Revitalizing Nursing Workplaces by the Introduction of the FISH! Philosophy

<p>The FISH! Philosophy is a pioneering workplace management system developed by the observation of work culture at Pike Place Fish Market in Seattle. The purpose of this research is to clarify how the introduction of the FISH! Philosophy into a nurses' workplace changes and stimulates its work culture. We launched a committee and conducted a staff training to revitalize the workplace of an acute hospital under study, and then introduced the FISH! Philosophy into it on March 2009. We, then, conducted satisfaction surveys of patients and nurses before and after the introduction of the FISH! Philosophy, and surveys of the FISH!-level in each hospital department and of self-judgment of motivation among nurses after its introduction. A total of 1,382 nurses and 4,573 patients were surveyed. We evaluated their practices of the FISH! Philosophy objectively and divided them into two groups — the departments that worked well to introduce it and the departments that did it poorly for making a comparison between them. There were following findings. In good-outcome groups of the FISH!-level three scores of the satisfaction survey at the workplace — occupation status, self-sufficiency as a member of profession, and the influence of interactive relations between nurses — became high. On self-judgment of motivation among nurses the scores of human relationship, environmental arrangement, and expectation/evaluation went up. On the satisfaction survey of patients the scores of greeting, explanation, response to nurse call, attention to noises, and the score of a nurse in charge became especially high in good-outcome groups. These findings reveal that the introduction of the FISH! Philosophy into nurses' working places properly improves nurses' satisfaction at work and motivation to work, leading to the improvement of patients' satisfaction.</p>