Culture change, leadership and the grass-roots workforce

Abstract

The NHS is arguably entering its most challenging era. It is being asked to do more for less and, in parallel, a cultural shift in response to its described weaknesses has been prescribed. The defi nition of culture, the form this change should take and the mechanism to achieve it are not well understood. The complexity of modern healthcare requires that we evolve our approach to the workforce and enhance our understanding of the styles of leadership that are required in order to bring about this cultural change. Identifi cation of leaders within the workforce and dissemination of a purposeful and strategic quality improvement agenda, in part defi ned by the general workforce, are important components in establishing the change that the organisation currently requires. We are implementing this approach locally by identifying and developing grassroots networks linked to a portfolio of safety and quality projects.

Improvement attributes in healthcare: implications for integrated care

“…In this domain attributes address beliefs, stories and group norms. Kaplan et al (2010) and Edwards et al (2014) reflected on the dynamics within professional networks, which are characterised by multiple interwoven strands, which Crema and Verbano (2013) attempted to untangle by listing key attributes: organisation and communication; process management; error management; and customer/patient management. Spiers et al (2010), Lee et al (2010) and Schaffer et al (2013) explained that the psychological contract with managers depends on rewards and respect for the values central to professional identity.…”

Keeping up with the literature: A current practice survey and qualitative needs assessment among emergency physicians

“…An easy starting point for educators may be to create guides to navigating resources and succinct, practice‐focused evidence updates. Combining grassroots and top‐down approaches can make a positive impact 18 . Department leaders can support physicians wishing to introduce evidence‐based initiatives, including quality improvement research around evidence‐based practice as well as integrating evidence into routine patient care (e.g., protocols, evidence‐based alerts in electronic records, departmental memos regarding best practices, and practices endorsed by local specialist consensus).…”

“…18 Department leaders can support physicians wishing to introduce evidence-based initiatives, including quality improvement research around evidence-based practice as well as integrating evidence into routine patient care (e.g., protocols, evidence-based alerts in electronic records, departmental memos regarding best practices, and practices endorsed by local specialist consensus). Health regions can develop educational modules, memos, and conferences around the latest evidence.…”