Implications for nursing management
Continuous quality improvement in nursing care deliv-ery systems is the highest priority for any nursing administrator worldwide today. Though any delivery systems can be improved in numerous ways, timely and authentic identification of problems warranting maxi-mum contemplation ensure the most efficient use of available resources, and thus holds the crux vis-a-vis any effective quality improvement implementation model in nursing care. Internalization of all the stake-holders to mitigate resistance to change is equally imperative. This study showcases an amalgamated approach to realize both these crucial objectives. It demonstrates the effectiveness of a two phase study, the Delphi technique involving the experts and the questionnaire (survey) involving a diligently drawn sample of staff nurses, in discerning identification of the prevailing problems in nursing care delivery. It also provides a subsequent in-depth analysis of these prob-lems wherever deemed necessary by the nursing admin-istrators. As all the stakeholder fraternities including nursing administrators, hospital executives, consul-tants, senior nursing staff and staff nurses are involved in different facets of this model, it is possible to assume that it will foster team spirit and minimize chances of resistance in the implementation phase. Besides, this approach strikes an optimal balance between objectiv-ity and subjectivity. Thus this model can be used as a prototype by nursing management in different health-care settings, after making scenario specific customiza-tions, in order to strategize quality implementation.