The Implementation of a Model of Person-Centred Practice In Older ...

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The implementation of a model of person-centred practice in older person settings corporate level). Currently, as other programmes show, successful practice development work seems to present a challenge to organisations to carry on with the approaches and processes that have been introduced. In regard to this programme some of that challenge will now sit with the NMPDU Directors and how they demonstrate their leadership in taking forward practice development in their areas. As Bevan (2010) argues bringing in or buying in external project leads and consultants does not ‘hard wire’ or embed change into practice. Instead ‘inside out’ change creates the capability and builds up sustainable improvements in quality and costs. In the current economic climate, HEIs and NMPDUs will need to work more and more on this principle. 7. Effective practice development requires the adoption of three key methodological principles – collaboration, inclusion and participation. This principle has already been discussed in other parts of this section. In part it is achieved by making use of the methods set out in earlier principles These processes are in many ways a cumulative and simplified statement of the process of engagement which is in turn central to enlightenment, empowerment and emancipation. Enlightenment requires inclusion. Individuals need to be emotionally connected with others and the environment around them to perceive and experience things differently. Empowerment requires inclusion and participation rather than acting on self-interest. This enables the generation of latent or untapped energy and the establishment of different types of relationships which will fuel changes in work practices. Finally emancipation requires collaboration as this is the pinnacle of social and collective action. This programme has helped clarify the ways in which different stakeholders can adopt these principles. However further research is needed to know more about which interventions in each attribute are essential. 8. There are a number of methods that are effective in ensuring participatory engagement and in bringing about changes in the culture and context of practice. These are: • Agreeing ethical processes • Analysing stakeholder roles and ways of engaging stakeholders • Person-centredness 181
The implementation of a model of person-centred practice in older person settings • Clarifying the development focus • Clarifying values • Clarifying workplace culture • Collaborative working relationships • Continuous reflective learning • Developing a shared vision • Developing critical intent • Developing participatory engagement • Developing shared ownership • Developing a reward system • Evaluation • Facilitating transitions • Generating new knowledge • Giving space for ideas to flourish • Good communication strategies • Implementing processes for sharing and disseminating • High challenge and high support • Knowing ‘self’ and participants • Use of existing knowledge What the programme did with varying degrees of success was to contextualise these methods across the sites. Effective practice developers maintain a critical dialogue between method and context (and available facilitator expertise). Thus assessment and evaluation of context and culture in practice development is essential. Hence this programme introduced the CAI and WCCAT tools. The organisation now needs to establish how to carry on working with these or similar tools. A huge success has been the Active Learning method. This has enabled development of the methodology and a contribution to practice development knowledge. However, this needs to be balanced with the challenges participants associated with reflection on practice and how much energy and resilience was needed by participants to influence colleagues. Only a minority of sites made significant progress in producing evidence of incorporating structured reflection into their programme days. Other active learning methods did help develop other forms of reflection skills. It may be clearer from this programme that attending to and promoting reflection, even critical reflection as the main source of learning in PD is 182
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