Leadership in Compassionate Care: Final Report 2012

This report reflects the initiation, planning, running and the important outcomes emerging from the Leadership in Compassionate Care Programme. The team worked in close partnership across the School of Nursing, Midwifery and Social Care, Edinburgh Napier University and NHS Lothian. This report also shares the highlights, challenges and solutions to embed compassionate care education and nursing practice.Additional co-authors: Fiona Smith, Stephen DM Smith, Ria Tocher, and Anne Waug

Teaching and assessing compassionate care in pre-registration nurse education

Background Compassionate care is considered to be fundamental to nursing practice (Scottish Executive Health Department 2006; Scottish Government Health Department 2007).Therefore embedding relationship-centred compassionate nursing practice within the nursing and midwifery programme at Edinburgh Napier University is a priority of The Leadership in Compassionate Care Programme (LCCP). The programme is a joint venture between Edinburgh Napier and NHS Lothian and is using action research to take forward developments in education and practice. Part of this has involved gathering patient, relative, staff and student stories which have provided valuable insight into their experiences. Key themes emerged from both the stories and other observational data gathered within practice, and these themes were used to reshape teaching and assessment within a module that uses simulation to teach recognition of acute illness and deterioration, so that compassionate caring attributes were made more explicit and assessed What we did We invited a range of participants, including lecturers, senior nurses in compassionate care, students and charge nurses to participate in an action meeting that would explore key compassionate elements that needed to be integrated into the module. The participants reflected on what matters to patients and families in the acute admission to hospital, key elements that nurses need to consider, and how care provision during this acute time can be not only safe and effective, but also compassionate. We examined this in the context of the teaching and assessment materials already in use for this module including patient scenarios. We then took steps to make compassionate care explicit within the online teaching materials. Selected patient, relative, staff and student stories that linked with the online topics of study were released for students on a dedicated module podcast site, and quotations taken from the stories were embedded within the units of study. Both of these activities were used to encourage reflection around aspects of compassionate care. The students were encouraged to consider the meaning of compassionate care, what matters to patients and relatives and how they can use this knowledge to influence their caring practice. Aspects of compassionate care were also made more explicit within the practical teaching. One way that this was achieved was through working with actor patients, who questioned students on what they were doing. For example when students placed a probe on the actors finger with no explanation, or when the students used medical jargon, the actors asked the students what they were doing and what they meant. They also provided cues for the students through for example, what they were wearing, in order to encourage the students to “make a connection” with their patient (one of the key themes that emerged from the LCCP). Aspects of compassionate care were also included in both the practical and written assessments.

Relationship centred outcomes focused on compassionate care for older people within in-patient care settings: Relationship centred compassionate care

This paper describes outcomes from research titled Leadership in Compassionate Care. The research adopts a participatory action research approach, utilizing appreciative inquiry and relationship centred care. Outcomes of the research are based upon relationships between patients, families and staff. This paper focuses on in-patient care for older people. A range of data generation activities were undertaken including: observation, interviews using emotional touch points and reflective accounts. To highlight outcomes in compassionate care, this paper uses case studies from two participating services. Principles of compassionate care were derived from understanding experiences of patients, relatives and staff and initiating responsive action projects. The aim was to enhance the experience of relationship centred, compassionate care. The process of emotional touch points enabled a richer understanding of experience. In terms of outcomes for patients this involved, enhanced quality of time spent with family and opening up conversations between families and staff. Outcomes for families involved enhanced access to relevant information and the opportunity to make sense of their situation. Staff outcomes were gaining experience in working alongside family to co-create the service, enhanced understanding of the experiences of patients and relatives led to direct changes in individual and team practice

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

Leadership in Compassionate Care: Executive Summary- Enhancing patient care by promoting compassionate practice.

The Leadership in Compassionate CareProgramme (LCCP) commenced in 2007 as athree year programme of work. Initial fundingwas received from a private benefactorand the two organisations involved in theprogramme (NHS Lothian and EdinburghNapier University) were required to matchthis funding. The work of the programmedeveloped beyond the initial funding. ALead Nurse and four Senior Nurses wereappointed to deliver the programme and awide range of staff from both organisationswere actively involved and participated withthis team. The impetus for this programmearose from local and National concernsabout care focussed on patients and theirrelatives experiencing a lack of empathyand compassion, acknowledging that it isoften small acts of kindness and a humanconnection, alongside clinical competencethat is appreciated by patients and relative

Leadership in Compassionate Care: Executive Summary- Enhancing patient care by promoting compassionate practice.

The Leadership in Compassionate CareProgramme (LCCP) commenced in 2007 as athree year programme of work. Initial fundingwas received from a private benefactorand the two organisations involved in theprogramme (NHS Lothian and EdinburghNapier University) were required to matchthis funding. The work of the programmedeveloped beyond the initial funding. ALead Nurse and four Senior Nurses wereappointed to deliver the programme and awide range of staff from both organisationswere actively involved and participated withthis team. The impetus for this programmearose from local and National concernsabout care focussed on patients and theirrelatives experiencing a lack of empathyand compassion, acknowledging that it isoften small acts of kindness and a humanconnection, alongside clinical competencethat is appreciated by patients and relative