Major hospital transformations: An integrative review and implications for nursing

Major hospital transformations, hospital projects that combine construction and quality improvement dimensions, are booming around the globe. These costly endeavours have the potential to revolutionize healthcare, yet no known review explores this phenomenon, undermining accessibility of knowledge for healthcare leaders. In order to provide guidance on healthcare project management and on future research avenues, this article aims to synthesize empirical knowledge concerning major hospital transformations and their implications for nursing. An integrative review of the literature using the systematic approach described by Whittemore and Knafl was selected. As major hospital transformations represent a new area of research, the review includes 13 articles out of 116 retrieved for screening. The search strategy included the following electronic databases: CINAHL, MEDLINE, and Business Source Complete. Three main themes emerged from the data: the challenging context of major hospital transformations, the project management office as a key to successful healthcare change, and the absence of certain stakeholders’ voices. Major hospital transformations are important to study holistically as multi-change initiatives cannot be understood through investigating individual changes alone. Healthcare leaders are called to reflect on their governance structures during organisational transformations, as well as on the inclusion and exclusion of certain stakeholders who are essential to making sustainable change.