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From Policy to Practice: A Qualitative Study on Reforms and Frontline Retention in Healthcare.

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Title: From Policy to Practice: A Qualitative Study on Reforms and Frontline Retention in Healthcare.
Authors: Dubé, Anik1 anik.dube@umoncton.ca, Collin, Stéphanie1, Hakim, Jennifer2, Johnson, Claire1, Laforest, Marie-Eve1, Landry, Michel H.1,2, Lauzier, Martin3
Source: Inquiry (00469580). 8/16/2025, Vol. 62, p1-9. 9p.
Subject Terms: *Corporate culture, *Qualitative research, *Autonomy (Psychology), *Focus groups, *Decision making, *Working hours, *Research methodology, *Employees' workload, Employee retention, Nurses, Psychology of physicians, Executives, Control (Psychology), Research funding, Hospital administration, Government agencies, Interviewing, Responsibility, Statistical sampling, Judgment sampling, Continuum of care, Health care reform, Linguistic minorities, Thematic analysis, Frustration, Organizational change, Data analysis software, Management, Health care rationing
Geographic Terms: New Brunswick
Abstract: In Canada, healthcare reforms typically aim to improve the quality of care and access while making healthcare systems more efficient. These reforms have led to a 2-level healthcare system consisting of provincial and regional health authorities (RHAs). RHAs are responsible for providing and administering health services within specific territories. One of the 2 language-based RHAs in New Brunswick (NB) operates in French-speaking rural minority communities. This study explored key factors affecting the retention of nurses and physicians within a RHA operating in a language minority context. This descriptive qualitative study explored how macro-level decisions are experienced on the frontlines. Data were collected through semi-structured interviews with 21 physicians and 37 registered nurses, as well as 2 focus groups involving 20 key informants in managerial roles. Thematic analysis was used to identify key themes. Three main factors emerged: organizational accountability and frustration, local autonomy and contextual responsiveness, and a culture of openness and perceived loss of control. These factors are associated with policy changes that affect operational settings and resource distribution within the RHA and influence the retention of nurses and physicians. Stakeholders in health system reforms, including governments and RHAs, must recognize that policy adjustments can have direct implications on everyday care. Participants expressed a growing disconnect from decision-making hierarchies and a perceived loss of control. Both are seen as barriers to delivering quality care. Ensuring adequate support and resources for implementing system-level changes is key to fostering professional engagement and enhancing job satisfaction. [ABSTRACT FROM AUTHOR]
Copyright of Inquiry (00469580) is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: From Policy to Practice: A Qualitative Study on Reforms and Frontline Retention in Healthcare.
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  Data: <searchLink fieldCode="AR" term="%22Dubé%2C+Anik%22">Dubé, Anik</searchLink><relatesTo>1</relatesTo><i> anik.dube@umoncton.ca</i><br /><searchLink fieldCode="AR" term="%22Collin%2C+Stéphanie%22">Collin, Stéphanie</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Hakim%2C+Jennifer%22">Hakim, Jennifer</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Johnson%2C+Claire%22">Johnson, Claire</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Laforest%2C+Marie-Eve%22">Laforest, Marie-Eve</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Landry%2C+Michel+H%2E%22">Landry, Michel H.</searchLink><relatesTo>1,2</relatesTo><br /><searchLink fieldCode="AR" term="%22Lauzier%2C+Martin%22">Lauzier, Martin</searchLink><relatesTo>3</relatesTo>
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  Data: <searchLink fieldCode="JN" term="%22Inquiry+%2800469580%29%22">Inquiry (00469580)</searchLink>. 8/16/2025, Vol. 62, p1-9. 9p.
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  Data: *<searchLink fieldCode="DE" term="%22Corporate+culture%22">Corporate culture</searchLink><br />*<searchLink fieldCode="DE" term="%22Qualitative+research%22">Qualitative research</searchLink><br />*<searchLink fieldCode="DE" term="%22Autonomy+%28Psychology%29%22">Autonomy (Psychology)</searchLink><br />*<searchLink fieldCode="DE" term="%22Focus+groups%22">Focus groups</searchLink><br />*<searchLink fieldCode="DE" term="%22Decision+making%22">Decision making</searchLink><br />*<searchLink fieldCode="DE" term="%22Working+hours%22">Working hours</searchLink><br />*<searchLink fieldCode="DE" term="%22Research+methodology%22">Research methodology</searchLink><br />*<searchLink fieldCode="DE" term="%22Employees'+workload%22">Employees' workload</searchLink><br /><searchLink fieldCode="DE" term="%22Employee+retention%22">Employee retention</searchLink><br /><searchLink fieldCode="DE" term="%22Nurses%22">Nurses</searchLink><br /><searchLink fieldCode="DE" term="%22Psychology+of+physicians%22">Psychology of physicians</searchLink><br /><searchLink fieldCode="DE" term="%22Executives%22">Executives</searchLink><br /><searchLink fieldCode="DE" term="%22Control+%28Psychology%29%22">Control (Psychology)</searchLink><br /><searchLink fieldCode="DE" term="%22Research+funding%22">Research funding</searchLink><br /><searchLink fieldCode="DE" term="%22Hospital+administration%22">Hospital administration</searchLink><br /><searchLink fieldCode="DE" term="%22Government+agencies%22">Government agencies</searchLink><br /><searchLink fieldCode="DE" term="%22Interviewing%22">Interviewing</searchLink><br /><searchLink fieldCode="DE" term="%22Responsibility%22">Responsibility</searchLink><br /><searchLink fieldCode="DE" term="%22Statistical+sampling%22">Statistical sampling</searchLink><br /><searchLink fieldCode="DE" term="%22Judgment+sampling%22">Judgment sampling</searchLink><br /><searchLink fieldCode="DE" term="%22Continuum+of+care%22">Continuum of care</searchLink><br /><searchLink fieldCode="DE" term="%22Health+care+reform%22">Health care reform</searchLink><br /><searchLink fieldCode="DE" term="%22Linguistic+minorities%22">Linguistic minorities</searchLink><br /><searchLink fieldCode="DE" term="%22Thematic+analysis%22">Thematic analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Frustration%22">Frustration</searchLink><br /><searchLink fieldCode="DE" term="%22Organizational+change%22">Organizational change</searchLink><br /><searchLink fieldCode="DE" term="%22Data+analysis+software%22">Data analysis software</searchLink><br /><searchLink fieldCode="DE" term="%22Management%22">Management</searchLink><br /><searchLink fieldCode="DE" term="%22Health+care+rationing%22">Health care rationing</searchLink>
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  Data: <searchLink fieldCode="DE" term="%22New+Brunswick%22">New Brunswick</searchLink>
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  Data: In Canada, healthcare reforms typically aim to improve the quality of care and access while making healthcare systems more efficient. These reforms have led to a 2-level healthcare system consisting of provincial and regional health authorities (RHAs). RHAs are responsible for providing and administering health services within specific territories. One of the 2 language-based RHAs in New Brunswick (NB) operates in French-speaking rural minority communities. This study explored key factors affecting the retention of nurses and physicians within a RHA operating in a language minority context. This descriptive qualitative study explored how macro-level decisions are experienced on the frontlines. Data were collected through semi-structured interviews with 21 physicians and 37 registered nurses, as well as 2 focus groups involving 20 key informants in managerial roles. Thematic analysis was used to identify key themes. Three main factors emerged: organizational accountability and frustration, local autonomy and contextual responsiveness, and a culture of openness and perceived loss of control. These factors are associated with policy changes that affect operational settings and resource distribution within the RHA and influence the retention of nurses and physicians. Stakeholders in health system reforms, including governments and RHAs, must recognize that policy adjustments can have direct implications on everyday care. Participants expressed a growing disconnect from decision-making hierarchies and a perceived loss of control. Both are seen as barriers to delivering quality care. Ensuring adequate support and resources for implementing system-level changes is key to fostering professional engagement and enhancing job satisfaction. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Inquiry (00469580) is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
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    Identifiers:
      – Type: doi
        Value: 10.1177/00469580251365821
    Languages:
      – Code: eng
        Text: English
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      Pagination:
        PageCount: 9
        StartPage: 1
    Subjects:
      – SubjectFull: Corporate culture
        Type: general
      – SubjectFull: Qualitative research
        Type: general
      – SubjectFull: Autonomy (Psychology)
        Type: general
      – SubjectFull: Focus groups
        Type: general
      – SubjectFull: Decision making
        Type: general
      – SubjectFull: Working hours
        Type: general
      – SubjectFull: Research methodology
        Type: general
      – SubjectFull: Employees' workload
        Type: general
      – SubjectFull: Employee retention
        Type: general
      – SubjectFull: Nurses
        Type: general
      – SubjectFull: Psychology of physicians
        Type: general
      – SubjectFull: Executives
        Type: general
      – SubjectFull: Control (Psychology)
        Type: general
      – SubjectFull: Research funding
        Type: general
      – SubjectFull: Hospital administration
        Type: general
      – SubjectFull: Government agencies
        Type: general
      – SubjectFull: Interviewing
        Type: general
      – SubjectFull: Responsibility
        Type: general
      – SubjectFull: Statistical sampling
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      – SubjectFull: Judgment sampling
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      – SubjectFull: Continuum of care
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      – SubjectFull: Health care reform
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      – SubjectFull: Linguistic minorities
        Type: general
      – SubjectFull: Thematic analysis
        Type: general
      – SubjectFull: Frustration
        Type: general
      – SubjectFull: Organizational change
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      – SubjectFull: Data analysis software
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      – SubjectFull: Management
        Type: general
      – SubjectFull: Health care rationing
        Type: general
      – SubjectFull: New Brunswick
        Type: general
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              Text: 8/16/2025
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