Foundation of Nursing Studies in partnership with the Burdett Trust for Nursing Patients First: Supporting nurse led innovation in practice Workshop 1

Patients First Hopes, fears and expectations Poster viewing Confidence line Time capsule

Sharon Fleming Royal Brompton Hospital “Our Journey on the Patients First Programme”

Patients First FoNS 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 beliefs Facilitation Culture and context Evaluation Reflection - learning in and from practice Action planning

Further Workshop Days 2013 Day 3- Thursday 7th March Day 4-Thursday 16th May Day 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)

Practice Development Model transforming individuals and contexts of care Improving patient-person centred care Learning in and from practice Systematic approaches Values and beliefs

Introducing a ward based exercise programme for older people across three in-patient care areas Project 1 Small project team Commitment to improving patient care Strong evidence base New role development and training Complex context

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

Commitment and Values underpinning Practice Development Person-centred care Collaboration and partnership Enabling facilitation and support Active learning and development Transforming 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 & Innovation Practice 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 Beliefs Values 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 explicit Developing a shared vision and purpose Helping us to recognise the gaps between what we say we believe/we do and what we actually do

Evaluation Evaluation is: A judgement of value/worth Happens 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 works Why it works For who it works Under what circumstances it works What 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 First Welcome to Workshop 2 Any 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?

“How things are done around here” 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 change The context will be influenced by the culture

Reflection in Practice Development Reflection 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 person Knowing self as person/professional role/carer Knowing own and others limitations Knowing the environment McCormack & McCance , 2010; McCormack & McCance 2006; McCormack 2004

Situational Facilitation Encouraging style Sharing Reinforcing Encouraging Praising Supporting style Turning or mulling over Leaving alone Letting go Being available Coaching style Involving Explaining Collaborating Negotiating Directing style Initiating Structuring Telling Guiding Hersey and Blanchard, 1996

Action Planning Making plans to take action Using a framework to check you progress What will you being doing tomorrow?

Ongoing Support On-going support from Jo Centre for Innovation- Info for website Maintaining networking and communication Future workshops , March, May, Oct 2012 Other needs and/or suggestions

Thank you for participating Have a safe journey Doodle evaluation/Postcard www.fons.org