This paper describes how an acute tertiary referral hospital moved away from a "culture of blame", using change management principles aligned with the concept of the learning organisation. I outline the process of change, and describe its outcomes. The result is summarised as an improvement in desired attributes of the organisation's culture, as evidenced by consistent improvement in the results of a proprietary staff survey. I conclude that the concept of the learning organisation is a useful one for hospitals that seek to improve the organisational culture.
To evaluate the effectiveness of a new patient flow system, `The Red Box` on the quality of patient care in respect of the time taken for the care to be delivered to the patient.
Retaining lectures in problem-based learning (PBL) curriculum places new demands on lecturers. In addition to subject knowledge, the lecturers must know the overall aims of the lectures, their context in the course, their relation to the subsequent examinations and the underlying educational philosophy.
SETTING: Medical ethics education has become common, and the integrated ethics curriculum has been recommended in Western countries. It should be questioned whether there is one, universal method of teaching ethics applicable worldwide to medical schools, especially those in non-Western developing countries.
OBJECTIVE: To characterise the medical ethics curricula at Asian medical schools.
DESIGN: Mailed survey of 206 medical schools in China, Hong Kong, Taiwan, Korea, Mongolia, Philippines, Thailand, Malaysia, Singapore, Indonesia, Sri Lanka, Australia and New Zealand.
PARTICIPANTS: A total of 100 medical schools responded, a response rate of 49%, ranging from 23%-100% by country.
MAIN OUTCOME MEASURES: The degree of integration of the ethics programme into the formal medical curriculum was measured by lecture time; whether compulsory or elective; whether separate courses or unit of other courses; number of courses; schedule; total length, and diversity of teachers' specialties.
RESULTS: A total of 89 medical schools (89%) reported offering some courses in which ethical topics were taught. Separate medical ethics courses were mostly offered in all countries, and the structure of vertical integration was divided into four patterns. Most deans reported that physicians' obligations and patients' rights were the most important topics for their students. However, the evaluation was diverse for more concrete topics.
CONCLUSION: Offering formal medical ethics education is a widespread feature of medical curricula throughout the study area. However, the kinds of programmes, especially with regard to integration into clinical teaching, were greatly diverse.
AIMS: To examine the relationships between nurses' empowerment, job satisfaction and organizational commitment in culturally and developmentally different societies.
BACKGROUND: Employment and retention of sufficient and well-committed nursing staff are essential for providing safe and effective health care. In light of this, nursing leaders have been searching for ways to re-engineer the healthcare system particularly by providing an environment that is conducive to staff empowerment, job satisfaction and commitment.
METHODS: This is a descriptive correlational survey of 556 registered nurses (RNs) in two teaching hospitals in England and Malaysia.
RESULTS: Although the Malaysian nurses felt more empowered and committed to their organization, the English nurses were more satisfied with their job.
CONCLUSION: The differences between these two groups of nurses show that empowerment does not generate the same results in all countries, and reflects empirical evidence from most cross cultural studies on empowerment.
IMPLICATIONS FOR NURSING MANAGEMENT: Nursing management should always take into consideration cultural differences in empowerment, job satisfaction and commitment of nursing staff while formulating staff policies.