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Practice Development Work (practice + development_work)

Distribution by Scientific Domains
Medical Sciences75%

Selected Abstracts

Facilitating collaborative development in practice

INTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 5 2009
Debbie Tolson PhD MSc BSc RGN
The promotion of stakeholder partnerships features within practice development work and is intuitively appealing, but in reality meaningful partnerships can be problematic. We report the findings of four parallel Nominal group Technique Interviews undertaken with groups of professional (nurses from practice and academia) and lay stakeholder representatives during a seminar event. The group work sought to explore the mechanisms, which could facilitate meaningful practice development partnerships between nurses, academic nurses and people. The most highly ranked suggestions included creating a culture where practice development is seen as everyone's business and establishing a unified collaborative infrastructure. A range of enabling and inhibiting conditions were explored and the complexity of achieving consensus decision-making processes that would allow realization of the policy rhetoric was exposed. [source]

Puzzling practice: A strategy for working with clinical practice issues

INTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 2 2008
Kenneth Walsh RPN RN BNurs PhD
In this paper we aim to share the evolution of innovative ways to explore, ,unpack' and reframe clinical issues that exist in everyday practice. The elements of these processes, which we call ,puzzling practice', and the techniques associated with them, were delineated over a two year period by the four authors using action theory based processes. The authors have evolved several different frameworks for ,puzzling practice' which we draw on and use in our practice development work and in our research practice. This paper pays attention to a particular form of puzzling practice that we have found to be useful in assisting individual clinicians and teams to explore and find workable solutions to practice issues. The paper uses a semi-fictitious example of ,Puzzling Practice' gleaned from our experience as practice development facilitators. In this example ,puzzling practice' uses seven different elements; naming the issue; puzzling the issue; testing the puzzle exploring the heart of out practice; formulating the puzzle question; visualizing the future; and generating new strategies for action. Each of the elements is illustrated by the story and the key foundations and ideas behind each element is explored. [source]

Sharing specialist skills for diabetes in an inner city: A comparison of two primary care organisations over 4 years

JOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 5 2006
Abdu Mohiddin MFPHM Lecturer
Abstract Objective, To evaluate the effects of organizational change and sharing of specialist skills and information technology for diabetes in two primary care groups (PCGs) over 4 years. Methods, In PCG-A, an intervention comprised dedicated specialist sessions in primary care, clinical guidelines, educational meetings for professionals and a shared diabetes electronic patient record (EPR). Comparison was made with the neighbouring PCG-B as control. In intervention and control PCGs, practice development work was undertaken for a new contract for family doctors. Data were collected for clinical measures, practice organizational characteristics and professional and patient views. Results, Data were analysed for 26 general practices including 17 in PCG-A and nine in PCG-B. The median practice-specific proportions of patients with HbA1c recorded annually increased in both areas: PCG-A from median 65% to 77%, while PCG-B from 53% to 84%. For cholesterol recording, PCG-A increased from 50% to 76%, and PCG-B from 56% to 80%. Organizational changes in both PCGs included the establishment of recall systems, dedicated clinics and educational sessions for patients. In both PCGs, practices performing poorly at baseline showed the greatest improvements in organization and clinical practice. Primary care professionals' satisfaction with access and communication with diabetes specialist doctors and nurses increased, more so in the intervention PCG. Only 16% of primary care professional respondents used the diabetes EPR at least monthly. Patient satisfaction and knowledge did not change. Conclusions, Improvements in practices' organizational arrangements were associated with improvements in clinical care in both PCGs. Sharing specialist skills in one PCG was associated with increased professional satisfaction but no net improvement in clinical measures. A shared diabetes EPR is unlikely to be used, unless integrated with practice information systems. [source]

Maintaining a focus on the child?

CHILD ABUSE REVIEW, Issue 4 2002
First impressions of the Framework for the Assessment of Children in Need, their Families in cases of child neglect
Abstract The Framework for the Assessment of Children in Need and their Families is guidance introduced by the Department of Health in England to improve assessment practice and promote better outcomes for children and their families. This paper considers ways in which the Assessment Framework can improve assessment practice in cases of child neglect. However, as with any national guidance, its effectiveness is dependent on local approaches to implementation. The author has undertaken practice development work around implementation with senior managers and frontline staff in area child protection committees (ACPCs) and social services departments. These experiences are used to explore the local issues and tensions encountered by both practitioners and managers responsible for implementing the Assessment Framework. An argument is made that these issues and tensions if not addressed can result in distorted assessments that lose the focus on the child. Copyright © 2002 John Wiley & Sons, Ltd. [source]