Influencing sceptical staff to become supporters of service improvement: a qualitative study of doctors' and managers' views
Influencing sceptical staff to become supporters of service improvement: a qualitative study of doctors' and managers' views
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DOI：
10.1136/qshc.2003.007450
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发表时间：
2004-04-01
影响因子：
--
通讯作者：
Ketley, D
中科院分区：
文献类型：
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作者：
Gollop, R;Whitby, E;Ketley, D
目的：探讨对旨在改善服务的工作实践的变化的怀疑和阻力。两个主要的问题进行了研究：（1）为什么有些人是怀疑或抵制改善方案和（2）是什么影响他们改变他们的想法。方法：半结构化的定性访谈进行了19名临床医生和19名管理人员谁举行的国家和地区的作用，在两个国家的服务改善方案在NHS涉及系统的组织变化的工作实践：结果：怀疑和抵制情绪在所有工作人员群体中普遍存在，尤其是在医务人员中。原因包括个人不愿改变、误解改善计划的目的，以及不喜欢推广计划的方法。怀疑的员工可能会受到影响，参与改进，但这通常需要时间。新赢得的支持可能是脆弱的，需要持续的证据的好处maintenance.Conclusions：卫生服务人员，特别是医生的支持，是至关重要的现代化议程的传播和可持续性。怀疑和抵制被视为阻碍进展。改进举措的领导者需要认识到怀疑和抵制的影响，并考虑如何使员工积极参与变革。
Objective: To explore scepticism and resistance towards changes in working practice designed to achieve service improvement. Two principal questions were studied: (1) why some people are sceptical or resistant towards improvement programmes and (2) what influences them to change their minds.Methods: Semi-structured qualitative interviews were conducted with 19 clinicians and 19 managers who held national and regional roles in two national programmes of service improvement within the NHS involving systematic organisational changes in working practices: the National Booking Programme and the Cancer Services Collaborative (now the Cancer Services Collaborative Improvement Partnership).Results: Scepticism and resistance exist in all staff groups, especially among medical staff. Reasons include personal reluctance to change, misunderstanding of the aims of improvement programmes, and a dislike of the methods by which programmes have been promoted. Sceptical staff can be influenced to become involved in improvement, but this usually takes time. Newly won support may be fragile, requiring ongoing evidence of benefits to be maintained.Conclusions: The support of health service staff, particularly doctors, is crucial to the spread and sustainability of the modernisation agenda. Scepticism and resistance are seen to hamper progress. Leaders of improvement initiatives need to recognise the impact of scepticism and resistance, and to consider ways in which staff can become positively engaged in change.