Humanising Services: A new transferable leadership strategy for improving ‘what matters to older people’ to enhance dignity in care
Authors: Galvin, K., Cowdell, F., Sloan, C., Pound, C., Ellis-Hill, C., Errser, S. and Watson, R.
Publisher: Burdett Trust for NursingAbstract:
Executive Summary Background: The research was led by academics at the University of Hull (Kathleen Galvin, overall Chief Investigator (CI)) and Fiona Cowdell, local Principle Investigator (PI) and Bournemouth University (Caroline Ellis-Hill, local Principle Investigator (PI)). Within two purposively selected diverse care settings, a dermatology out-patient clinic in Hull and a stroke rehabilitation unit in Bournemouth, a tripartite humanising team comprised of older service users, healthcare staff including nurses and academics have engaged in a ‘humanising improvement’ process, with the aim of developing a transferable strategy for improving ‘what matters to people’ in order to support enhancements of dignity in care. Aim: Eight humanising theory-led action research sessions were conducted in each location over the period of one year with the aim of answering the following question: What are the transferable benefits of a new participatory leadership strategy for improving the human dimensions of human services? Project stages: In the first stage of the study both groups, facilitated by academic partners, learned about a new humanisation theory (Galvin & Todres, 2012) and explored the eight humanising dimensions (Todres et al., 2010), relating them to their own experiences of humanisation and dehumanisation in each setting which created new understandings and insights relevant to each setting. During the second stage, group members carried out a humanised care assessment of the setting, drawing on each group member’s experience of practice in their setting. This stage involved listening to and collecting examples of both humanising and dehumanising practices and then deciding how to take a humanising approach forward. An explicit theory application strategy was used in Hull, and an implicit strategy using ‘Appreciative inquiry at Bournemouth. Both are compared in a cross site comparison of the application of the theory to improve what matters to older people. The third stage focused on implementation of actions that would enhanced care practices that focus on the human dimensions of care and development of transferable strategies for other care settings beyond the life of the project. A humanised care plan within each setting was initiated and dissemination materials and activities were created and engaged in with the purpose of sharing and transferring the study experience of the group participants to other health care staff in the setting. Outcomes: As had been anticipated, differences in the locations, contexts, health conditions experienced and needs of the service users as well as the approaches taken by the two humanising improvement action research teams produced interesting contrasts in both processes and outcomes. In both instances group members were actively engaged in application of the humanisation framework, led by patients’ own experiences and journeys, which enabled them to participate in decision-making about enhancing care in humanising terms. A transferable leadership strategy is offered in the form of a suite of materials developed as part of the project, including a humanising care toolkit, DVD film of team project experience with each teams humanising journey and a humanising care assessment tool in the form of a validated questionnaire. These were developed with transferability in mind to be utilized in future dissemination and to help develop and extend the life, reach and applicability of the work. Of particular note is our aim to offer a transferable leadership strategy through this suite of materials: ‘Humanising Toolkit’ and the production of the ‘Humanised Care Assessment Tool’.
Transferable outcomes from this project are intended to enhance impacts on practice and educational curricula. The overall strategy used included engaging diverse service user groups within in-patient and out-patient health service and service providers in order to ensure benefits would be transferred widely. The present report details the processes and outcomes of the project, provides a Toolkit that includes a process guidebook and film (DVD) aimed at sharing humanising care improvements and indicating transferable steps that can be employed. The development of the Humanised Care Assessment tool and piloting are described in detail with suggestions for its use. The project has culminated in two service user led dissemination events and development and piloting of a humanising care assessment tool in the form of a questionnaire. The findings and outcomes contribute to pathways and directions for practice in enhancing dignity in care.