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Patients with extended hospital admissions had no recreation facilities in the ward. They were often confined to spaces around their beds, using the ward corridor for rehabilitation. The purpose of this paper is to outline a quality improvement (QI) intervention-provision of a recreational space for long-stay patients.

An exploratory quantitative pre-, post-test design was utilised, and executed in three phases: patients, visitors and staff survey to explore recreation and comfort needs and preferences; store room refurbishment; and patient, visitor and staff satisfaction with the recreation room.

Overall, 77 questionnaires were completed (n=49 staff; n=28 patient/visitor). Almost two-thirds (64.7 per cent; n=11) of patients had a stay greater than six weeks. Insufficient private space and concerns about disturbing other patients were identified as barriers to taking part in activities. Consequently, a store room was refurbished as a recreation room (9.0 m × 6.0 m) and furnished in three distinct areas. Following refurbishment, over 90 per cent (n=24) of respondents agreed that there was a suitable space where patients could “go and chat” and spend time with family and visitors or speak to the healthcare team.

The physical environment in acute hospitals is seldom prioritised. Needs-based QI projects can improve patient hospital experiences.

This case study highlights how nursing staff can be informed by patients’ and families’ needs and preferences, and initiate QI projects that improve patient hospital experiences.

The authors explored clinical staff perceptions of their interactions with middle management and their experiences of the uncongeniality of their working environment.

Semi-structured interviews of clinical staff from an Australian public health service's Emergency, Surgery and Psychiatry departments. Volunteer interview transcripts were inductively coded using a reflexive thematic content analysis.

Of 73 interviews, 66 participants discussed their interactions with management. Most clinicians considered their interactions with middle management to be negative based on a violation of their expectations of support in the workplace. Collectively, these interactions formed the basis of clinical staff perceptions of management's lack of capacity and fit for the needs of staff to perform their roles.

Strategies to improve management's fit with clinicians' needs may be beneficial for reducing uncongenial workplaces for healthcare staff and enhanced patient care.

This article is among the few papers that discuss interactions with management from the perspective of clinical staff in healthcare. How these perspectives inform the perception of workplace uncongeniality for clinicians contributes greater understanding of the factors contributing to adversarial relationships between clinicians and managers.

The paper is based on a five year, UMIST‐Institute of Management study into the changing nature of the quality of working life and seeks to uncover differences in the incidence and impact of organizational change on the perceptions and experiences of managers in the public sector, the private sector and the (former public) utilities. The research indicates that there are significant differences in the impact of organizational change on managers in the three sectors with public sector managers and managers from the utilities having been more adversely affected. An analysis of managers’ perceptions of their “organization as a place to work”, prevailing managerial styles in their organization and managers’ perceptions of the “changing nature of their job” also reveals wide differences between managers in the three different sectors.

REPERCUSSIONS of the Margate Conference will be felt for some time to come. There is still the suggestion that one or the other side won in the debate on central control, for example, but we would suggest that it was an occasion when a case was stated and combatted and that the result was the only wise one; that is to say, both parties agreed that the Council should consider the matter. It would be in the highest degree dangerous if at any open meeting of over 1,000 members of the Library Association any policy, then for the first time outlined, should be adopted as a settled rule of life. Such questions as central control have to be considered in all their bearings, and admirable as was the case Colonel Mitchell made for it, and forceful as was Mr. Berwick Sayers's rejoinder, they would not be regarded as final statements, even by themselves. There were some murmurings at the swift close of the debate, and there were more than murmurings that so important a matter should arise without due notice. These are not quite reasonable, and no one could have handled the meeting more quietly and impartially than the President (Mr. Savage) did. That no notice was given of the debate is hardly true although the words of the motion proposed by Colonel Mitchell were not known until the debate began; but the intention of the debate was to elicit opinions which might help the council in framing a policy; there was no intention to reach a decision or to publish the results of the meeting. A considered report, twelve months hence, on the deliberations of the L.A. Council on the matter should be far better than any account of the vapourings at Margate.