Participation in decision-making when designing care programmes and integrated care pathways

The need for improved quality in health care has forced health-care organizations worldwide to critically review and improve their current care delivery processes. While some of these projects succeed, there are also a number of projects that fail. One of the factors contributing to their success or failure is willingness to change. That is why a number of re-design methods, including care pathway development, emphasize frontline staff involvement to reduce resistance. One of the mechanisms used in care pathway development to involve staff is the sharing of influence or decision-making between superiors and their subordinates. This mechanism is also known as participatory decision-making (PDM). In this research paper, we have addressed this issue by investigating whether or not increasing PDM by developing care pathways and care programmes leads to increased organizational commitment, trust in management and willingness to change. Our research shows that PDM leads to increased trust in management and organizational commitment. Evidence indicating that PDM indirectly contributes to an increased willingness to change was also found. The outcome of our research suggests that increasing PDM when developing care programmes and care pathways can be an effective method of increasing the chances of success for care pathway development projects.