Perceptions of Change Among Emergency Department Staff in a University Teaching Hospital in the United Kingdom

University teaching hospitals provide acute and emergency care in most healthcare systems. One of the priority areas in hospitals are emergency departments (ED) where practice changes are the norm due to the unpredictable and open “public good access” nature of service demands. At present changes to EDs are implemented to improve efficiency and reduce costs in the United Kingdom (UK) and other developed countries. Also, at present, there is limited evidence on how or why change is successful in some instances and not in others. The objective of this research was to study staff perceptions of change and the factors influencing the implementation of changes at a university teaching hospital in the UK. A modified grounded theory methodology was used to perform a secondary analysis of 41 interview transcripts to answer the research questions. Interview transcripts from participants consisted of 20 physicians, 13 nurses, two support workers and six managers involved in paediatric emergency care at the hospital. Data analysis provided answers to the first research question of how changes happen in the emergency department by identifying triggers and barriers to both planned and emergent changes. The second research question of what factors impact change identified three themes; communication, education and leadership. The concept that permeated all identified themes was that change provokes emotional responses at individual, team, and organizational levels. Good communication leading to staff involvement, education about new processes and credible trusted leadership, encouraged positive emotions and reduced negative emotions. In this study, negative emotions stemmed from a perceived inability of healthcare professionals to function effectively and efficiently to ensure safe patient care with changes. Professional values dictated the actions or inactions that transpired either as a result of these emotions or despite these emotions in health professionals. The study findings illustrate an emerging concept of emotions in change and the importance of acknowledging the reasons for negative emotions and fostering positive emotions in individuals and groups through communication, education and good leadership. I hope this concept will ultimately advance the theoretical understanding and practical strategies to help the process of change management in healthcare organizations.Ph.D.2021-03-21 00:00:0