1. Professor Kenneth Walsh (UOW) Associate Professor Cheryle Moss (Monash) Without an Understanding of Purpose and Context, Data is Blind: The Development of a Model of Care Toolkit.

2. Evidence and Practice Change Knowing what to do is not enough to bring about practice change. Change is a social process and as such is complex The formula for getting evidence into practice SI=f(E, C,F) Kitson, et al 1998 Practice is often invisible to those involved in it The importance of context

3. Principles “A person is more likely to integrate and accept that which is reached by his or her own reasoning processes” “I learn what I believe when I hear myself talk” (Miller, 1983: 120)

4. ‘CCR’ Framework for articulating your Model of Care

5. Element 1: Name, Purpose & Description of Service This element is a key to understanding the context of your model of care CONTEXTCONTEXT How would you describe the context of your service?

6. Element 2: Consumers Who are our consumers? =CONTEXT=CONTEXT What key aspects of the patient journey do we work with? Key markers & transitions from meet & greet to discharge from the service

7. Element 3: Governance Governance here is in the sense of orchestrating & achieving the overall co-ordination of care CARECARE Some questions…In your MOC...  Who is involved? Health professionals? others?  What does each do?  How does the MDT team manage the care & patient journey?

8. Element 4: Need for care & Intervention Care plans Clinical pathways Care protocols CARECARE Specific disciplinary inputs

9. Element 5: Transparency for Patients & Families Signalling who is involved in the care, features of the context Signalling key markers of progress Features of care - Negotiating goals & management plan Checking satisfactions & perceptions - in process (not as outcomes) CARECARE

10. Element 6: Evaluation Key outcome measures  Clinical  Team  Service  Other REVIEWREVIEW Some questions… In your MOC...  Why would outcomes in each of these areas be important?  What would constitute key outcomes in each of these areas?  How would you measure or evaluate these?

11. Element 7: Reform Local & National Organisational strategic maps Health care gaps Health policies National & International Modernisation Evidence REVIEWREVIEW When & how would you /do you incorporate these into your MOC?

12. References Binnie, A. & Titchen, A. (1999) Freedom to Practise: The Development of Patient-Centred Nursing, Oxford: Butterworth-Heinemann. Harvey, G., Loftus-Hills, A., Rycroft-Malone, J., Titchen, A., Kitson, A., McCormack, B. & Seers, K. (2002) Getting evidence into practice: The role and function of facilitation, Journal of Advanced Nursing, 37 (6), pp.577-588. Hughes, F; Duke, J; Bamford, A; & Moss, C (2006). ‘Enhancing Nursing Leadership through Policy, Politics & Strategic Alliances’. Nurse Leader. 4(2) 24-27 Kitson A, Harvey G, McCormack B (1998). ‘Enabling the implementation of evidenced based practice: A conceptual framework.’ Quality in Health Care 7(3): 149–58. Lawless, J & Moss, C (2007). ‘Exploring the Value of Dignity in the Work-life of Nurses’. Contemporary Nurse. 24(2) 225-236. Manley, K. & McCormack, B. (2003) Practice development: Purpose, methodology, facilitation and evaluation, Nursing in Critical Care, 8 (1), pp. 22-29. Manley, K. (1999) Developing a culture for empowerment, Nursing in Critical Care, 4 (2), pp. 57-58. McCormack B., Manley, K. & Garbett, R. (2004) Practice Development in Nursing, Oxford: Blackwell Miller W. Motivational interviewing with problem drinkers, Behavioural Psychotherapy. 1983; 11 (2), 147 –172.

13. MacLeod, R., Vella-Brincat, J., & Macleod, A. (2004). The palliative care handbook, incorporating the Nurse Maude palliative care formulary: Guidelines for clinical management and symptom control. (2nd ed.): Genesis Oncology Trust. Rycroft-Malone J., Harvey G., Seers K., Kitson A., McCormack B. & Titchen, A. (2004) An exploration of the factors that influence the implementation of evidence into practice, Journal of Clinical Nursing 13 (8), pp.913-924. Therapeutic Guidelines Ltd. (2001). Therapeutic guidelines: Palliative care. (Version 1) Melbourne: Author. Walsh, K & Moss, C (2007). ‘Practice Development in New Zealand: Reflections on the Influence of Culture and Context’. Practice Development in Health Care. 6(1) 82-85. Walsh, K & Moss, C (2007) ‘Transitions in Mental Health (Chapter 9)’. In McAllister, M (Ed.), (2006). Solution Focused Nursing: Rethinking Practice. Palgrave Macmillan. Walsh, K; Moss, C & FitzGerald, M (2006). ‘Solution Focused Approaches and their Relevance to Practice Development’. Practice Development in Health Care. 5(3) 145-155. Walsh, K; Lawless, J; Moss, C & Allbon, C. (2005). ‘The Development of an Engagement Tool for Practice Development’. Practice Development in Health Care. 4(3) 124-130. Ward, C. & McCormack, B. (2000) Creating an adult learning culture through practice development, Nurse Education Today, 20 (4), pp.259-266.