The Big Conversation about the Quality of Nursing ... - CLAHRC-NDL

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Plenary Delegates were reminded that the event was about engagement and a need to „bottle up‟ their approach. Even if one ward is „cracked‟ the approach doesn‟t transfer, it‟s about making it known and understanding how to share best practice and which forums to use for doing so. Practice doesn‟t necessarily transfer, but talking to each other helps, asking for the reality in practice, sharing the bad and the good. It‟s similar to the end of a project, reflecting so people can see the process. Patients also need to understand the process and then it isn‟t so stressful. A key issue is helping and empowering each other and being aware that change isn‟t for its own sake. During this session the board answered questions and at times it was only a 2 way discussion and not enough space for debate across the tables. Key Points Work collaboratively Get the basics right Manage expectations, some systems don‟t fit with modern life Give change a chance Don‟t give up on a bad idea Everything involves communication Understanding different systems and therefore expectations We need continuous improvement, communities of practice We find it hard to share, if we can crack this then it would be really good. The board were asked about the future and what „spin‟ would be put onto care. Delegates were told we must learn from ideas such as AQP and not just implement blanket reform, for example as in Derbyshire Choices. We may have to change the way some people work, as the hospital does not „wake-up‟ until 8:30am. Another new idea is the elderly care pathway. The board were asked how can we feed into this and delegates were told that we must get it right as we develop. The stress of the workload was highlighted which was linked to not achieving the fundamentals and compromising the integrity of the nurse. It was asked, is the nurse going under? It was stated that we should monitor, measure and report the problem using nurse sensitive indicators. 22
Delegates from learning disability teams informed delegates of the work they had been doing and it was recommended that they try to get publishes so that their best practice could move beyond Derbyshire. Key Points We need to care for each other We should celebrate success Be patient focused Continuous sharing of good practice No blame culture Positive learning environment (focus on organizational to value professional requirements for PREP and clinical supervision) Nurse directors have a responsibility for variability in care but poor care is usually not deliberate We need a just and fair culture We should all ask would I want this for my VIP? Delegates were asked to save 3 points that were raised so it isn‟t just talking but also doing something about it. Examples of 3 learning points 1. The patient experience is a welcome focus as the patient has often been unheard 2. Focus on the ordinary, invest and empower HCA‟s 3. Listen to the voice of the frontline nurse, ward to ward e.g. back to floor 1. Clear focus on priorities 2. Revisiting the basics, better access to care 3. Education and training at board level. Dame Elizabeth Fradd asked the delegates to listen carefully to one another, as they were doing fantastic things. She urged them to hold onto what they are doing and what you know is good. She asked them to put their heads above the parapet where needed and have a courageous discussion. 23
Page 1 and 2: The Big Conversation Tit about the
Page 3 and 4: About the author Bridget Roe is a d
Page 5 and 6: Acknowledgements The author is grat
Page 7 and 8: Executive Summary Background This m
Page 9 and 10: which were complimented by groups s
Page 11 and 12: someone noted, develop an “NHS Sp
Page 13 and 14: Feedback Around 50% of delegates fi
Page 15 and 16: Report of the Day’s proceedings T
Page 17 and 18: 11. Variable quality of monitoring/
Page 19 and 20: 2. Delegate: Are things worse? DEF:
Page 21: often do not take responsibility an
Page 25: About CLAHRC-NDL The Collaboration

The Big Conversation about the Quality of Nursing ... - CLAHRC-NDL

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