A shared purpose framework to deliver person-centred, safe and effective care: organisational transformation using practice development methodology

Abstract

Background: A shared purpose is an essential part of developing effective workplace cultures and one of the founding principles of practice development in establishing person-centred, safe and effective practices that enable everyone to flourish. Aims and objectives: The paper describes the aims of a piece of work first commissioned in 2011 (Phase 1) to review specialist practice – initially nursing and midwifery – across a large National Health Service trust in England. It then focuses on how this piece of work informed the development of a trustwide, shared purpose framework relevant to all staff, culminating in the strategies, processes and systems being used at individual, team and organisational levels to embed the framework, with the workplace as the main resource for learning. The challenges and successes along the way are highlighted. Methods: Practice development, a complex intervention, is used together with a strong partnership joint appointment model between the trust and the England Centre for Practice Development at Canterbury Christ Church University, to enable a transformational journey of cultural change across the organisation, starting with the creation of a shared purpose framework. Results: Examples from the trust’s workplace programmes are presented to demonstrate how the shared purpose and the skills required for transforming culture are brought to life, enabling a critical mass of people with transformational leadership skills to grow. Conclusions and implications for practice: The strength of this work is underpinned by the partner relationship, which drives the focus of innovative programmes of research, scholarship and continuing professional development so that the local university offers systematic support to the organisational strategic objectives of delivering person-centered, safe and effective evidence informed care. The support is designed to develop these skills, using learning and development strategies that draw on the power of the workplace for active learning, as well as focusing on the outcomes and impact important to service providers. Key messages include: Regardless of the size of any initiative, it is important to establish a shared purpose at the start Collaboration, inclusion and participation principles, and associated practice development methodology, enable a focus on achieving person-centred, safe and effective cultures at organisational and at micro-systems levels Once shared purpose is agreed, ways of working that reflect it also need to be agreed Systems for learning, development, research, innovation and evaluation need to be established that enable shared purposes and values to be embedded in everyday activity