PT  - JOURNAL ARTICLE
AU  - Marilyn Swinton
AU  - Meredith Vanstone
AU  - Peter Phung
AU  - Thanh H Neville
AU  - Alyson Takaoka
AU  - Orla M Smith
AU  - Andrew Baker
AU  - Allana LeBlanc
AU  - Denise Foster
AU  - Vinay Dhingra
AU  - France J Clarke
AU  - Neala Hoad
AU  - Anne Woods
AU  - Anne Boyle
AU  - Feli Toledo
AU  - Deborah J Cook
TI  - Hospital leadership perspectives on the value of the 3 Wishes Project: a qualitative study
AID  - 10.1136/leader-2020-000302
DP  - 2021 Jun 01
TA  - BMJ Leader
PG  - 87--92
VI  - 5
IP  - 2
4099  - http://bmjleader.bmj.com/content/5/2/87.short
4100  - http://bmjleader.bmj.com/content/5/2/87.full
SO  - BMJ Leader2021 Jun 01; 5
AB  - Background Healthcare organisations are increasingly interested in improving the work life of their employees. By encouraging individualised acts of compassion for dying patients and their families, the 3 Wishes Project (3WP) has been shown to ease grief for both families and clinicians.Purpose The objective of this study was to explore the perspectives of hospital leaders on the value of the 3WP to the hospital and how decisions are made about which programmes to support.Methods We conducted semistructured interviews with 20 hospital leaders in four North American institutions. Transcripts were analysed using qualitative content analysis.Results Interviews with 12 clinical managers and 8 senior administrators identified the institutional value of the 3WP as improving patient and family experiences, enhancing staff morale, translating institutional mission and values into front-line practice, and creating positive public relations. Hospital leaders acknowledged potential resource challenges, including staff time, space to store supplies and funds to purchase items for some wishes. However, citing stories they had heard from families and staff, hospital leaders shared their view of how their decisions about the value of clinical programmes extend beyond quantifiable outcomes.Conclusions When reflecting on this personalised palliative care programme, hospital leaders described how inspiring narratives promoted institutional values in ways that are difficult to measure quantitatively. Leaders underscored the need to balance the value that a programme brings with the resources it requires, stating how different types of evidence influence their support of new programmes.Trial registration number NCT04147169.No data are available. The qualitative data sets generated during the current study are not publicly available due to the potentially identifying nature of the complete qualitative transcripts and lack of consent from participants to publicly share these data.