The impact of implementing a person-centred pain management intervention on resistance to change and organizational culture

BMC Health Services Research

Helena Brisby¹  Adad Baranto¹  Eva Angelini²  Axel Wolf³  Helle Wijk⁴ 

[1] Department of Orthopaedics, Institute of Clinical Sciences, at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden;Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden;Department of Orthopaedics, Institute of Clinical Sciences, at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden;Institute of Health and Care Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden;Sahlgrenska Universitetssjukhuset Forskningsenhet ortopedi, Länsmansgatan 28, 431 80, Mölndal, Sweden;Institute of Health and Care Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden;Institute of Health and Care Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden;Department of Quality Improvement, Sahlgrenska University Hospital, Gothenburg, Sweden;Architecture, Chalmers University of Technology, Gothenburg, Sweden;

关键词: Resistance to change;    Organizational culture;    Organization;    Person-centred care;    Implementation;    Spine surgery;   

DOI  :  10.1186/s12913-021-06819-0

来源: Springer

【 摘 要 】

BackgroundResistance to change and organizational culture are essential factors to consider in change management in health care settings. Implementation of structural change remains a challenge. There is a lack of studies providing information on the impact of implementation processes on the organization. The aim of this study was to describe the impact of implementing a systematic change process concerning postoperative person-centred pain management on resistance to change and organizational culture in an orthopaedic spine surgery unit.MethodsThe study was set in an orthopaedic spine surgery unit at a university hospital. Person-centred bundles of care for postoperative pain management of spine surgery patients were developed in co-creation by a multi-professional expert group and implemented throughout the care pathway. The intervention was underpinned by theories on organizational culture and inspired by principles of person-centred care. Quantitative data were collected using the Resistance to Change Scale and the Organizational Culture Assessment Instrument and analysed using descriptive statistics.ResultsThe findings showed a low resistance to change decreasing during the study. The organizational culture shifted from a result-oriented to a formalized and structured culture after the implementation. The culture preferred by the staff was team-oriented and participation-focused throughout the study. The discrepancy between the current and preferred cultures remained extensive over time.ConclusionIt is challenging to describe the influence of the development and implementation of a postoperative pain management program on organizational culture as well as in terms of resistance to change, in a complex health care setting. In the current study the unit was under organizational strain during the implementation. Albeit, the important discrepancy between the current and preferred organizational culture could imply that structural changes aren’t enough when implementing person-centred pain management structures and needs to be combined with relational aspects of change.

【 授权许可】

CC BY