Leadership In Compassionate Care Programme Research Articles

Embedding compassionate care in local NHS practice: developing a conceptual model through realistic evaluation

The aim of this study was to critically analyse the impact of the ‘Leadership in Compassionate Care Programme’ and offer a conceptual model of factors that can embed compassionate care in contemporary health care environments. This three-year initiative (2008–2011) was designed to embed compassionate care in both practice and pre-registration education. Using a realistic evaluation approach this longitudinal qualitative study involved data collection in eight participating wards. The ‘level of adoption’ of the Programme varied across the wards, which pointed to key context and mechanisms that were influential in embedding compassionate care. Contextual factors that promoted adoption of the Programme were stability, support and leadership. The most important mechanisms were appreciative inquiry coupled with skilled facilitation. Powerful practice development techniques focused on articulating and demonstrating values; giving patients, relatives and staff a voice to express their experiences and emotions; and instituting effective feedback mechanisms. In the high adopting wards the main outcomes included personalisation of patient care, an increased sense of involvement for relatives and ‘caring conversations’ becoming an accepted part of working practice. Embedding and sustaining compassionate care demands strategic vision and investment in a local infrastructure that supports relationship-centred care, practice development and effective leadership at all levels.

Reflections about experiences of compassionate care from award winning undergraduate nurses – What, so what … now what?

From 2007 until 2012 Edinburgh Napier University’s School of Nursing Midwifery and Social Care in conjunction with NHS Lothian, collaborated on a programme of action research entitled, the Leadership in Compassionate Care Programme. One strand of this research focused on learning and teaching about compassionate care within the undergraduate curriculum. This debate article focuses on the care issues raised by two award winning nursing students who reflected on the development of their compassionate caring skills during their three year Bachelor of Nursing programme. The reflective accounts debate the following issues related to compassionate care; Personal drivers supporting the provision of compassionate care, Challenging and influencing care practices, Providing relationship centred care and, Living with what can’t be achieved. Throughout the debate a model of compassionate care developed from the Leadership in Compassionate Care Programme is used to reflect on key practice issues and provide a framework for practice development. The care issues presented in this paper identify a need to support students in healthcare to; Develop strategies in questioning care practices which do not meet expectations of compassionate care; undertake focussed reflective activities where each student can explore personal drivers, values and perspectives of compassion; actively connect learning in practice with theory in university, enable development in compassionate caring and strategies that support self-compassion; facilitate an understanding and development of emotional intelligence supporting development of resilience. Implications for healthcare staff are to; Collectively seek, hear and respond to feedback about their service; activate caring conversations within the healthcare team; consider how the model of compassionate care presented in this paper, can be used to reflect on practice and provide a framework for development; consider how we maximise the experience of care during brief moments of contact with patients/families; activate leadership that promotes a culture of openness facilitating the development of compassionate care.

Compassionate Care: Student nurses' learning through reflection and the use of story

IntroductionCurrent concern in health care about delivering care that is compassionate has important implications for how compassion is taught and made explicit in nurse education curricula. This paper will describe the use of stories within the curricula to enhance knowledge and skills in compassionate caring. MethodologyThe Leadership in Compassionate Care Programme (LCCP) was a 3-year action research project that sought to capture what compassionate care means within practice and utilise this learning within education. Stories gathered within clinical practice were used to stimulate reflective learning as part of a nursing module that teaches recognition of acute illness and deterioration at Edinburgh Napier University. Students listened to stories which included experiences of staff, students, patients and relatives and related these to their own experiences in practice. In this paper, examples from the online discussions are discussed with reference to one of six themes that emerged from the LCCP, that of caring conversations. FindingsThe discussions suggest that reflective learning and the use of stories about the experience of giving and receiving care can contribute to the development of the knowledge, skill and confidence that enable student nurses to provide compassionate relationship centred care within practice. ConclusionsReflective learning can be a valuable strategy for students to ponder new knowledge and allow predetermined ideas to be challenged. Stories can initiate this process and help student nurses to understand not only the needs of others, but their own expectations and values, which in turn can inform how they plan and deliver person centred compassionate care.

An exploration of a restorative space: A creative approach to reflection for nurse lecturer's focused on experiences of compassion in the workplace

This study was undertaken as part of a larger programme of research; the Leadership in Compassionate Care Programme. The aim of this study was to explore and respond to the perceptions of nurse lecturers in regard to experiences of compassion in the workplace. A participatory action research approach was adopted. The study took place in a large school of nursing and midwifery in the United Kingdom, eight lecturers participated in this study. A series of four facilitated reflective workshops titled a restorative space were provided and participants used the medium of collage as a process for reflection. Data was gathered in the form of collages, field and reflective notes. Data analysis involved an iterative process between facilitators and participants during the workshops and resulting actions were implemented. Findings from this study identified three key themes related to compassion in the workplace; leadership, culture, professional and personal development. Actions identified and implemented as a consequence of these findings included opportunities for lecturers to participate in a leadership development programme and implementing rapid feedback processes between lecturers and the senior management team. The restorative space workshops and utilisation of the creative medium of collage provided a valuable process for practitioners to collaboratively reflect on their workplace experiences.

The personal development tutor role: An exploration of student and lecturer experiences and perceptions of that relationship

This exploratory study formed part of the Leadership in Compassionate Care Programme (LCCP) that considered embedding the principles of person-centred compassionate care within an undergraduate nursing curriculum. Currently, there is a lack of literature regarding compassionate care in relation to the student-personal development tutor (PDT) relationship. The aim of the study was to explore the current personal development tutor role, within a pre-registration adult nursing programme, in relation to the support provided to students by PDTs and from this, establish what was important in the role from the student and lecturer perspectives, within the context of the LCCP. A qualitative approach utmilising participant interviews was employed. Six undergraduate nursing students on a Bachelor of Nursing adult programme and five PDTs participated in the study and Emotional Touchpoint technique was used to elicit participant experiences. Data were analysed using an adapted version of the Senses Framework, originally proposed by Nolan et al. (2006). The results demonstrate the importance that students and their PDTs attach to the relationship and how elements of care arising from the Senses Framework are fundamental to developing and sustaining this relationship. Further, it is apparent that role modelling in relation to care is considered an important element of the PDT role which has relevance to nurse education and practice. In light of these findings a range of strategies are proposed to enhance the PDT relationship by utilising a modified version of the Senses Framework as a model for PDT and student interaction.

Clarifying misconceptions about compassionate care

To discuss the meaning of compassionate care as it applies to staff, patients and families in health and social care settings, its application to practice and how organizational infrastructures affect the delivery of care. The term compassion has assumed headline status and inclusion in current health and social care policy. Clarity of what the term means in practice is needed and may help to promote delivery of compassionate care consistently across health and social care settings. Discussion paper. This article draws on data from an action research programme (Leadership in Compassionate Care Programme, 2007-2011) that focused on embedding compassionate care into practice and education and related literature focused on compassionate person-centred care. A literature search was conducted and articles published in English relating to the terms compassionate, person-centred care between 1999-2011 were included. Perceptions of compassion, practising compassion and the infrastructure to support compassion are discussed. It is anticipated that this discussion will prompt further debate, raise awareness and help to clarify the meaning of compassion in everyday practice with patients, relatives and staff, so that it can be more clearly named, valued and defended. This article challenges some of the beliefs and values that underpin the meaning of compassionate care and its application to practice. It brings greater clarity to the meaning of compassion, which could be used to form the basis of shared visions of caring, both strategic and operational, across organizations.

Caring about caring: Developing a model to implement compassionate relationship centred care in an older people care setting

AimThis study actively involved older people, staff and relatives in agreeing a definition of compassionate relationship-centred care and identifying strategies to promote such care in acute hospital settings for older people. It was a major component of a three year programme (the Leadership in Compassionate Care Programme, LCCP) seeking to integrate compassionate care across practice and educational environments. BackgroundCompassionate caring and promoting dignity are key priorities for policy, practice and research worldwide, being central to the quality of care for patients and families, and job satisfaction for staff. Therapeutic relationships are essential to achieving excellence in care but little is known about how to develop and sustain such relationships in a culture that increasingly focuses on throughput and rapid turnover. Approach and methodsThe study used appreciative inquiry and a range of methods including participant observation, interviews, story telling and group discussions to actively engage older people, relatives and staff. A process of immersion crystallization was used to analyze data with staff as co-analysts. FindingsThe study adds considerably to the conceptualization of compassionate, relationship-centred care and provides a model to aid staff deliver such care in practice, based on ‘appreciative caring conversations’ that enable all parties to gain two forms of ‘person and relational knowledge’ about ‘who people are and what matters to them’ and ‘how people feel about their experience’. Such knowledge enables staff, patients and carers to ‘work together to shape the way things are done’. The study generated a model called the 7 ‘C's that captures in detail the factors necessary to promote ‘appreciative caring conversations’. Conclusions and implicationsThe study demonstrates that engaging in ‘appreciative caring conversations’ promotes compassionate, relationship-centred care but that these conversations involve practitioners taking risks. Such ‘relational practices’ must therefore be valued and accorded status. Staff require appropriate support, facilitation and strong leadership if these practices are to flourish.

Guidelines must be underpinned by compassion and empathy.

It is refreshing to read that the Leadership in Compassionate Care programme is benefiting from £1 million of funding from former nurse Ann Gloag (features September 12).

Compassion for keeps

A three-year programme in Scotland to encourage compassion in every aspect of nursing care drew to a close this summer. However, senior nurses are still involved in the Leadership in Compassionate Care programme, and are determined that its influence will continue to spread across the country.

Use of emotional touchpoints as a method of tapping into the experience of receiving compassionate care in a hospital setting

Improving the patient and family experience in hospital and supporting people to deliver compassionate dignified care is a priority on the policy agenda in the UK. The purpose of this paper is to describe our experiences of using the method of emotional touchpoints to learn about compassionate care in hospital settings. This work is part of the Leadership in Compassionate Care Programme which is using an action research approach to embed compassionate care in practice and education. Data were generated using the touchpoint method from 16 patients and 12 relatives from a range of care settings that included medicine for the elderly, older people’s mental health and a stroke unit. The benefits of using this approach include its ability to help practitioners to see in a more balanced way both the positive and negative aspects of an experience, and to help service users to take part in a meaningful and realistic way in developing the service. Significant learning arose from these stories that has directly influenced change on the wards. The changes have not only focused on practical solutions but have also provided a platform for discussing some of the more complex cultural aspects that contribute to the delivery of compassionate care.