Organizational transformation elements for evidence-based practice by hospital nursing staff: a qualitative study using 7-S framework.

backgroundExisting models that promote the implementation of evidence-based practice (EBP) give a fragmented picture of the process and factors. This means that a comprehensive view of the elements necessary for an organization to implement sustained EBP is lacking. Clarifying organizational transformation elements using the 7-S framework (Styles, Superordinate goals, Skills, Staff, Strategy, Systems, Structure) allows the organizational conditions to be comprehensively assessed, guiding transformation efforts toward sustaining EBPs. In addition, while ward-level group learning supports EBP sustainment, its organizational antecedents remain unclear.

aimThis study aimed to clarify organizational transformation elements for the sustainable implementation of EBPs by the nursing staff through group learning.

methodsThis qualitative study used face-to-face or online focus-group interviews with 30 healthcare professionals in eight wards of five hospitals. The participants were nursing staff (nurse managers, registered nurses, clinical nurse specialists), and other healthcare professionals involved in the implementation of the EBPs in the selected wards. In the interviews, for the eight activities in the Group Organizational Learning Activities Inventory, participants were asked about the facilitating/inhibiting factors for performing each activity related to sustaining the selected EBP. Qualitative content analysis was conducted using the 7-S framework as the axis of analysis. After the researchers repeatedly checked the categories, member checking was conducted with the four interview participants to confirm content validity and face validity of the extracted categories and items, as well as data saturation.

resultsIn total, 39 items in eight S categories, including socio-political context and healthcare policy as the new S category, were extracted as elements of an organizational transformation framework for EBPs. Furthermore, group conversations suggested that each S and item may be related to each other.

conclusionsThis study systematically and comprehensively identified the elements required to transform organizations and sustain EBP. The novelty of the 8 S framework is based on how it enables a multifaceted assessment of both the soft and hard aspects of organizations concerning EBP sustainability. Given that the eight S elements are likely to be interrelated, successful organizational transformation can be achieved by intervening in multiple elements. CLINICAL TRIAL NUMBER: Not applicable.