Heart Of Health Care Research Articles

The Neglected Healers: Urgent Need for Physicians Self-care in Healthcare

In the heart of healthcare, where doctors tirelessly tend to their patients, a crisis quietly brews – the disregard for their own well-being. The phenomenon of physician burnout is rampant, fuelled by relentless work demands, unyielding stress, and a culture that prizes patient care above self-care. In Pakistan, where the health system is still developing, clinicians have to go beyond their capacity for the provision of standard care to the patients. Physician burnout, a shadow that looms over the medical profession, is reaching alarming proportions. Studies reveal shocking rates of emotional exhaustion, detachment, and a sense of diminished accomplishment among doctors.1 This epidemic not only threatens the mental health of physicians but also compromises patient care and safety.2 Yet, burnout is just the tip of the iceberg. Mental health struggles, like anxiety and depression, affect doctors at disproportionately high rates.3 Stress-induced ailments, from hypertension to musculoskeletal disorders, plague the healers who sacrifice their own well-being in the name of their patients. The solution lies in a radical shift – a culture of wellness and self-care within the medical community. Institutions must step up to provide the support systems necessary for doctors to thrive. Mental health resources, wellness initiatives, and flexible work arrangements are not luxuries but necessities in combating burnout and promoting resilience.4 Doctors must carve out time amidst their demanding schedules for rest, rejuvenation, and reflection. Regular exercise, mindfulness practices, and hobbies are essential tools for preserving physical and emotional well-being.5 Education on stress management and self-care should be woven into the fabric of medical training, right from the medical college, empowering future generations of physicians to prioritize their own health. Peer support networks and mentorship programs offer a great support in the face of adversity.2 As there are regular campaigns and awareness sessions for the patients and general public, there is an immense need to talk about well-being of the health professionals. In conclusion, the plight of physicians neglecting their own health demands urgent attention. By championing self-care and wellness, we can create a more resilient medical workforce, better equipped to navigate the challenges of patient care with compassion and efficacy.

The Heart of Healthcare: Development and Initial Validation of ‘Malasakit’ Scale in Healthcare Services

‘Malasakit’ is an innate Filipino identity that manifests through the compassionate actions of healthcare professionals in their patient care, resonating ‘Malasakit’ throughout our society and culture. This study aims to develop and validate a ‘Malasakit’ scale by examining the psychometric properties and exploring how ‘Malasakit’ is perceived and implemented in healthcare settings. A scale of 85 items was given to 130 professionals in various healthcare services. The results of an analysis showed that the initial framework of four factors (Empathy, Care, Compassion, and Concern) was partially confirmed using Exploratory Factorial Analysis. Using the oblique rotation method (Promax) and principal axis factoring estimation, we extracted factors to comprehend variable relationships, ensuring analytical validity. We eliminated 39 of 85 questions with factor loadings below .50. We excluded items with two-factor cross-loadings near .50. Due to persistently low factor loadings below .35, arousal and relax factors were removed. To ensure a stricter scale, all items must share above 0.70 similarities. This strict approach yielded 19 items arranged into two categories. As a key finding, two characteristics emerged: Empathy (Cognitive and Somatic Empathy), found in the literature, and Compassion (Multicultural Competence Care, Reflective Patient-Centered Care, Affective Empathy, and Hospitality), emerging in Filipino health care services. The study found that the scale can assess empathy and care in healthcare services, including factors specific to Filipino healthcare practices.

MEmory Monologues: Voices from the Heart of Healthcare

mEmory Monologues: Voices from the Heart of Healthcare

Narrative-based learning for person-centred healthcare: the Caring Stories learning framework

This paper describes the learning framework for an innovative narrative-based training platform for healthcare professionals based on older patients’ narratives. The aim of Caring Stories is to place patients’ desires...

Impact of Digital Health on Awareness innovations

Abstract Background In the era of increasingly expanding digital ecosystem, infodemic became highly risky, especially the information sources which are non-evidence based. This problem is magnified due to the vulnerability of most internet users, especially the adults & adolescent's information seekers who lack health literacy. Communication is the foundation of driving successful outcomes inside of the healthcare ecosystem; leveraging the right techniques for all populations is critical to build successful care delivery including in virtual care scenarios Objective The objective of this abstract is to explore the patterns of digital health usage among population and their level of awareness towards choosing online health information (OHI) as well as its impact on the awareness innovations, and crossing the gap between healthcare professionals and patients to increase patient engagement with remote devices and empower them to take control of their own health. Methods Digitalization of healthcare is not just about adopting new digital technology but it's about reforming the healthcare sector for the digital age using the power of data, AI, cloud-based platforms, and new business models to improve behavioral economics, health outcomes, and improve the human care experience for patients and staff alike. In order to discover the next steps in the future of communication technology and how this can be best utilized by healthcare professionals and consumers, an approach of translational research methodology of T1 and T2 was applied, T1 was the translation from research to application and T2 is translation from application to adaptation of the community, leveraging new tools such as the Cloud and AI, to see if they can build automated, reliable, interoperable workflows. Results (1) Digitalizing Legacy Communication to Streamline Patient Care and Healthcare Operations: • Communication is the foundation of driving successful outcomes inside of the healthcare ecosystem; leveraging the right techniques for all populations is critical to build successful care delivery including in virtual care scenarios • Expand - a member of ICOM Group created ‘MyHealth Digest’ Website and Mobile Application. The vision of this digital platform is to put clear patient communication at the heart of healthcare, improving patient experience and quality of care by connecting them with the best professors and doctors in each specialty, and reducing health inequalities. (2) Support operational, therapeutic, and clinical decision-making with AI: • Integrate AI levers into workflows to support operational, clinical, and shared decision-making along the patient pathway • Learn how to overcome obstacles such as clinician resistance and resource constraints to scale AI pilot schemes into efficient systems used organization wide • Understand the latest advancements in AI that have refined algorithm accuracy and further increased the rate that patient data is analyzed (3) Increase patient engagement with remote devices and empower them to take control of their own health • Improve the regularity of your patient's interaction with remote devices to manage costs, reduce readmissions and improve patient progress outside of the clinical setting • Empower self-health through instructions that are simple and touchpoints for information that are very accessible • Leverage patient data to understand adherent and non-adherent patients and tailor targeted interventions where necessary (4) Ensure digital health is a force for greater health equity • Break down barriers and create Digital Health for all by expanding the availability of digital messaging, self-service, and translation services • Overcome problems of connectivity by leveraging devices that trigger off cellphone towers to provide the critical updates your clinician requires • Provide standardized devices for all patients under your care, that not only enable access to all but also simplify the process of patient monitoring for your clinicians Conclusion The integration of digital technologies into our daily lives and the increasing global connectivity have reached unprecedented levels. Innovation, especially in the digital segment, is progressing at an extraordinary pace. However, the potential for utilizing digital health solutions to enhance population health remains unbroached. There is significant scope for leveraging digital technologies and health innovations to raise awareness and expedite the global achievement of health and well-being.1

A Descriptive Phenomenological Study on Professional Role Transition of New Graduate Nurses in Selected Hospital, Bangalore

Background: Nursing is the largest, the most diverse, and one of the most respected among the health care professions. Nurses play an integral role in the healthcare system and they have been correctly referred to as the heart of healthcare. The climate and culture have perhaps the largest impact on a new graduate nurse’s transition into the workforce. New graduates often have a difficult time distinguishing between prioritizing patients and prioritizing care. Objective: The objective of this research was to describe the experiences of new graduate nurses during their professional role transition in their first twelve to eighteen months of experience in critical care areas. Methods: A Descriptive phenomenological approach was selected for the study. Based on the Descriptive phenomenological approach four step was used: bracketing, intuiting, analysis and describing. The investigators identified and clarified their interest in the study and maintained initial reflective note and memoing. Results: The initial stage, (1-3 months) of professional roles transition of new graduate nurses was marked by a high level of stress, fear and disappointment with the disparity between what is anticipated and what is expected from them. Through their professional journey during next 4-5 months, they found themselves moderately stressful, confident and being trusted by their seniors. By the end of 12 months all the graduates have gained confidence and higher level of decision-making abilities and wanted to empower themselves through higher education. Interpretation and Conclusion: The findings of the study shown that life experiences of newly graduate nurses gradually change as they transit from novice to skilled nurse. Keywords: Transition, Professional role transition, and new graduate nurse.

Скелетно-м’язові ураження в перебігу коронавірусної хвороби (COVID-19) у педіатричній практиці. Власне спостереження: клінічний випадок

Актуальність. Пандемія коронавірусної хвороби залишається в центрі уваги вітчизняної і світової системи охорони здоров’я. Патогенні властивості вірусу SARS-CoV-2 обумовлюють ураження як нервової системи, так й інших органів і систем людини. Мета: привернути увагу лікарів до діагностики скелетно-м’язових уражень, зокрема рабдоміолізу, для запобігання можливим ускладненням при коронавірусній хворобі (COVID-19). Матеріали та методи. Нами обстежена й спостерігається група дітей зі скелетно-м’язовими ураженнями на тлі перебігу коронавірусної хвороби (COVID-19) протягом 2020–2021 років. Клінічний випадок власних спостережень такого хворого наведено в статті. Результати та висновки. В пацієнта, хлопчика 15 років, після перенесеної гострої фази коронавірусної хвороби через 33 дні з’явилися загальна слабкість, сильний біль в ділянці правого стегна і кульшового суглобу, лихоманка. Проведена диференціальна діагностика скелетно-м’язових уражень і остеомієліту. Дифузні хвороби сполучної тканини, захворювання, що відносяться до онкогематологічних, а також гепатити були виключені на підставі клінічних даних і проведених обстежень. Ідентифіковані на підставі клінічного обстеження та результатів МРТ запальні зміни клубового, затульного та грушоподібного м’язів з формуванням абсцесу, разом із високим рівнем трансаміназ крові свідчили про розвиток рабдоміолізу. Виявлений позитивний IgG до вірусу SARS-CoV-2 підтверджував зв’язок даного патологічного стану з перенесеною раніше гострою фазою COVID-19. Ознаки коагулопатії, анемія в гемограмі одночасно з клінічними симптомами рабдоміолізу, дозволили підтвердити системність ураження в перебігу коронавірусної хвороби в дитини. Своєчасна оцінка клінічної симптоматики (загальної слабкості, болю в м’язах) і рівня КФК, трансаміназ, електролітів, креатиніну, сечовини крові допоможе здійснити ранню діагностику рабдоміолізу, призначити адекватну терапію і запобігти розвитку тяжких ускладнень.

From evidence to quality improvement to provide high value and patient centered care

Evidence-based practice and quality improvement should be at the heart of healthcare and public health. However, their implementation remains insufficient which is reflected in Switzerland in the high frequency of low-value care, in the wide regional variation in care practices, and in the absence of quality monitoring for the majority of healthcare processes. It is necessary to strengthen the monitoring of quality, particularly that perceived by patients, to help strengthening high-value and patient centered care. Because data do not speak for themselves, it is critical to organize how to use indicators for decision.

Special Issue – July/August 2022: Elevating the human experience through caring for the healthcare workforce

Patient Experience Journal (PXJ) is excited to announce the call for submissions for its July/August 2022 special issue on the impact that caring for the healthcare workforce can have on transforming the human experience. Well before the pandemic and elevated by it, the importance of the healthcare workforce in ensuing the best in experience has been essential. It is why at the heart of the definition of patient experience itself, that culture is identified as an essential element. More so, the Declaration for Human Experience (https://transformhx.org/) reinforced this through a foundational commitment to “understand and act on the needs and vulnerabilities of the healthcare workforce to honor their commitment and reaffirm and reenergize their purpose.” This special issue will look for pieces that address evidence-based efforts at addressing workforce experience, reveal practices that are focused on caring for the healthcare workforce and share personal stories of the impact these issues have had. Through this special issue, PXJ looks to not only build a foundational collection of knowledge and information that will continue to push the conversation on experience forward, but also create a platform for action in addressing this issue that rests firmly at the heart of healthcare.

A call to action for human experience

As we open the 8th volume of Patient Experience Journal (PXJ), we all stand in a world much different than we did just a year ago. A year ago we were in the height of crisis, facing unknowns and uncertainty. We didn’t know if we were tackling an issue that was weeks, months or years in front of us. We were truly not even sure what tomorrow might bring. As I shared in opening Volume 7, we were already experiencing something special in the midst of real tragedy. We were seeing light peeking through heavy clouds. I opened that issue sharing, “At the heart of healthcare, we are human beings caring for human beings, [and] at the heart of the actions and efforts of so many at this time of crisis, we find the true essence of the humanness of healthcare. Yes, the clinical excellence at healthcare’s roots will ensure we save lives, but the efforts we are seeing to elevate the human experience now will ensure we honor those lives through and beyond this crisis as well.” While this crisis challenged us in ways we have never seen, it equally highlighted the realities we knew already existed but had yet to fully address. The opportunity this reveals provides a significant moment of choice: do we perpetuate our efforts of the past or do we bend the arc for a new future? We are at a unique moment for our community, for our world…one we must not miss. Please join us in transforming the human experience by sharing your ideas via PXJ, taking action in your organizations, working to impact the communities in which you live and work, by signing and acting on the Declaration for Human Experience. That is the least we can do for one another in an industry, and I dare say a world, where we must forever be human beings caring for human beings. We are the human experience, and now is the time to act.

Abstract PO-072: Doctors and nurses during COVID19 pandemic: A different perception of cancer care

Abstract Background: The spread of coronavirus disease brought the need to reorganize clinical activity in oncology. Cancer patients are very vulnerable, and it is well known that their treatment has to be strictly planned. The most critical considerations still relate to the entry of the virus into hospitals, the heart of health care, where cancer patients are protected. Instead, during the COVID19 pandemic the oncologic department had to limit access to care to protect patients from a more dangerous disease for them, witnessing a paradox of health care. This brought with it worries in oncologic health care professionals in replanning activities in order to guarantee therapeutic continuity and quality of care. It is well known that physicians and nurses have different role concepts and role expectations. The purpose of our study was to investigate doctors’ and nurses' perception of cancer patient reorganization during the COVID19 pandemic in a sample of Italian health care professionals in oncology. Methods: We submitted a survey to oncologic health care workers (physicians and nurses) of Italian National Health Care System during the pandemic to investigate clinical activity reorganization and cancer patient management through 12 closed questions. The survey promoted by Clinica Oncologica, AOU Riuniti di Ancona-Università Politecnica delle Marche was electronic and anonymous. Results: A total of 383 oncology health workers completed the survey, 60 nurses (15%) and 323 physicians (85%). 60% of interviewed physicians perceived qualitatively lower than usual the therapeutic path of patients taken in charge in this historical moment, while 45% of nurses declared it was the same (P<0.01). The continuity of the multidisciplinary team was defined as guaranteed for 68% of oncologists, while almost 40% of nurses declared to not know it. Almost all physicians (95%) answered that their clinical activity was reorganized, compared to a lower portion of nurses (80%) who replanned their care role (p<0.01). Deferring treatments caused fear and anxiety in 62% of physicians and 46% of nurses (P=0.027). Conclusion: The survey underlined the need to integrate skills and involve all professional figures in planning cancer patients’ treatment to guarantee optimal therapeutic strategies and a global take in charge in all its details, even during emergencies. Citation Format: Lucia Bastianelli, Filippo Merloni, Nicoletta Ranallo, Luca Cantini, Lorenzo Mariotti, Alessandra Lucarelli, Zelmira Ballatore, Rossana Berardi. Doctors and nurses during COVID19 pandemic: A different perception of cancer care [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2020 Jul 20-22. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(18_Suppl):Abstract nr PO-072.

Health Literacy-How Do We Improve the Conversation at the Heart of Healthcare when We Know so Many People are Struggling with It?

The Scottish Government published "Making it Easy - A Health Literacy Action Plan for Scotland" in 2014, and in 2017 the next steps were set out in "Making it Easier - A Health Literacy Action Plan for Scotland 2017-2025." This article discusses what health literacy is, outlining the key points from these national action plans. The importance of understanding and addressing health literacy in relation to renal services, and dialysis in particular, is highlighted by use of an example of a Scottish renal unit's practice to outline the principles being used in a service.

Elevating the discourse on experience in healthcare’s uncertain times

Over the last five years, we have been inspired by the breadth of contributions that have helped shape the experience landscape through PXJ as well as the reach that the conversation on patient experience has had. Both the authors and readers of PXJ reinforce that the conversation on patient experience and the human experience in healthcare is not one dominated by national intent or even policy. While for some motivation has come in some part from mandated action, for most tackling this idea in healthcare is it grounded in two core realities. The first, in healthcare at its core we remain committed to ensuring the best for those we serve as active and engaged people, not simply as passive participants in care. This requires a different way of thinking and doing than a simple model for throughput or a checklist mentality. The complexity of the humanity at the heart of healthcare perhaps is also its greatest strength. In acknowledging the humanity of healthcare, we breathe life into our organizations, we excavate lost purpose in burned out and fatigued practitioners and we give permission to connect with others. This connection is not simply in the buildings we find ourselves, but it is our humanity that links us across communities and countries, continents and oceans. This connection and the conversation that supports it will forever be the grounds on which healthcare will ultimately succeed, it is the foundation on which we can and must elevate the discourse on experience.

Bases of Person Centered Medical Education to Enhance Health Systems Worldwide

Medicine is at the heart of healthcare. Healthcare systems have contributed to increasing the life expectancy and the wellbeing of millions of people worldwide during the 20th century [1] and they represent an asset of utmost importance in achieving fairness in accessing health-related prevention, promotion and recovery from illness [2]. Thus one of the driving purposes of medical education must be to enhance the performance of health systems for meeting the needs of patients and populations in an equitable and efficient way. A crucial factor in this endeavor will be the successful adaptation of professional education for local and national leadership in workforce teams that are capable of extending reach to all people. The purpose of this paper is to explore a deeper understanding that a person centered approach is essential as to how this can be achieved.Health is about people. The goal of physicians and all health professionals, irrespective of nationality and specialty is to share a common global vision for the future. [3] In this, all health professionals in all countries should be educated to gather knowledge, and to engage in critical reasoning and practice to high ethical standards so that they are competent to participate in person-centered and people-centered health systems as members of locally responsive and globally connected teams. The ultimate vision must be to assure universal coverage of high-quality comprehensive services that are essential to advancing opportunity for health equity within and between countries [4]. The aspiration for better health commonly shared will resonate with aspiring young professionals who seek value and meaning in their work.

Relationship Centred Practise

Introduction: The interaction between patients and clinicians is at the heart of health care. They are the first point of contact and a familiar interaction with the health service for most patients. Consultations happen in a variety of contexts, locations and with many different clinical professions. Relationship Centred Practise is about enablement, viewing patients as assets not burdens and seeks to support them to recognise, engage with and develop their own sense of resourcefulness building on their own unique range of capabilities. Such interactions consider the patient’s life goals, how they plan to work towards them and what support they need to help get there. Practice Change Implemented : Principles of grounded theory were used to develop a framework for relationship centred practise. In the first phase, workshops were held with over five hundred participants including policy makers, leaders of health services and clinicians and these insights used to develop a framework for testing. In the second phase, semi structured interviews were held with thirty one participants from professional backgrounds of doctor, nurse and therapist and at levels of policy maker, leader and clinician and these insights used to refine the framework. Aim and Theory of Change: The framework contains seven elements namely ; preparation; agenda setting; information gathering; discussing options; agreeing the way forward; implementation; review and further actions, with each of these elements supported by reflective learning and service improvement. Insights obtained led to development of a grounded theory model for implementation with roots in the theory of planned behaviour and describes elements of clinician attitude, clinician norms and controls impacting on intention with action factors of patient self-efficacy, the framework and leadership support leading to behaviours. The most significant issues perceived were ; conflict between the framework and current models; power relationships; the context of the interaction; patient self-efficacy; clinician understanding ; the conflicting expectance of patients about the clinician’s role; time constraints and ; clinician training. Discussion : Relationship centred practise has increasing recognition and evidence base as a transformative approach to delivering health care. It is acknowledged that changing health outcomes requires a transformational change in the relationship between clients and clinicians. A training package has been developed that builds on Maori models of care, international knowledge of relationship centred practise and the framework.The training package consists of : - Initial Introductory e-learning module suitable for all Central Region employees - Face to face skills training for clinicians of three half day sessions spaced one month apart - Advanced e-learning module to consolidate and develop skills Conclusions : Relationship centred practise is widely accepted as an opportunity to deliver person and whanau centred services. A training package has been developed based on 17 years developing and implementing relationship centred practise training models. The training package is relevant to the New Zealand context, integrating Whanau Ora, Maori models of care, aligning with the Triple Aim, and the New Health Strategy. The training package is based on nine elements of practise that improves clinicians’ resilience and well being in preparation for relationship centred interactions with patients.

Using the Gold Standards Framework to deliver good end of life care

The aims of excellent end of life care (EOLC) and nursing are at the heart of healthcare. Chelsea and Westminster Hospital NHS Foundation Trust, a multi-site London teaching care provider, recognises and values the importance of good EOLC, and the quality of EOLC is used as one of the key metrics in assessing the quality of patient and family care across the trust. The principles of EOLC, including those enshrined in the Gold Standards Framework (GSF), are closely aligned with the trust's core values. Each member of staff is encouraged and supported, through the GSF process, to recognise and respond as befits their role in implementing the principles of EOLC, agreed by staff, and by patients and their relatives. This article describes the experience of, and collaboration between, trust staff and members of the GSF team, who have worked together for the past 18 months, and how this work has placed EOLC at the heart of patient care and staff recruitment. This collaboration has helped to enrich the culture of compassion and care that the trust aims to deliver, and to focus on providing person-centred care.

Working to put clean water at the heart of health care

British Journal of MidwiferyVol. 24, No. 10 CommentWorking to put clean water at the heart of health careKate NorgroveKate NorgroveSearch for more papers by this authorKate NorgrovePublished Online:7 Oct 2016https://doi.org/10.12968/bjom.2016.24.10.689AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References UNICEF (2014) Committing to Child Survival: A Promise Renewed. http://tinyurl.com/n8hzyxn (accessed 28 September 2016) Google ScholarUnited Nations (2015) Sustainable Development Goals. www.un.org/sustainabledevelopment/sustainable-development-goals (accessed 28 September 2016) Google ScholarWorld Health Organization, UNICEF (2015) Water, sanitation and hygiene in health care facilities: Status in low-and middle-income countries and way forward. www.who.int/water_sanitation_health/publications/wash-health-care-facilities (accessed 28 September 2016) Google Scholar FiguresReferencesRelatedDetails 2 October 2016Volume 24Issue 10ISSN (print): 0969-4900ISSN (online): 2052-4307 Metrics History Published online 7 October 2016 Published in print 2 October 2016 Information© MA Healthcare LimitedPDF download

Design of paediatric hospitals.

The impact of healthcare environments on children and young people's (CYP) health and psychosocial wellbeing has attracted much attention in recent years. This sits within the realm of the political drive for enhanced awareness of the need to take account of the rights and voice of the child. Perhaps as a direct result of the United Nations Convention on the Rights of the Child, and recognition from evidence in adult population studies of the impact of healthcare environments on psychosocial healing, contemporary times have witnessed a discernible movement towards enhancing quality care by promoting child and adolescent-friendly hospital environments. The Council of Europe guidelines on child-friendly health care moved to place the rights and needs of children at the heart of health care. The Council acknowledges that the delivery of child-oriented services, which includes the notion of family-centred care, should be delivered in child and family friendly environments. However, knowledge about what constitutes a child-friendly healthcare environment from CYP's perspective is often lacking with hospital architectural blueprints predominantly designed around adult proxy-reported assumptions about the needs and desires of children.

Patient experience: Driving outcomes at the heart of healthcare

There is no longer a question that patient experience matters in healthcare today. It matters for those that are cared for and served and matters to all those working each and every day to provide the best in care at all touch points across the healthcare continuum. With this recognition, there too needs to be a change in mindset about patient experience itself. When addressing the topic of patient experience, the conversation is about something much broader than the “experience of care”, as identified in the triple aim. The idea of experience reflects our biggest opportunity in healthcare, where experience encompasses quality, safety and service moments, is impacted by cost and the implications of accessibility and affordability, is influenced by the health of communities and populations and by both private and public health decisions that have systemic implications. A focus on experience at the broadest sense leads to the achievement of the four outcomes leaders aspire to in varying combinations in healthcare organizations around the world: clinical outcomes, financial outcomes, consumer loyalty, and community reputation. With the rapid growth in research, a diverse and expanding global community, and a shared commitment to outcomes, patient experience has now claimed its place at the heart of healthcare.

Using a nurse leads team to spearhead workforce change

Most clinical commissioning groups (CCGs) in England have a primary care nurse lead to focus on education, supervision and support. Lambeth CCG has tried a new approach involving a team of nurse leads Primary care is at the heart of health care but there are not enough well-trained nurses and health care assistants (HCas) to cope. This study describes how the first ever practice nursing workforce team in England was set up to tackle this in Lambeth, London. Rather than having one nursing lead, the CCG employs a group of nurses who also work day-to-day in clinical practice. A cross-sectional research design was used to collect information about the nurse leads group. Data were collected retrospectively to compare before and after this model was introduced. Information was collected using a survey with 43 practice nurses and 21 HCAs, group discussions and reflections from the nurse lead group and comparison of statistics before and after the nurse lead group was in post. Over a 2-year period, the nurse lead group has increased the number of HCAs in Lambeth, increased the training and supervision available to HCAs and practice nurses, and increased satisfaction with training and support. Before the team was in place there was no register of nurse mentors. Now there is a register with 38 trained mentors. Previously, only one practice took student nurse placements, now four do. Ten clinical supervision groups run at different times during the week, with 80 nurses taking part (80%). The number of HCAs has increased by 25%. All HCAs have attended an upskilling course and seven out of ten attend regular supervision. Other areas could also have a team of nurse leads rather than relying on one person. Making sure that nurse leads are part of the clinical workforce helps to promote empathy and credibility. Having a team helps to share the workload and means that nurses can divide their time between clinical practice and workforce development activities.