The impact of progress toward a Clinical Development Unit in Cardiology

Abstract

Health care organisations are continually implementing quality initiatives to develop staff to enhance the provision of patient care. However, the impact of such initiatives often fail to be assessed which can jeopardise provision for their systematic support. This paper reviews staff perceptions of how progress toward a Clinical Development Unit has influenced their practice in Cardiology. The process began in August 2003 when the unit philosophy included the use of best evidence into practice. Key initiatives integral to the development of a CDU were: facilitated engagement with clinical evidence, assisted through a structured education program for all staff; and opportunities for involvement in patient centred research. This evaluation sought descriptive information from staff as sustainability of such units is reliant on positive attitudes. Feedback was obtained from a convenience sample of staff who participated in three focus groups conducted over two months, 29 staff in total. Prevailing themes that emerged indicated the development of a positive ward culture. Four dominant themes emerged: the development of a culture of evidence into practice; a continuous learning environment; awareness of the contribution of research; and a ‘re’-focus on patient care. While structures and processes were in place to support learning and practices based in evidence that staff viewed favourably, there was little indication of individual staff members being ‘pro-active’ and being initiators of seeking evidence to make changes to practice.