title: Health care professionals implementing a smoke-free policy at inpatient psychiatric units.
abstract: Smoke-free grounds policies (SFGPs) were introduced to inpatient psychiatric hospital settings to improve health among patients, staff, and visitors. We conducted an ethnographic study in Northern British Columbia, Canada, to describe how the implementation of SFGPs is affected by institutional cultures. Data reported here included participant observation, document review, informal discussions (n = 11), and interviews with health care professionals (HCPs; n = 19) and staff (n = 2) at two hospitals. We used iterative and inductive processes to derive thematic findings. Findings related to HCPs illustrate how local contexts and cultural factors affect SFGP implementation. These factors included individual beliefs and attitudes, the influence of group norms, leadership and consensus building, and locale-specific norms. Strong, consultative leadership, in which leaders solicited input from and long-term support of people most directly responsible for policy implementation, was key to success.
authors.affiliation: Saskatchewan Institute of Applied Science and Technology, Saskatoon, Saskatchewan, Canada lggrant@ualberta.net.
authors.forename: Lyle G
authors.initials: LG
authors.lastname: Grant
authors.affiliation: University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: John L
authors.initials: JL
authors.lastname: Oliffe
authors.affiliation: University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Joy L
authors.initials: JL
authors.lastname: Johnson
authors.affiliation: University of British Columbia, Okanagan Campus, Kelowna, British Columbia, Canada.
authors.forename: Joan L
authors.initials: JL
authors.lastname: Bottorff
mesh_terms: D001955:British Columbia; D006739:Hospital Administration; D006778:Hospitals, Psychiatric; D006801:Humans; D007407:Interviews as Topic; D016134:Organizational Policy; D012907:Smoking; D014028:Tobacco Smoke Pollution / Q000517:prevention & control*
chemical_list: D014028:Tobacco Smoke Pollution
keywords: addiction / substance use; ethnography; health care, remote / rural; health policy / policy analysis; mental health and illness; mental health nursing; research, qualitative; smoking cessation; tobacco and health