RESUMEN
Purpose This paper aims to explore the impact of action learning (AL) on an individual and an organisation, particularly the process by which each affected the other. The organisation is a UK National Health Service (NHS) Trust that includes two hospitals. Design/methodology/approach This is a single person case study involving a clinician, but the voice of an author can also be heard. It involves the experience of the individual as they experience AL as part of a leadership development programme leading to a postgraduate certificate. The authors explain their caution of the case study approach and in doing so offer their thoughts in how this paper could be read and impact on practice. Findings The authors show a process whereby an AL set participant moves from being confident about their project to one of uncertainty as the impact of the project ripples throughout the organisation. Through this process of unsettlement, the individual's unnoticed assumptions are explored in ways that enable practical action to be taken. In doing so, the individual's leadership and identity developed. Research limitations/implications This is a single person case study in one organisation, thus affecting wider generalisation. Originality/value This single case study contributes to the debate on critical AL and the use of AL in the NHS.
Asunto(s)
Administración Hospitalaria , Relaciones Interpersonales , Aprendizaje Basado en Problemas , Inglaterra , Humanos , Liderazgo , Estudios de Casos Organizacionales , Medicina EstatalRESUMEN
Transformation in the structure and delivery of services for children and young people in the UK Children Act (Department for Education & Skills, 2004. The Children Act. London: HMSO) initiated new alliances between statutory, public and voluntary agencies. Traditional relationships and notions of partnership have been extended, necessitating an innovative approach to dialogue and multiple perspectives. Hudson's assertion that although the "rhetoric on partnering remains strong, the real policy thrust is now about choice and contestability" (2006, Journal of Integrated Care, 14(1), 13-21) exemplifies the dynamic policy context around notions of partnership and the rationale for collaborative advantage. This paper explores the experiences of practitioners working in a relatively new multi-agency context--the common assessment framework (CAF). Envisaged as a standardized approach to the assessment of need and as a tool to facilitate integrated working, the CAF is utilized by practitioners in the UK to improve outcomes for children and young people. We present data from a study that employed an interpretative phenomenological analysis approach and gathered semi-structured interviews with 20 practitioners. Interviews drew upon their experiences of interprofessional working in which diversity, partnership working, and competing aims and objectives emerged as significant themes. The insights that were gained are discussed in terms of their potential impact on service delivery in the UK and their contribution toward responsive practice across dynamic professional boundaries.
Asunto(s)
Actitud del Personal de Salud , Servicios de Salud del Niño/organización & administración , Relaciones Interprofesionales , Asociación entre el Sector Público-Privado/organización & administración , Agencias Voluntarias de Salud/organización & administración , Adulto , Niño , Servicios de Salud del Niño/legislación & jurisprudencia , Conducta Cooperativa , Femenino , Humanos , Relaciones Interinstitucionales , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Asociación entre el Sector Público-Privado/legislación & jurisprudencia , Investigación Cualitativa , Reino Unido , Agencias Voluntarias de Salud/legislación & jurisprudenciaRESUMEN
One of the key challenges for practitioners in present day health and social care has been responding effectively in the interprofessional teamwork setting, where collaboration is at the centre of professional activity. For whilst practitioners are expected to work interprofessionally there often remains limited attention to the actual process of interprofessional practice itself, within organizational strategy, local workforce development planning and individual continuing professional development. These concerns were a driver for this research with practitioners in the field of learning disability which resulted in the development of a conceptual framework for interprofessional practice. This paper sets out the process of conceptual framework development, underpinned by the concepts of knowledge of learning disabilities, contextual socialisation, empowerment, conflict management, transforming capability and interprofessional reflection on action. The researcher suggests that the framework may offer clinical leaders in learning disabilities and a range of other practice settings a tool to facilitate individual practitioner development, enabling as it does, the identification of a range of critical factors which impact on the outcomes of interprofessional practice intervention.
Asunto(s)
Relaciones Interprofesionales , Liderazgo , Discapacidades para el Aprendizaje , Enfermeras Clínicas/organización & administración , Grupo de Atención al Paciente/organización & administración , Apoyo Social , Servicio Social/organización & administración , Actitud del Personal de Salud , Conflicto Psicológico , Inglaterra , Conocimientos, Actitudes y Práctica en Salud , Humanos , Discapacidades para el Aprendizaje/terapia , Modelos de Enfermería , Modelos Organizacionales , Modelos Psicológicos , Enfermeras Clínicas/educación , Enfermeras Clínicas/psicología , Rol de la Enfermera , Investigación Metodológica en Enfermería , Poder Psicológico , Guías de Práctica Clínica como Asunto , Servicio Social/educación , Socialización , Encuestas y CuestionariosRESUMEN
Several decades of policy and service change in the field of learning disability have set in place new service boundaries in health and social care, leading to different working relationships for professionals based on interprofessional and interagency collaboration. However, economic pressures may result in agencies offering resource-led rather than needs-led services, resulting in fragmented services and tensions between professional groups faced with tough choices in order to meet the long-term needs of people with learning disabilities. One of the key roles of the registered learning disability nurse (RLDN) is that of facilitator in meeting the healthcare needs of people with learning disabilities, which involves interprofessional working across these new health and social care boundaries. The aim of this article is to present the findings from a small scale research study that was undertaken to explore the views of the RLDN group in relation to interprofessional practice in the long-term support of people with learning disabilities. Set within a grounded theory methodology, this article focuses on one element of the research study, which was a descriptive analysis of individual practitioners' experiences. In documenting the practitioners' accounts, the research begins to identify a series of key roles and significant practice knowledge held by those employed in learning disability nursing positions.
Asunto(s)
Actitud del Personal de Salud , Discapacidades para el Aprendizaje/enfermería , Enfermeras Clínicas/organización & administración , Enfermeras Clínicas/psicología , Rol de la Enfermera , Grupo de Atención al Paciente/organización & administración , Conflicto Psicológico , Interpretación Estadística de Datos , Inglaterra , Humanos , Relaciones Interprofesionales , Evaluación de Necesidades , Enfermeras Clínicas/educación , Investigación Metodológica en Enfermería , Defensa del Paciente , Poder Psicológico , Autoeficacia , Apoyo Social , Servicio Social/educación , Servicio Social/organización & administración , Encuestas y CuestionariosRESUMEN
In recent years a number of research studies have explored the role of key professionals in the field of learning disability. These have been predominantly large studies, nationally commissioned and offering a broad structural picture of the professionals' current function. This article explores a localized research study undertaken in the Avon, Gloucestershire and North Wiltshire area of the south-west of England. While acknowledging the national context in which both learning disability nurses (RN(LDs) and social workers operate, this study offers a more intimate insight into what form of future practitioner would be most effective. The qualitative research study included a series of topic-focused interviews and focus groups comprising professionals, people with learning disabilities, carers and representatives from the voluntary and independent sectors. Findings established that the desired future practitioner would maintain the specialist way of thinking of the RN(LD), together with the care management facilitation role of the social worker. For the research participants the optimal choice of practitioner was a dually qualified RN(LD)/social worker. Although the study was set in a particular locality, the researchers suggest that the outcomes both endorse and identify tensions in the proposed national developments for professional education, at a crucial point for the delivery and design of health and social care learning disability services.