title: The 'Releasing Time to Care--the Productive Ward' programme: participants' perspectives.
abstract: OBJECTIVE
  The aim of this study was to explore the perceptions of nursing staff concerning the implementation of the 'Releasing Time to Care - the Productive Ward' programme in a specialist cardiothoracic hospital.
  
  
  BACKGROUND
  The 'Releasing Time to Care - the Productive Ward' programme uses the 'lean' philosophy originally developed in the Japanese motor industry to improve the efficiency of hospital wards. Its aim is to increase the proportion of time that nurses are able to spend in direct patient care.
  
  
  METHODS
  This study used a descriptive qualitative method with a sample size of four nurses and two health-care support workers. Thematic analysis of the interview transcripts was undertaken using the procedure developed by Burnard.
  
  
  RESULTS
  Thematic content analysis identified five major themes: starting to implement the programme, anxiety and defensiveness, the importance of leadership and communication, challenges, and learning and personal development.
  
  
  CONCLUSIONS
  Overall, the programme had a positive impact on both the wards studied. Challenges that were identified included the need to sustain momentum once the initial enthusiasm had waned.
  
  
  CONCLUSIONS
  This study highlighted the importance of key transformational leadership skills at ward manager level, such as the ability to inspire nurses to approach old problems in new ways, in the implementation of the 'Releasing Time to Care - the Productive Ward' programme.
authors.affiliation: Papworth Hospital NHS Trust, Cambridgeshire, UK. jaxd@btinternet.com
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Davis
authors.forename: John
authors.initials: J
authors.lastname: Adams
mesh_terms: D001291:Attitude of Health Personnel; D017598:Efficiency, Organizational; D006757:Hospital Units / Q000458:organization & administration*; D006782:Hospitals, Special; D006801:Humans; D007857:Leadership; D009723:Nurse-Patient Relations; D015401:Nursing Administration Research; D009732:Nursing Care / Q000379:methods*; D015403:Nursing Evaluation Research; D015404:Nursing Methodology Research; D009741:Nursing Staff, Hospital / Q000458:organization & administration / Q000523:psychology*; D036301:Qualitative Research; D013997:Time Factors