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      Exploring the ripple effects of an Australian hospital redevelopment: a protocol for a longitudinal, mixed-methods study

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          Abstract

          Introduction

          Hospital redevelopment projects typically intend to improve hospital functioning and modernise the delivery of care. There is research support for the proposition that redevelopment along evidence-based design principles can lead to improved quality and safety. However, it is not clear how redevelopment influences the wider context of the hospital and its functioning. That is, beyond a limited examination of intended outcomes (eg, improved patient satisfaction), are there additional consequences (positive, negative or unintended) occurring within the hospital after the physical environment is changed? Is new always better? The primary purpose of this study is to explore the ripple effects of how hospital redevelopment may influence the organisation, staff and patients in both intended and unintended ways.

          Methods and analysis

          We propose to conduct a longitudinal, mixed-methods, case study of a large metropolitan hospital in Australia. The study design consists of a series of measurements over time that are interrupted by the natural intervention of a hospital redevelopment. How hospital redevelopment influences the wider context of the hospital will be assessed in six domains: expectations and reflections of hospital redevelopment, organisational culture, staff interactions, staff well-being, efficiency of care delivery and patient experience. Methods of data collection include a hospital-wide staff survey, semistructured interviews, a network survey, a patient experience survey, analysis of routinely collected hospital data and observations. In addition to a hospital-level analysis, a total of four wards will be examined in-depth, with two acting as controls. Data will be analysed using thematic, statistical and network analyses, respectively, for the qualitative, quantitative and relational data.

          Ethics and dissemination

          The study has been reviewed and approved by the relevant Ethics Committee in New South Wales, Australia. The results will be actively disseminated through peer-reviewed journals, conference presentations and in report format to the stakeholders.

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          Most cited references22

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          Readiness for Organizational Change: The Systematic Development of a Scale

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            Changing how we think about healthcare improvement

            Complexity science offers ways to change our collective mindset about healthcare systems, enabling us to improve performance that is otherwise stagnant, argues Jeffrey Braithwaite
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              Organisational change management: A critical review

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                Author and article information

                Journal
                BMJ Open
                BMJ Open
                bmjopen
                bmjopen
                BMJ Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2044-6055
                2019
                9 July 2019
                : 9
                : 7
                : e027186
                Affiliations
                [1] departmentAustralian Institute of Health Innovation, Centre for Healthcare Resilience and Implementation Science , Macquarie University , Sydney, New South Wales, Australia
                Author notes
                [Correspondence to ] Chiara Pomare; chiara.pomare@ 123456mq.edu.au
                Author information
                http://orcid.org/0000-0002-9118-7207
                http://orcid.org/0000-0002-9923-3116
                http://orcid.org/0000-0002-0553-682X
                http://orcid.org/0000-0002-2012-1980
                http://orcid.org/0000-0003-0296-4957
                Article
                bmjopen-2018-027186
                10.1136/bmjopen-2018-027186
                6615845
                31289072
                1fea283f-404e-40db-889b-5919b173970e
                © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 10 October 2018
                : 09 April 2019
                : 18 June 2019
                Funding
                Funded by: Research Training Program;
                Funded by: FundRef http://dx.doi.org/10.13039/501100000925, National Health and Medical Research Council;
                Categories
                Health Services Research
                Protocol
                1506
                1704
                Custom metadata
                unlocked

                Medicine
                quality in health care,qualitative research
                Medicine
                quality in health care, qualitative research

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