title: Change process during redesign of a model of nursing practice in a surgical ward.
abstract: OBJECTIVE
  This paper reports a case study of nursing practice model redesign in a surgical ward at a large metropolitan acute care hospital in Sydney, Australia.
  
  
  BACKGROUND
  Literature suggests that factors such as financial restraints and shortage of nurses necessitate redesign of nursing care.
  
  
  METHODS
  A descriptive case study design was used. The nursing practice model was changed from a patient allocation model to a team-nursing model and a new role of Clinical Activities Coordinator was introduced.
  
  
  RESULTS
  This study has confirmed that people need to be able to empower themselves to ensure an effective change process. It was also apparent in the case study that the staff were resistant to the redesign.
  
  
  CONCLUSIONS
  Change is a difficult process, which needs to involve all stakeholders. The planning process needs to consider the characteristics of the context such as workload and skill required, and the measures such as patient and staff satisfaction and health outcomes.
authors.affiliation: Clinical Nursing Research Unit, University of Western Sydney, Sydney, Australia.
authors.forename: Brenda
authors.initials: B
authors.lastname: Hayman
authors.forename: Lesley
authors.initials: L
authors.lastname: Wilkes
authors.forename: Jane
authors.initials: J
authors.lastname: Cioffi
mesh_terms: D001291:Attitude of Health Personnel; D003266:Continuity of Patient Care / Q000458:organization & administration*; D006301:Health Services Needs and Demand; D006801:Humans; D007588:Job Satisfaction; D016294:Models, Nursing; D009517:New South Wales; D024802:Nurse's Role; D015403:Nursing Evaluation Research; D015404:Nursing Methodology Research; D009741:Nursing Staff, Hospital / Q000458:organization & administration* / Q000523:psychology; D009746:Nursing, Team / Q000458:organization & administration*; D009936:Organizational Innovation; D013527:Perioperative Nursing / Q000458:organization & administration*; D010934:Planning Techniques; D011209:Power, Psychological