Deborah Jamieson and the University College London Hospitals

Deborah Jamieson, Advanced Practitioner at the University College London Hospital (UCLH) National Health Service (NHS) Trust, had been employed to set up nurse-led pre-admissions clinics within the Trust and to improve the existing day surgery clinics. The case describes how she manages to recruit and train nurses to run these clinics. She draws on her experience in the US to encourage the nursing staff to take on more clinical responsibilities. The case examines how nurses' roles are developing within the NHS as they take on more tasks that have traditionally been the responsibility of doctors and consultants (attending physicians). The case describes how Jamieson changes the mindset of the key players (managers, consultants and anaesthetists), and how she implements the pre-assessment clinics and improves the existing day surgery pre-admission process. Patient satisfaction is increased and fewer operations are cancelled, thus reducing costs for the Trust.

This case can be used to illustrate the following leadership and management concepts: - Strategic change and the alignment of change activities at the business unit, team and individual levels - Issues related to the adoption of externally developed managerial innovations - Economic complements and substitutes as applied to professional role expansion -The process of leading organizational change initiatives