CHANGING THE
CULTURE IN THE DELIVERY OF CHILDREN’S SERVICES
Coad J. E.1, Mountford S. D. 2
1 Birmingham University, Birmingham, U.K.
2 George Eliot NHS Trust, North Warwickshire, U.K.
Objectives: 1. To share the principles of a
framework of nursing management that requires ‘shared governance’ where all
levels of nursing and medical staff are personally involved in
decision-making in order to develop the service. 2.To apply the framework
to one provider of children’s services in the UK to demonstrate how it is
not only changing the culture of clinical care delivery but also
organization and education of staff who deliver the care. 3. To share an
evaluation project which has highlighted the challenges and real gains of
changing the culture of children’s service delivery. 4.To demonstrate that
this innovative project seeks to improve the delivery of care for children
and families and could be a blueprint for other childrens service delivery
areas.
Methods: Following an external review in one Hospital
Trust for childrens services in the National Health Service (NHS) in the
United Kingdom (UK) it was felt that a clearer, strategic direction was
required in order to manage and improve services for staff, children and
their families.
In 2000, a framework was
implemented that involved all levels of nursing and medical staff to work
together in a climate of ‘shared governance’. All staff, ‘bottom up/top
down’ are now personally involved in decision-making and for developing the
strategy and delivery of children’s services.
An evaluation project
was commissioned to monitor the change in service delivery. This involved a
longitudinal investigation using interviews and questionnaire, which
highlighted the challenges and real gains of changing the culture of
children’s service delivery.
Results: The strategic framework has not only changed the
culture of clinical care delivery but also the organization and
education/training needs of staff who deliver that care.
Conclusion: This innovative project has changed the
work culture for nursing & medical staff and has aimed to improve
quality of care delivery for children and families. Thus the strategies
employed are not only of interest but are transferable to other
international healthcare and societal cultures.