ORIGINAL PRACTICE DEVELOPMENT AND RESEARCH Journey to a shared vision for nursing in a university hospital

Background: Demographic and epidemiological shifts, as well as increasing quality control and greater emphasis on cost effectiveness are the challenges for today’s healthcare organisations. Against this background, institutions are undertaking reforming processes in order to adapt to this complex and unstable market. These transformations require innovative practice and highly effective leadership – leaders who are capable of conveying the need for change and creating a vision for the future. Despite its growing importance, the development process of such a vision is barely addressed in the literature. Aim: The aim of this article is to describe the process of a university hospital towards developing a shared vision for nursing practice. Methods: By means of the four phases of the evidence-based appreciative inquiry process (Discovery – Dream – Design – Destiny), a shared vision was developed. The main methods used were individual interviews, focus group interviews and SWOT analyses. The different datasets produced were synthesised and abstracted to form a vision and corresponding strategic objectives. Conclusions: Although the developmental process was rather time consuming and complex, it provided a systematic approach to change and enabled the leaders involved to commit to the strategic orientation. Implications for practice: • A vision provides direction and meaning for leaders and their teams in complex transformation processes within healthcare organisations • The approach of appreciative inquiry is well suited to facilitate the creative and innovative process of developing a vision • Before initiating the process of developing a vision, it is important to consider the time factor and to plan accordingly so that the necessary creative thinking and reflection can take place