Workshop 1

Patients FirstHopes, fears and

expectationsPoster viewing Confidence lineTime capsule

“Our Journey on the Patients First Programme”

Patients FirstFoNS in partnership with the Burdett Trust for Nursing is offering expert support and facilitation to nurse-led teams over a 12-15 month period to:

Explore how nursing teams can work with patients and other stakeholders to develop practice

Identify areas of patient care which can be improved

Develop a proposal for a locally focused practice development project/initiative

Enable the implementation of a strategy for developing, changing and evaluating practice

Overview of Workshop 1 & 2

Values and beliefsFacilitationCulture and contextEvaluationReflection - learning in and from practice

Action planning

Further Workshop Days 2013

Day 3- Thursday 7th MarchDay 4-Thursday 16th MayDay 5-Thursday 3rd October

Practice Development - Definition“Practice development is a continuous process of

developing person centred cultures. It is enabled by

facilitators who authentically engage with individuals

and teams to blend personal qualities and creative

imagination with practice skills and practice wisdom.

The learning that occurs brings about transformations

of individual and team practices. This is sustained by

embedding both processes and outcomes in corporate

strategy.”

Manley, McCormack and Wilson (2008)

Improving patient-personcentred care

Learning in

and from

practi

ce

Systematic

approaches

Practice Development Model

Project 1

Small project teamCommitment to improving patient careStrong evidence base New role development and trainingComplex context

Introducing a Introducing a ward based ward based exercise exercise programme for programme for older people older people across three in-across three in-patient care patient care areasareas

Project 2

Ward based team with two lead facilitators

Involvement of all ward staff

Wide evidence based including patient experience

Focus on learning in and through practice

Complex context

Improving Improving mealtimes for mealtimes for older people in a older people in a ward for older ward for older people in an people in an acute trustacute trust

Commitment and Values underpinning Practice

DevelopmentPerson-centred careCollaboration and partnership Enabling facilitation and supportActive learning and developmentTransforming workplace culture Evaluation

Shaw (2012)

Questions…

What other activities are you aware of that support improvement and innovation?

Are they the same or different to Practice Development?

How does Practice Development contribute to innovation and improvement?

Improving Practice & InnovationPractice Development Service Improvement

…it is a methodology underpinned by the key

values of person-centredness, collaboration and partnership, enabling

facilitation, active learning, culture transformation and

evaluation for the development of healthcare practitioners and practice, for the ultimate purpose of achieving patient-centred

care

…it is an activity contributes to the development and

improvement of practice and practitioners but the

methods and processes may not enable the level of

collaboration, inclusion and participation that could lead

to culture change

Values and BeliefsValues and beliefs affect our

attitudes and behaviours

Values and beliefs are often implicit

We can assume that we share the same values and beliefs

Values Clarification

Values clarification is a way of:

Making our values and beliefs explicitDeveloping a shared vision and purposeHelping us to recognise the gaps between what we say we believe/we do and what we actually do

EvaluationEvaluation is:A judgement of value/worthHappens on an informal level in everyday healthcare practice In the context of practice development:A clear evaluation plan is central to being systematic Evaluation is a systematic way of practitioners learning from a collection of evidence they analyse

Evaluation Frameworks

An evaluation framework in practice development should answer the following questions about a programme or intervention:

Whether it worksWhy it worksFor who it worksUnder what circumstances it worksWhat has been learnt to make it work

Redfern,1998; McCormack and Manley, 2004

Review of the Day and Closure

Liked most…?

Liked least…?

One learning point…?

Any areas for clarification…?

Patients FirstWelcome to Workshop 2Any areas for clarification overnight…?

Today's programme

Knowing your Workplace Culture and Context

What does it look like?What does it feel like?What is an effective workplace culture?How can we evaluate it?How does it influence practice change?

What is Culture?

“How things are done around here”

Drennan (1992)

What Do We Mean By Context?

The setting and environment in which care is provided

The context may changeThe context will be influenced by the culture

Reflection in Practice DevelopmentReflection is a key activity in practice

development and enables us to learn from practice

Learning in practice development arises from self knowledge and awareness through structured and intentional reflection

Critical analysis and reflection acts as a motivator for action

Facilitating Person Centred Care

Knowing the personKnowing self as person/professional

role/carerKnowing own and others limitationsKnowing the environment

McCormack & McCance , 2010; McCormack & McCance 2006;

McCormack 2004

Situational FacilitationEncouraging styleSharingReinforcingEncouragingPraising

Supporting styleTurning or mulling

overLeaving aloneLetting goBeing available

Coaching styleInvolvingExplainingCollaboratingNegotiating

Directing styleInitiatingStructuringTellingGuidingHersey and Blanchard, 1996

Action PlanningMaking plans to take action

Using a framework to check you progress

What will you being doing tomorrow?

Ongoing SupportOn-going support from JoCentre for Innovation- Info for websiteMaintaining networking and

communicationFuture workshops , March, May, Oct

2012Other needs and/or suggestions

Thank you for participatingHave a safe journey

Doodle evaluation/Postcard

www.fons.org