Table 1 Indicative types of data ( and methods for collecting data) for each level and domain of culture in a hospital change programme

Observable behaviour and artefacts (audits, surveys, patient satisfaction monitoring, observation of activities undertaken as part of a redesign programme, content analysis of information and communication)

Patient information leaflets/posters; lay members of boards; methods for consultation/involvement in redesign initiatives

Frequency and extent of consultation with or full involvement of stakeholders in decision making; modes and content of communication about potential and actual changes to the service; management structures

New building layout and facilities; reallocation of services between primary, secondary, tertiary or community health spaces; development of day surgery units; tension between consolidation and decentralization of services

Values and habits of social actors (phenomenological interviewing, participant-observation)

Value statements from staff and patients about initiatives to involve patients; ways of talking about everyday practice and change

Value statements from senior and frontline staff; deployment of ‘change agents’ to show where perceived barriers to change are; views on role of government policy

Associations made between buildings and quality; views on community; co-design practices for new clinical space

Basic assumptions (theory, discourse analysis, ethnography)

Power relations between staff and patients; professional and organisational structures; ideologies of care

Power relationships between clinicians and management; organisational hierarchies; professional divisions of labour

Ideologies of progress, technological development and modernization; communities of practice