Abstract
To explore the utility and feasibility of implementing eight person-centred nursing key performance indicators in supporting community nurses to lead the development of person-centred practice. Policy advocates person-centred health care, but few quality indicators exist that explicitly focus on evaluating person-centred practice in community nursing. Current quality measurement frameworks in the community focus on incidences of poor or missed opportunities for care, with few mechanisms to measure how clients perceive the care they receive. An evaluation approach derived from work of the Medical Research Council was used, and the study was underpinned by the Person-centred Practice Framework. Participatory methods were used, consistent with person-centred research. Data were thematically analysed, revealing five themes: giving voice to experience; talking the language of person-centredness; leading for cultural change; proud to be a nurse; and facilitating engagement. The findings suggest that implementing the eight person-centred nursing key performance indicators (KPIs) and the measurement framework is feasible and offers a means of evidencing person-centredness in community nursing. Person-centred KPI data, used alongside existing quality indicators, will enable nurse managers to evidence a high standard of care delivery and assist in the development of person-centred practice.
Highlights
In a move to broaden perspectives of quality in global health policy, there is an increased focus on humanizing health care, foregrounding patient and carer experiences (Picker Institute Europe, 2014; World Health Organisation (WHO) 2016; Department of Health, 2016)
This paper reports the findings of a feasibility study to test the acceptability and impact of using these key performance indicators (KPIs) in community nursing settings with a focus on leading person-centred practice
Several significant aspects of person-centredness are evidenced in extracts from the stories relating, in particular, to KPI 3: patient's sense of safety whilst under the care of the nurse; KPI 4: patient's involvement in decisions made about his/her nursing care; KPI 6: respect from the nurses for patient's preferences and choice; and KPI 8: nurse's understanding of what is important to the patient and their family, as illustrated in Table 4 below
Summary
In the UK, current quality measurement frameworks in the community focus on incidences of poor or missed opportunities for care (e.g. falls, pressure ulcers, infection rates), generated through national data sets, perhaps accounting for the invisibility of community nursing reported in the literature (Maybin et al, 2016; Queens Nursing Institute, 2017) This narrow view of quality standardizes practice across health care organisations and disciplines, often without incorporating individual experience of care (Foot et al, 2014; Horrocks et al, 2015; Kaehne, 2018). The evolution of this research led to a further study to develop and test the feasibility of a technological solution to facilitate the collection of data using the measurement tools It demonstrated that the App made information more accessible, was captured in real time and used to improve the experience of care (McCance et al, 2020). This paper reports the findings of a feasibility study to test the acceptability and impact of using these KPIs in community nursing settings with a focus on leading person-centred practice
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