Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, North Ryde, NSW, Australia.
PLoS One. 2022 Oct 25;17(10):e0272251. doi: 10.1371/journal.pone.0272251. eCollection 2022.
Changes to hospital infrastructure are inevitable in ever-evolving healthcare systems. The redevelopment of hospitals and opening of new buildings can be a complex and challenging time for staff as they must find ways to deliver safe and high-quality care while navigating the complexities and uncertainties of change. This study explores the perspectives and experiences of staff and patients before and after the opening of a new hospital building as part of a large public hospital redevelopment in Sydney, Australia.
The study comprised a longitudinal mixed methods case study design. Methods included two rounds of staff surveys (n = 292 participants), two rounds of staff interviews (n = 66), six rounds of patient surveys (n = 255), and analysis of hospital data at tri-monthly intervals over two years. Data were compared before (2019) and after (2020) a new hospital building opened at a publicly funded hospital in Sydney, Australia.
Four key themes and perspectives emerged from the interviews including change uncertainty, communication effectiveness, staffing adequacy and staff resilience. Significant differences in staff perceptions of change readiness over time was identified. Specifically, perceptions that the organisational change was appropriate significantly decreased (2019: 15.93 ± 3.86; 2020: 14.13 ± 3.62; p < .001) and perceptions that staff could deal with the change significantly increased (2019: 17.30 ± 4.77; 2020: 19.16 ± 4.36; p = .001) after the building opened compared to before. Global satisfaction scores from patient survey data showed that patient experience significantly declined after the building opened compared to before (2020: 81.70 ± 21.52; 2019: 84.43 ± 18.46)), t(254) = -64.55, p < 0.05, and improved a few months after opening of the new facilities. This coincided with the improvement in staff perceptions in dealing with the change.
Moving into a new hospital building can be a challenging time for staff and patients. Staff experienced uncertainty and stress, and displayed practices of resilience to deliver patient care during a difficult period of change. Policy makers, hospital managers, staff and patients must work together to minimise disruption to patient care and experience. Key recommendations for future hospital redevelopment projects outline the importance of supporting and informing staff and patients during the opening of a new hospital building.
在不断发展的医疗体系中，医院基础设施的变化是不可避免的。医院的重建和新建筑的开放对员工来说是一个复杂而具有挑战性的时期，因为他们必须在应对变化的复杂性和不确定性的同时，寻找提供安全和高质量护理的方法。本研究探讨了澳大利亚悉尼一家大型公立医院重建过程中新医院大楼启用前后员工和患者的观点和体验。
该研究包括一个纵向混合方法案例研究设计。方法包括两轮员工调查（292 名参与者）、两轮员工访谈（66 名）、六轮患者调查（255 名）和两年内每三个月分析一次医院数据。数据在澳大利亚悉尼一家公立医院的新医院大楼启用前后（2019 年和 2020 年）进行了比较。
访谈中出现了四个关键主题和观点，包括变化的不确定性、沟通的有效性、人员配备的充足性和员工的适应力。随着时间的推移，员工对变革准备情况的看法存在显著差异。具体来说，对组织变革是否合适的看法明显下降（2019 年：15.93 ± 3.86；2020 年：14.13 ± 3.62；p <.001），而员工应对变革的能力的看法明显增加（2019 年：17.30 ± 4.77；2020 年：19.16 ± 4.36；p =.001）。患者调查数据的全球满意度评分显示，与启用前相比，患者体验在大楼启用后显著下降（2020 年：81.70 ± 21.52；2019 年：84.43 ± 18.46），t(254) = -64.55，p < 0.05，在新设施启用几个月后有所改善。这与员工应对变革能力的提高相吻合。
搬进新医院大楼对员工和患者来说都是一个具有挑战性的时期。员工经历了不确定性和压力，并表现出适应能力，在困难的变革时期提供患者护理。政策制定者、医院管理者、员工和患者必须共同努力，将对患者护理的干扰和体验降到最低。对未来医院重建项目的建议强调了在新医院大楼启用期间支持和告知员工和患者的重要性。
