Creating a Mindful Culture: Exploring Mental Models that Influence Mindfulness Implementation in Hospital Settings—An Action Research Study

Abstract Objectives Mindfulness-based interventions effectively improve mental health among healthcare professionals and foster compassionate care. However, the process of implementing mindfulness and ensuring long-term sustainability within hospital departments remains underexplored. Thus, this study aimed to identify and explore the mental models of healthcare professionals and managers that influence mindfulness implementation in hospital settings, to uncover strategies to support long-term sustainability.

Methods: Guided by action research, 14 healthcare professionals and eight managers from two hospital departments were engaged in a 2-year mindfulness implementation process. Data collection consisted of four workshops followed by six focus group interviews. A thematic data analysis was conducted using the Immunity to Change model.

Results: Three mental models were identified: “Time pressure as a barrier for creating a mindful culture,” “A common understanding as essential,” and “Management support as a prerequisite.” Over the study period, these mental models evolved, with healthcare professionals describing their introduction to mindfulness as a “new way of being,” characterized by increased awareness, presence, and calmness. Psychological safety surfaced as an important factor for successful implementation, alongside the recognition that while management support is crucial, bottom-up initiatives from staff are equally important.

Conclusions: Implementing mindfulness in hospital settings requires holistic strategies that address both structural and cognitive elements. This process calls for collaborative efforts that balance top-down support with bottom-up initiatives. Involving enthusiastic mindfulness ambassadors, sharing various strategies for integrating mindfulness into clinical practice, and recognizing the need for psychological safety are essential in promoting collective learning and enhancing implementation and sustainability.