Hi Antony, coming from a healthcare background I understand what you are dealing with. Culture and behaviour particularly in hospital settings is so deeply entrenched any change has to be slow, well planned and water-tight. I would focus on using what works within the culture, what makes people sit up and take notice? In hospitals, evidence-based practice rules, so use this to your advantage, develop your change/improvement programme using research as your friend. And be patient like you never have before... I once wrote a Reportable Events policy and procedure for a DHB...it took 2 years and 19 revisions to get it signed off... persistence pays... eventually!!!