Person-centred Practice Research Centre Institute of Nursing & Health Research

Person-centred Practice Research Centre: Work Strands The Provision Of Care To Older People Methodology Development Person-centred Practice Development

Person-centred Practice Development Focuses on implementation studies in collaboration with partner organisations for the purposes of promoting person-centredness in practice Developing and testing methodological approaches in this area

What is Practice Development? a systematic approach which aims to help practitioners and healthcare teams to look critically at their practice and identify how it can be improved. Its purpose is to develop effective workplace cultures that have embedded within them person centred processes, systems and ways of working. Skilled facilitators help frontline staff to get underneath the surface of daily routine, to critically reflect on the values and beliefs they hold about patient care. Teams are challenged to consider if the behaviours, systems and processes used in practice are consistent with person centred values and what needs to be changed. Develops evidence from practice, and implements evidence into practice. Achieves sustainable change through its focus on continuous learning in practice.

PD is ‘micro-system’ oriented and context specific. PD works with individuals and teams to: engage with a shared vision create links with their own aspirations translate complex organisational and strategic agendas into practice reality make sense of complex forms of evidence become clear about what constitutes person centred care. move the energy that would otherwise have been expended in conflictual agendas and resistance towards shared agendas. facilitate the system as a whole to re-engage with the untapped potential lying within the healthcare workforce and their patients.

Transforming culture and context of care Practice Development Values & Beliefs Transforming culture and context of care PERSON CENTERED CARE Systematic and rigorous Learning in and from practice (Garbett & McCormack, 2003)

Person-centred Nursing Framework (McCormack & McCance 2010)

The PCN Framework CARE ENVIRONMENT The context in which care is delivered PREREQUISITES Attributes of the nurse In summary, the four constructs within the Framework include: Prerequisites focus on the attributes of the nurses The care environment focuses on the context in which care is delivered Person-centred processes focus on delivering care through a range of activities Outcomes, the central component of the framework, are the results of effective person-centred nursing. It is useful to highlight the relationship between the constructs, which works from the outside in. Attributes of the nurse need to be in place in order to effectively manage the care environment, which enables the delivery of person-centred processes , which should then lead to positive outcomes. Elements of the Framework have been illustrated in the 10 stories presented. CARE PROCESSES Delivering care through a range of activities OUTCOMES Results of effective person-centred nursing

Using a different lens to learn from practice?

Use of the framework in practice To promote an understanding of person-centred care To analyse barriers to change As an aid for reflection To focus the implementation and evaluation of developments in practice To inform strategy

Person-centredness and PD “Developing person-centredness is at the heart of practice development and despite much policy and strategic rhetoric, practice development continues to be the only methodology that has the development of person-centredness as its primary purpose and which recognises that person-centredness is not developed through one-off change events. Instead, it needs continuous reflective and critical relationships to be developed and sustained over time.” (McCormack 2008, p.161)

Recommendations from the Francis Report The NHS and all who work for it must adopt and demonstrate a shared culture in which the patient is the priority in everything done. This requires: A common set of core values and standards shared throughout the system; Leadership at all levels from ward to the top of the Department of Health, committed to and capable of involving all staff with those values and standards; A system which recognises and applies the values of transparency, honesty and candour; Freely available, useful, reliable and full information on attainment of the values and standards; A tool or methodology such as a cultural barometer to measure the cultural health of all parts of the system.

Project Examples ‘Paediatric International Nursing Study (PINS) - embedding Key Performance Indicators into Paediatric Practice’ Rose Kelly, Manager, Acute Paediatrics & Neonatology, SET ‘Developing Person-centred Cultures in BHSCT’ Tanya McCance and Participants from the Belfast Trust Person-centred Practice Programme 'Caring for the carers - working in partnership to achieve person centred care'. Annemarie Tunney, NHSCT Person Centred Practice in Emergency Care – what are the challenges? Donna McConnell and Vidar Melby.