes, to learn to operate new equipment, and to adapt to different ways of working. As such, employee attitudes play a critical part in determining immediate and long-term success of the change process, and these attitudes need to be understood.

To explore the attitudes and experiences of healthcare employees prior to and following a change in facilities in a New Zealand healthcare setting, semi-structured interviews were conducted with over 25 affected team members, both before and after the change process. Participants came from a range of roles including specialists, junior doctors, nurses, nurse educators, technical and administrative staff. Participants were asked about the components of their job, and about their working environment. Those who were interviewed before the change process were asked to share their thoughts either about the upcoming change itself, or their expectations of their work environment following the change. Participants who were interviewed after the change were asked to reflect on the change process. They were also asked to talk about their experiences, either positive or negative, in their regular work and to explain the different ways that their role and their day-to-day tasks had been impacted by the change. Interviews are being transcribed and thematic analysis is currently underway.

Preliminary analysis suggests healthcare workers’ experiences throughout the change process were largely positive; Participants indicated, for instance, that training to use new equipment was comprehensive prior to the change. As such, there was already a sense of familiarity about the new environment created by the change, and many aspects of the transition were smooth. Participants felt the design of the new facility turned out to be very patient-centric contributing to patient well-being and that of their family. However, some apprehensions were expressed about the extra demands created by the new premises, some participants felt the change in the physical space spread them thin and put them under increased pressure. Others felt the nature of their jobs had changed considerably, creating unintended consequences elsewhere in the ward, something that could be termed a “ripple effect” (Pomare et al., 2019b). As we are still in the process of transcribing and analysing, our poster will share the final findings.

We take Kotter’s 8 step model (1995, 1996) to (a) reveal how change was successful and unsuccessful in our case organisation and (b) explain where further efforts may be needed to assist hospital employees in achieving positive long-term outcomes from the change. Specifically, we use Kotter’s earlier steps to explain how our case organisation was successful in: creating a strong sense of urgency about the need for change (step 1), creating a guiding coalition to lead change (step 2), developing and communicating a vision for change (steps 3 and 4), helping employees feel empowered about the change (step 5), and realising short term gains (step 6). We then make suggestions on how the case organisation could and should work to consolidate gains and continually produce more small changes (step 7), as well as anchor new ways of working in their everyday operations (step 8) in order to produce ongoing positive outcomes.

When managed appropriately, significant change in the ways of working for healthcare staff can be successful. We look forward to presenting the findings, as well as our recommendations for the case organisation and more general practical and theoretical implications, at the online Work Stress and Health Conference in September 2021.

Tags: Applied research, Case studies; single study; informal field studies; or similar reports and findings, Empirical study, Hazardous Work Environments and Safety, Health care and social assistance, Interventions in the Workplace, Organization- and Job-Level Environments and Practices