Major hospital transformations: An integrative review and implications for nursing

Abstract

Major hospital transformations, hospital projects that combine construction and quality improvement dimensions, are booming around the globe. These costly endeavours have the potential to revolutionize healthcare, yet no known review explores this phenomenon, undermining accessibility of knowledge for healthcare leaders. In order to provide guidance on healthcare project management and on future research avenues, this article aims to synthesize empirical knowledge concerning major hospital transformations and their implications for nursing. An integrative review of the literature using the systematic approach described by Whittemore and Knafl was selected. As major hospital transformations represent a new area of research, the review includes 13 articles out of 116 retrieved for screening. The search strategy included the following electronic databases: CINAHL, MEDLINE, and Business Source Complete. Three main themes emerged from the data: the challenging context of major hospital transformations, the project management office as a key to successful healthcare change, and the absence of certain stakeholders’ voices. Major hospital transformations are important to study holistically as multi-change initiatives cannot be understood through investigating individual changes alone. Healthcare leaders are called to reflect on their governance structures during organisational transformations, as well as on the inclusion and exclusion of certain stakeholders who are essential to making sustainable change.

The client's essential stakeholder collaboration activities at the front-end phase of a hospital construction project

“…Hospital projects, which demonstrate duality as both a construction project and an organisational change project, require a combination of a large number of different skills, knowledge, stakeholders, resources and project perspectives. Therefore, hospital construction projects are labelled as complex projects and quite often also include a parallel organisational change process in the healthcare organisation and its processes (Fréchette et al. , 2020; Gordon and Pollack, 2018).…”

“…The development of healthcare often consists of large public projects with multiple stakeholders and organisational, leadership and management issues; they are usually longterm and represent major investments in and changes to established welfare systems, which have a significant impact (Fr echette et al, 2020;Glouberman and Mintzberg, 2001;Snowden and Boone, 2007). As a result, both the setting of strategic goals and the success of the ensuing healthcare projects are crucial.…”