Introduction Major business change is a complex process requiring clear direction, planning, specialist resources and above all a massive commitment from the organisation. Our Hospice has achieved such transformational change.

Aims To do different things and to not just do the same things differently.

Methods For hospices to prevail in the 21st century the original vision of the hospice movement needs aligning with the changes in health/social care communities. Methods were the development of strategic aims, a business plan and sharing this with managers. Time was given to understand this plan, its key messages (integration, innovation, workforce development, excellence, education and support, initiative and public involvement). Buy in was achieved.

Results

1. An electronic patient record system that allows better integration across sites Unexpected results were a new culture overnight of computer literacy, transparency of who thinks what about a patient and improved role profile as all staff can see what each are doing

2. Increased bed occupancy

3. Redesign of social care services which were based on a new model of care

4. Clinical Governance requirements were followed up via a Falls Audit completed by the Physiotherapist. The recommendations achieved new approaches in falls management, that is, intentional rounding and purchase and use of sensor alarms for patients at high risk of falls.

Discussion Time was given to develop trust in the process of business planning via a newly formed management level. The question is how this is now embedded further across all staff groups.

Conclusion We are on a track rather than just moving. True engagement with the public and with our users is needed. Priorities are quality in our services; to assert this when the competition approaches and to build on the trust placed in us by the local community.