Bridges, J;
May, C;
Griffiths, P;
Fuller, A;
Wigley, W;
Gould, L;
Barker, H;
(2017)
Optimising impact and sustainability: a qualitative process evaluation of a complex intervention targeted at compassionate care.
BMJ Quality & Safety
, 26
(12)
pp. 970-977.
10.1136/bmjqs-2017-007356.
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Abstract
Background: Despite concerns about the degree of compassion in contemporary health care, there is a dearth of evidence for health service managers about how to promote compassionate health care. 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, 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 wellbeing 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 organizational culture focused on tasks and targets that constrained opportunities for staff mutual support and learning. Conclusions: Relational work in caregiving organisations depends not just on individual caregiver agency but also 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.
| Type: | Article |
|---|---|
| Title: | Optimising impact and sustainability: a qualitative process evaluation of a complex intervention targeted at compassionate care |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1136/bmjqs-2017-007356 |
| Publisher version: | http://dx.doi.org/10.1136/bmjqs-2017-007356 |
| Language: | English |
| Additional information: | Copyright © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Education UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education > IOE - Education, Practice and Society |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1566982 |
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