This project involved developing a research framework to underpin the Productive Ward Programme (PWP), one of a series of initiatives from the NHS Institute for Innovation and Improvement designed to improve care and its organisation across a range of NHS services. The PWP project offers a pathway for improving the delivery of ward-based care and empowering staff to be more productive.
Details of my Fellowship, Debbie Kelly, August 2009
Phase two of the East of England NHS Productive Ward evaluation began in September. This included conducting key stakeholder interviews with NHS staff who have been involved with Productive Ward at a strategic level, and conducting three organisational case studies in trusts within the region. Unfortunately time does not allow for more trusts to be selected.
However data from all trust (n=36) monthly returns will be drawn on to inform the analysis and provide a broader context within which to draw conclusions and offer recommendations for the future of this work.
Three trusts were selected to take part in a more in-depth review of the impact of the Productive Ward. They have been chosen based on the following criteria:
- Timing of adoption of the programme (the programme will have been running for at least six months, in more than one ward and will have completed two or more modules)
- Foundation or non-foundation trust status
- Rural or urban location
- Geographical representation across the East of England
These criteria will enable comparisons to be made and provide a wide range of views about adopting and implementing the Productive Ward Programme. The case studies consist of interviews with a broad range of both frontline and senior trust staff with a hands-on and strategic role in the Programme.
Each case study site provided a unique insight into each trust’s ‘real-world’ experience of implementing the Productive Ward. Data collection are now complete and analysis and report writing is underway. A final report is due to be delivered to the organisation in January 2010.
The findings from the evaluation will be used to gain a better understanding of key drivers for successful implementation and sustainability, and how different approaches to implementation and organisational factors appear to influence success of the Programme in each trust.
The findings will also be useful in sharing best practice on how the Productive Ward can be spread and sustained across the region. This may be especially important as more Productive products, such as Productive Operating Theatre and Productive Community Services, are introduced and taken up over the next year.
It has been interesting and challenging to work alongside lead nurses and policy leads within the nursing directorate of NHS East of England. I have learnt a great deal about how an SHA operates at a strategic level across a region to affect the health economy it covers. It has been a unique experience for me and one from which I have learnt a lot.
Reflections on my Fellowship, Debbie Kelly, June 2010
The original purpose of my placement at NHS East of England was to do some evaluative work to develop research questions which would underpin a knowledge base for the effectiveness of a new service improvement initiative within the NHS known as Releasing Time to Care: Productive Ward, developed by the NHS Institute for Improvement and Innovation.
However once I was in post it became clear the brief had changed; the Productive Ward initiative was now up and running and what was now required was a full-blown service evaluation to inform the SHA’s future strategic planning. On reflection such a task was probably too great for one person who only had one year on the placement in which to deliver it.
Nevertheless an evaluation was what was required and an evaluation was what I would deliver. Due to time restraints, the evaluation was smaller than I would have liked, only three case study sites were involved, although various data was analysed from a wide range of trusts across the East of England.
I was able to attend meetings on the topic I was researching, meet people who were closely involved in the work and visit several trusts rolling out the initiative – one of which was outside the East of England region but had been a pilot site for the project in its initial stages and considered an exemplar in good practice for Productive Ward nationally.
Again I was able to reflect on how fortunate I was to have this level and amount of insight into one programme of service delivery, and see at first hand some of the impact the Programme could have on patient safety, experience and workforce development.
There were a number of benefits to me personally from the fellowship experience, namely:
- Experience of working within a public sector organisation and seeing what knowledge I could transfer from the academic to the public sector - initially this did not seem obvious but was reflected back to me by my colleagues during the placement.
- A wonderful opportunity to see how an SHA works, what systems are used and how it delivers policy and assesses effectiveness.
- The opportunity to develop knowledge around the theory and practice which underpins NHS service improvement initiatives and to see if my research skills where sufficient to evaluating one – I’m not convinced they were!
One final reflection is that the whole experience – working in a different environment, location, part of the public sector and learning from colleagues with different professional backgrounds, skills and knowledge bases provided a stimulating, sometimes arduous, but ultimately rewarding working year, one which will certainly stay with me for years to come.
Deborah Kelly
Deborah Kelly is a Research Advisor and Patient and Public Involvement Lead at the NIHR East of England Research Design Service (RDS), School of Medicine, Health Policy and Practice University Of East Anglia, Norwich.