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Clinical nurse specialists in palliative care. Part 2. Explaining diversity in the organisation and costs of Macmillan nursing services

Clinical nurse specialists in palliative care. Part 2. Explaining diversity in the organisation and costs of Macmillan nursing services
Clinical nurse specialists in palliative care. Part 2. Explaining diversity in the organisation and costs of Macmillan nursing services
In the UK, the work of Macmillan clinical nurse specialists in palliative care is now well established. There has been little research, however, into the organizational context in which these nurses operate and the implications for the services they deliver. We report on a major evaluation of the service delivery, costs, and outcomes of Macmillan nursing services in hospital and community settings. The study was based on eight weeks of fieldwork in each of 12 selected services. Data are presented from semi-structured interviews, clinical records, and cost analysis. We demonstrate wide variation across several dimensions: location and context of the services; activity levels; management patterns; work organization and content; links with other colleagues; and resource use. We suggest that such variation is likely to indicate the existence of both excellent practice and suboptimal practice. In particular, our study highlights problems in how teamwork is conceptualized and delivered. We draw on recent organizational theories to make sense of the heterogeneous nature of Macmillan nursing services.
CLINICAL NURSE SPECIALISTS, COSTS, MACMILLAN NURSES, PALLIATIVE CARE ORGANIZATION
0269-2163
375-385
Clark, D.
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Seymour, J.
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Douglas, H-R.
84cab7b1-3f3e-4a5d-a6c7-dc3b3a0e1796
Bath, P.
741a6ac6-1929-47e3-b8e2-6d9af8b8399c
Beech, N.
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Corner, J.
9544a106-1833-4c73-9e60-0f5d287a38ec
Halliday, D.
b93d10f9-26b0-46ae-9e95-cbebac9d9aa3
Hughes, P.
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Haviland, J.
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Normand, C.
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Marples, R.
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Skilbeck, J.
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Webb, T.
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Clark, D.
0943b0f5-3f40-41b6-8386-a30c5dfcce9e
Seymour, J.
c6e4fb93-71b5-4c4b-bd7f-f8edb9a3474b
Douglas, H-R.
84cab7b1-3f3e-4a5d-a6c7-dc3b3a0e1796
Bath, P.
741a6ac6-1929-47e3-b8e2-6d9af8b8399c
Beech, N.
43d37ae7-c351-4a02-ac54-dbe3a46009a0
Corner, J.
9544a106-1833-4c73-9e60-0f5d287a38ec
Halliday, D.
b93d10f9-26b0-46ae-9e95-cbebac9d9aa3
Hughes, P.
5bd3dd2d-388a-42af-b26b-3b6915ae563d
Haviland, J.
3857460b-05c8-4bcb-b9de-8e511063d220
Normand, C.
f8307c24-2875-4b85-89f6-c356dee0cba0
Marples, R.
a81596dc-e384-4ee0-ad19-77c1a803edde
Skilbeck, J.
5c5eb40e-206f-42a7-8fb5-1ec07503d51c
Webb, T.
938e7323-840d-45f5-96f2-eb7b5591fd20

Clark, D., Seymour, J., Douglas, H-R., Bath, P., Beech, N., Corner, J., Halliday, D., Hughes, P., Haviland, J., Normand, C., Marples, R., Skilbeck, J. and Webb, T. (2002) Clinical nurse specialists in palliative care. Part 2. Explaining diversity in the organisation and costs of Macmillan nursing services. Palliative Medicine, 16 (5), 375-385.

Record type: Article

Abstract

In the UK, the work of Macmillan clinical nurse specialists in palliative care is now well established. There has been little research, however, into the organizational context in which these nurses operate and the implications for the services they deliver. We report on a major evaluation of the service delivery, costs, and outcomes of Macmillan nursing services in hospital and community settings. The study was based on eight weeks of fieldwork in each of 12 selected services. Data are presented from semi-structured interviews, clinical records, and cost analysis. We demonstrate wide variation across several dimensions: location and context of the services; activity levels; management patterns; work organization and content; links with other colleagues; and resource use. We suggest that such variation is likely to indicate the existence of both excellent practice and suboptimal practice. In particular, our study highlights problems in how teamwork is conceptualized and delivered. We draw on recent organizational theories to make sense of the heterogeneous nature of Macmillan nursing services.

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Published date: 2002
Keywords: CLINICAL NURSE SPECIALISTS, COSTS, MACMILLAN NURSES, PALLIATIVE CARE ORGANIZATION

Identifiers

Local EPrints ID: 9414
URI: http://eprints.soton.ac.uk/id/eprint/9414
ISSN: 0269-2163
PURE UUID: a375c92e-ce64-4640-813e-bca5b238e457

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Date deposited: 21 Oct 2004
Last modified: 15 Jul 2019 19:37

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Contributors

Author: D. Clark
Author: J. Seymour
Author: H-R. Douglas
Author: P. Bath
Author: N. Beech
Author: J. Corner
Author: D. Halliday
Author: P. Hughes
Author: J. Haviland
Author: C. Normand
Author: R. Marples
Author: J. Skilbeck
Author: T. Webb

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