Team Around the Patient: multi-professional opportunities to support care delivery in hospitals.

Abstract

Background: Demands on healthcare are outstripping the resources available. Many organisations are struggling to recruit sufficient registered nursing staff to maintain service delivery and are re-evaluating how safe, high quality, sustainable care could be provided. The concept “Team Around the Patient” being piloted in Hywel Dda University Health Board seeks to understand who can provide what care outside of traditional workforce models. The objective of this study is to examine perceptions of key health board stakeholders of the Team Around the Patient model of care and establish research priorities, and to design and test a workforce analysis model to test the implementation of Team Around the Patient. The model will be designed for use in adult, acute inpatient hospital wards.
 Methods: Before implementing the Team Around the Patient on select adult surgical and medical wards semi structured interviews were undertaken with key health board stakeholders to gather their understandings and perspectives on the concept, and create a working definition. A purposive approach was taken to engage a range of professional opinions including corporate and operational nursing, patient experience, allied health professionals, workforce and operational development. Interview topics included opportunities, quality indicators, barriers and enablers and organisational impacts. Ethical approval was provided by Swansea University and through The Integrated Research Application System (IRAS). Interviews were recorded, transcribed and thematically analysed. 
 Results: In total 15 participants were interviewed. High level findings show support for the concept, with many participants identifying the potential new roles to be included. Key quality indicators such as inpatient falls, medication errors, pressure damage, length of stay, complaints and staff experience were identified as being important measures for this concept. Challenges associated with introducing new roles were mainly associated with workforce culture, delegation and finance. 
 Conclusion: The results indicate overall support for “Team around the Patient” as a model of care which will help to alleviate issues surrounding skill shortages, while introducing more collaborative, inter-professional working. Further research is underway to gain wider perspectives of the concept from national and international experts in the fields of health care, academia and policy makers. The next stage of the research will include observational studies of health care delivery in practice to test the model of workforce analysis. The aim will be to identify opportunities for non-nursing staff groups to support care delivery where a gap in practice, or inefficiencies in the timely delivery of care, has been identified.