Transformational change: Perceptions of process and outcomes by nursing staff in a health care facility.

Abstract

This qualitative exploratory case study focused on how nursing staff perceived a complex transformational change within a large tertiary care teaching hospital. In an effort to improve the understanding of transformational learning and change, this study examined a change that required nursing staff to critically reflect on their practice and if necessary change their values, beliefs and attitudes. The objectives of the transformational innovation were to increase professional accountability and authority by changing the decision-making of nursing staff to a more autonomous process. The structural changes introduced included implementation of unit councils and primary nursing. Study data consisted of documentation collected over a three and a half year period during the implementation of the transformational change. During the analysis, similar phrases were coded and categorized and then re-categorized into major patterns or ideas reflecting perceptions of the innovation, transformational learning process, and outcomes of the change. Results describe the concerns, learning needs, and system considerations that influenced staff when implementing a transformational change. The results of this study will be of interest to administrators and educators as they prepare staff for future challenges.