title: Augmenting nursing care quality and implementing change management in India: an amalgamated approach.
abstract: OBJECTIVE
  High dependency on nursing care in healthcare delivery systems in recent times has made the quality appraisal of nursing care even more imperative for nursing administrators. This study demonstrates the utility of a two-phase technique to identify the most significant shortcomings pertaining to nursing care delivery in general wards of a tertiary care hospital. The same could be used to set priorities.
  
  
  METHODS
  The first phase involved the use of the Delphi technique facilitating the experts to identify the major problems. The mean rank score was used for grading the problems. The second phase of the study involved getting direct feedback from the ward nurses. The sample size was 147 at a level of significance of 5%.
  
  
  RESULTS
  Consensus was reached among experts on four problems that should galvanize nursing administration vis-à-vis quality improvement. The responses of ward nurses in the second phase gave a better insight into these problems.
  
  
  CONCLUSIONS
  Identifying the existing problems and fostering a team spirit among all stakeholders hold the key in strategizing quality improvement in nursing care. Nursing administrators worldwide, after making suitable situation-specific customizations, may use this approach to realize both these objectives.
authors.affiliation: Department of Hospital Administration, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.
authors.forename: Arvind Vashishta
authors.initials: AV
authors.lastname: Rinkoo
authors.forename: Garima
authors.initials: G
authors.lastname: Singh
authors.forename: Ramanjeet
authors.initials: R
authors.lastname: Kaur
authors.forename: Vidha
authors.initials: V
authors.lastname: Chandra
authors.forename: Leela
authors.initials: L
authors.lastname: Masih
authors.forename: Hem
authors.initials: H
authors.lastname: Chandra
mesh_terms: D003697:Delphi Technique; D006801:Humans; D007194:India; D007318:Inservice Training / Q000592:standards; D015401:Nursing Administration Research; D009732:Nursing Care / Q000592:standards*; D011446:Prospective Studies; D058996:Quality Improvement
keywords: Delphi technique; change management; nursing care; quality improvement