'If we can't do more, let's do it differently!': using appreciative inquiry to promote innovative ideas for better health care work environments.
OBJECTIVE
To examine the use of appreciative inquiry to promote the emergence of innovative ideas regarding the reorganization of health care services.


BACKGROUND
With persistent employee dissatisfaction with work environments, experts are calling for radical changes in health care organizations. Appreciative inquiry is a transformational change process based on the premise that nurses and health care workers are accumulators and producers of knowledge who are agents of change.


METHODS
A multiple embedded case study was conducted in two interdisciplinary groups in outpatient cancer care to better understand the emergence and implementation of innovative ideas.


RESULTS
The appreciative inquiry process and the diversity of the group promoted the emergence and adoption of innovative ideas. Nurses mostly proposed new ideas about work reorganization. Both groups adopted ideas related to interdisciplinary networks and collaboration. A forum was created to examine health care quality and efficiency issues in the delivery of cancer care.


CONCLUSIONS
This study makes a contribution to the literature that examines micro systems change processes and how ideas evolve in an interdisciplinary context.


CONCLUSIONS
The appreciative inquiry process created an opportunity for team members to meet and share their successes while proposing innovative ideas about care delivery. Managers need to support the implementation of the proposed ideas to sustain the momentum engendered by the appreciative inquiry process.
Richer
Marie-Claire
MC
Transition Office, McGill University Health Centre, Montréal, QC, Canada H3H 2R9. Marie-claire.richer@muhc.mcgill.ca
Ritchie
Judith
J
Marchionni
Caroline
C
D000328:Adult; D002173:Cancer Care Facilities / Q000458:organization & administration; D006801:Humans; D008962:Models, Theoretical; D009369:Neoplasms / Q000628:therapy*; D019982:Organizational Case Studies; D009936:Organizational Innovation; D010348:Patient Care Team / Q000458:organization & administration*; D010934:Planning Techniques; D011792:Quebec; D017749:Total Quality Management / Q000379:methods* / Q000458:organization & administration