Some of you may have heard of the Caring Behaviours Assurance System (CBAS), which supports clinical governance and the assurance of high-quality, personcentred care for service users and their families. The CBAS approach addresses culture, improvement, accountability and assurance. It provides a framework that supports conversations about values, care and caring behaviours; their assessment, the identification of what works well or less well, staff resilience, and the incorporation of current improvement approaches and measures of patient experience within NHS Scotland. CBAS allows the recognition of context and that no organisation is starting from the beginning, and may already be undergoing a number of initiatives that can align with CBAS. CBAS consists of a number of components that provide the framework, tools, and techniques that support leadership and accountability for the service users’ care and caring experience. These include multisource data collection, feedback techniques of what is important to service users and staff, action planning to support improvement and measurement of impact. It supports the training of quality champions to promote and coordinate these activities and ensure involvement and ownership of the healthcare team. The first step in the CBAS process is to develop a Person-Centred Quality Instrument and ensure ownership of this process by involving staff and service users. A list of approximately 100 items describing a range of caring behaviours, across the 6Cs, is used as a basis for a team to discuss priorities with patients, carers and each other. This assessment tool provides staff with a framework to collect data about caring behaviours. The process stimulates conversations and feedback from team members and service users on what caring is and its importance. The outcome has raised awareness of what caring means from different viewpoints in order to promote a shared view of the team and service users’ values and beliefs about caring; identify good practice, and highlight concerns that require improvement. Multiple methods of data collection to support feedback from staff, service users and family members are explored and practiced. The data collection methods include interviews with patients, families and managers, including emotional touch points, observation of practice, an environmental review and review of documentation. The aim is to integrate these methods with every-day practice and work processes. Once data is collected, the quality champions are encouraged to give feedback on the outcomes of this review to the team or individual staff members through caring conversations. These conversations held between colleagues are practised in a caring and respectful manner, with recognition that they may be challenging, in order to enable reflective practice. It is proposed that Rory Farrelly NHS Greater Glasgow and Clyde Director of Nursing Acute Services Division the skills that are needed involve listening and remaining resilient when conversations become stressful. CBAS recognises that managing stress using the ‘HeartMath’ technique supports staff ability to enact these caring conversations and to achieve a personal balance, and coherence in life. Since 1991, the Institute of HeartMath has been studying the links between stress, physiology, care, productivity and clinical outcomes. What emerged was the discovery that the human heart plays a significant role in creating a healing environment both for the care-giver and the patient. This discovery
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