Optimising impact and sustainability: a qualitative process evaluation of a complex intervention targeted at compassionate care
Optimising impact and sustainability: a qualitative process evaluation of a complex intervention targeted at compassionate care
Background: despite concerns about the degree of compassion in contemporary healthcare, there is a dearth of evidence for health service managers about how to promote compassionate healthcare. This paper reports on the implementation of the Creating Learning Environments for Compassionate Care (CLECC) intervention by four hospital ward nursing teams. CLECC is a workplace educational intervention focused on developing sustainable leadership and work-team practices designed to support team relational capacity and compassionate care delivery.
Objectives: to identify and explain the extent to which CLECC was implemented into existing work practices by nursing staff, and to inform conclusions about how such interventions can be optimised to support compassionate care in acute settings.
Methods: process evaluation guided by normalisation process theory. Data gathered included staff interviews (n=47), observations (n=7 over 26 hours) and ward manager questionnaires on staffing (n=4).
Results: frontline staff were keen to participate in CLECC, were able to implement many of the planned activities and valued the benefits to their well-being and to patient care. Nonetheless, factors outside of the direct influence of the ward teams mediated the impact and sustainability of the intervention. These factors included an organisational culture focused on tasks and targets that constrained opportunities for staff mutual support and learning.
Conclusions: relational work in caregiving organisations depends on individual caregiver agency and on whether or not this work is adequately supported by resources, norms and relationships located in the wider system. High cognitive participation in compassionate nursing care interventions such as CLECC by senior nurse managers is likely to result in improved impact and sustainability.
Bridges, Jackie
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May, Carl
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Griffiths, Peter
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Fuller, Alison
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Wigley, Wendy
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Gould, Lisa
363cc1b3-078d-48eb-a164-feee7dcd9246
Barker, Hannah
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Libberton, Paula
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Bridges, Jackie
57e80ebe-ee5f-4219-9bbc-43215e8363cd
May, Carl
17697f8d-98f6-40d3-9cc0-022f04009ae4
Griffiths, Peter
ac7afec1-7d72-4b83-b016-3a43e245265b
Fuller, Alison
0b5ba9fd-c1af-448d-8dba-c5dfaa515702
Wigley, Wendy
bb0682f2-e95c-4e15-8a26-5d2b0665ebf7
Gould, Lisa
363cc1b3-078d-48eb-a164-feee7dcd9246
Barker, Hannah
94312934-2508-4d08-a5fe-6f54544f96cf
Libberton, Paula
d6c21e87-26b1-4842-bb74-d897de7dba14
Bridges, Jackie, May, Carl, Griffiths, Peter, Fuller, Alison, Wigley, Wendy, Gould, Lisa, Barker, Hannah and Libberton, Paula
(2017)
Optimising impact and sustainability: a qualitative process evaluation of a complex intervention targeted at compassionate care.
BMJ Quality and Safety.
(doi:10.1136/bmjqs-2017-006702).
Abstract
Background: despite concerns about the degree of compassion in contemporary healthcare, there is a dearth of evidence for health service managers about how to promote compassionate healthcare. This paper reports on the implementation of the Creating Learning Environments for Compassionate Care (CLECC) intervention by four hospital ward nursing teams. CLECC is a workplace educational intervention focused on developing sustainable leadership and work-team practices designed to support team relational capacity and compassionate care delivery.
Objectives: to identify and explain the extent to which CLECC was implemented into existing work practices by nursing staff, and to inform conclusions about how such interventions can be optimised to support compassionate care in acute settings.
Methods: process evaluation guided by normalisation process theory. Data gathered included staff interviews (n=47), observations (n=7 over 26 hours) and ward manager questionnaires on staffing (n=4).
Results: frontline staff were keen to participate in CLECC, were able to implement many of the planned activities and valued the benefits to their well-being and to patient care. Nonetheless, factors outside of the direct influence of the ward teams mediated the impact and sustainability of the intervention. These factors included an organisational culture focused on tasks and targets that constrained opportunities for staff mutual support and learning.
Conclusions: relational work in caregiving organisations depends on individual caregiver agency and on whether or not this work is adequately supported by resources, norms and relationships located in the wider system. High cognitive participation in compassionate nursing care interventions such as CLECC by senior nurse managers is likely to result in improved impact and sustainability.
Text
Optimising impact and sustainability - a qualitative process evaluation ACCEPTED
- Accepted Manuscript
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Accepted/In Press date: 21 July 2017
e-pub ahead of print date: 15 September 2017
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Local EPrints ID: 412763
URI: http://eprints.soton.ac.uk/id/eprint/412763
ISSN: 2044-5415
PURE UUID: 542fcee2-b706-4c43-ae27-ed969f2a78b7
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Date deposited: 01 Aug 2017 16:31
Last modified: 24 Apr 2024 04:01
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Author:
Carl May
Author:
Alison Fuller
Author:
Wendy Wigley
Author:
Hannah Barker
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