RORY’s VALUES
Accreditation: concept or reality?
© 2014 MA Healthcare Ltd
I
f you want to answer a question you need to know what works. As nurses we all need a means to assure and ensure high quality nursing care that is safe, effective and patient/family centred at all times, therefore is a ‘ward/department assurance and/or ward/department accreditation’ approach just a concept or do we need to turn it into reality in order that we get consistency, structure and oversight? Increasingly there is an onus on healthcare, particularly nursing, to assure the quality of its provision. Many steps have been undertaken across all four countries through the evolution and implementation of the Quality Indicators Measures (Baskin et al, 2010; Leigh et al, 2005). For example, Complaints, Patient Safety Programmes, Leadership Development, Values, Patient Experiences, Person Centred Programmes, Culture to name but a few. Some NHS organisations locally have developed data reporting structures and ward/department nursing quality dashboards that are linked with staffing numbers on shift, tissue viability data, falls data, infection control data, complaints data, and more. While such developments are essential in improving the quality of care and experience of our patients and their families, there is still some concern relating to the assurance of care provision from ward/ department to board. A number of national reports have been critical of organisations as sometimes performance measures don’t reflect observed or experienced care. It is clear that there is little written in the professional literature regarding the development and use of ward/ department accreditation, however, much mentioned through a variety of NHS Foundation Trust Quality Accounts (Leigh et al, 2005), for example,Wexham Park, Central Manchester, Bolton, Imperial College University and Cambridge University Hospitals. The terms used within these organisations vary from ward/department assurance programmes to exemplar ward/department programmes. In essence, they cover areas such as patient safety, quality indicators, healthcare-associated infections, complaints, patient experience (incorporating privacy and dignity, patient and family/carer experiences, compassionate care, and effectiveness of care (incorporating clinical and patient reported outcome data, workforce data, mortality data). There is no doubt nurses at all levels from ward/ department to board are required to do the job with the correct support and supervision as set out by the Nursing and Midwifery Council (NMC) with accountability, responsibility and professionalism at all levels. Some NHS organisations have a system of peer review against set criteria citing that there is personal learning and transferable learning to be gained within
British Journal of Nursing, 2014, Vol 23, No 4
this model (Robson et al, 2013), while others identify a more distant approach through data interrogation. Morris (2012) describes a robust assessment process undertaken by one individual who has engagement with other key stakeholders but full engagement and ownership from the chief executive, executive directors and management and professional staff at all levels was crucial. Morris (2012) states that Salford Royal NHS Foundation Trust has implemented systems that support both the process and outcomes following assurance assessment and an internal accreditation processes. The Trust identified the significant impact the programme has had on the quality of patient care and experience. All nurses at ward/department must level remain visible and accessible in the ward/department to patients and their families and to each other, this principle is applied in different ways, e.g. handover approach, multidisciplinary team working, ward rounds, and nursing rounds at visiting times. Clinical leadership creates a culture where learning and development for research, evidence-based practice and listening to patients and their families is vital. The questions we as nurses need to answer for our patients and their families and our profession are: ■■ Does accreditation inspire and motivate our patients and our profession in providing and receiving care? ■■ Does accreditation enable our patients and our profession to understand we are getting it right? ■■ Does accreditation enable our patients and our profession to demonstrate our practice is safe, effective and person centred at all times? ■■ Does accreditation bring pride to our patients and our profession? While a large number of NHS organisations do not have a formal ward/department assurance or accreditation programmes there are several differing mechanisms for assuring care quality that all nurses should be familiar with. I would, however, encourage you all as nurses to ask the above questions with your patients, their families and your team. If the answer is yes to any one of these questions we must challenge ourselves to implement accreditation and ensure it makes a difference to our patients, their families, and BJN our teams.
Rory Farrelly NHS Greater Glasgow and Clyde Director of Nursing Acute Services Division
Baskind R, Kordowicz M, Chaplin R (2010) How does an accreditation programme drive improvement on acute inpatient mental health wards? An exploration of members’ views. J Ment Health 19(5): 405-11 Leigh JA, Douglas CH, Lee K, Douglas MR (2005) A case study of a preceptorship programme in an acute NHS Trust--using the European Foundation for Quality Management tool to support clinical practice development. J Nurs Manag 13(6): 508-18 Morris F (2012) Assessment and accreditation system improves patient safety. Nurs Manag 19(7): 29-33 Robson S et al (2013) The Clinical Area Safety Assessment, a Peer Review of Safety across an Acute Trust. Journal of Hospital Administration 2(2):27–37
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British Journal of Nursing. Downloaded from magonlinelibrary.com by 165.123.034.086 on December 3, 2015. For personal use only. No other uses without permission. . All rights reserved.
Accreditation: concept or reality?
© 2014 MA Healthcare Ltd
I
f you want to answer a question you need to know what works. As nurses we all need a means to assure and ensure high quality nursing care that is safe, effective and patient/family centred at all times, therefore is a ‘ward/department assurance and/or ward/department accreditation’ approach just a concept or do we need to turn it into reality in order that we get consistency, structure and oversight? Increasingly there is an onus on healthcare, particularly nursing, to assure the quality of its provision. Many steps have been undertaken across all four countries through the evolution and implementation of the Quality Indicators Measures (Baskin et al, 2010; Leigh et al, 2005). For example, Complaints, Patient Safety Programmes, Leadership Development, Values, Patient Experiences, Person Centred Programmes, Culture to name but a few. Some NHS organisations locally have developed data reporting structures and ward/department nursing quality dashboards that are linked with staffing numbers on shift, tissue viability data, falls data, infection control data, complaints data, and more. While such developments are essential in improving the quality of care and experience of our patients and their families, there is still some concern relating to the assurance of care provision from ward/ department to board. A number of national reports have been critical of organisations as sometimes performance measures don’t reflect observed or experienced care. It is clear that there is little written in the professional literature regarding the development and use of ward/ department accreditation, however, much mentioned through a variety of NHS Foundation Trust Quality Accounts (Leigh et al, 2005), for example,Wexham Park, Central Manchester, Bolton, Imperial College University and Cambridge University Hospitals. The terms used within these organisations vary from ward/department assurance programmes to exemplar ward/department programmes. In essence, they cover areas such as patient safety, quality indicators, healthcare-associated infections, complaints, patient experience (incorporating privacy and dignity, patient and family/carer experiences, compassionate care, and effectiveness of care (incorporating clinical and patient reported outcome data, workforce data, mortality data). There is no doubt nurses at all levels from ward/ department to board are required to do the job with the correct support and supervision as set out by the Nursing and Midwifery Council (NMC) with accountability, responsibility and professionalism at all levels. Some NHS organisations have a system of peer review against set criteria citing that there is personal learning and transferable learning to be gained within
British Journal of Nursing, 2014, Vol 23, No 4
this model (Robson et al, 2013), while others identify a more distant approach through data interrogation. Morris (2012) describes a robust assessment process undertaken by one individual who has engagement with other key stakeholders but full engagement and ownership from the chief executive, executive directors and management and professional staff at all levels was crucial. Morris (2012) states that Salford Royal NHS Foundation Trust has implemented systems that support both the process and outcomes following assurance assessment and an internal accreditation processes. The Trust identified the significant impact the programme has had on the quality of patient care and experience. All nurses at ward/department must level remain visible and accessible in the ward/department to patients and their families and to each other, this principle is applied in different ways, e.g. handover approach, multidisciplinary team working, ward rounds, and nursing rounds at visiting times. Clinical leadership creates a culture where learning and development for research, evidence-based practice and listening to patients and their families is vital. The questions we as nurses need to answer for our patients and their families and our profession are: ■■ Does accreditation inspire and motivate our patients and our profession in providing and receiving care? ■■ Does accreditation enable our patients and our profession to understand we are getting it right? ■■ Does accreditation enable our patients and our profession to demonstrate our practice is safe, effective and person centred at all times? ■■ Does accreditation bring pride to our patients and our profession? While a large number of NHS organisations do not have a formal ward/department assurance or accreditation programmes there are several differing mechanisms for assuring care quality that all nurses should be familiar with. I would, however, encourage you all as nurses to ask the above questions with your patients, their families and your team. If the answer is yes to any one of these questions we must challenge ourselves to implement accreditation and ensure it makes a difference to our patients, their families, and BJN our teams.
Rory Farrelly NHS Greater Glasgow and Clyde Director of Nursing Acute Services Division
Baskind R, Kordowicz M, Chaplin R (2010) How does an accreditation programme drive improvement on acute inpatient mental health wards? An exploration of members’ views. J Ment Health 19(5): 405-11 Leigh JA, Douglas CH, Lee K, Douglas MR (2005) A case study of a preceptorship programme in an acute NHS Trust--using the European Foundation for Quality Management tool to support clinical practice development. J Nurs Manag 13(6): 508-18 Morris F (2012) Assessment and accreditation system improves patient safety. Nurs Manag 19(7): 29-33 Robson S et al (2013) The Clinical Area Safety Assessment, a Peer Review of Safety across an Acute Trust. Journal of Hospital Administration 2(2):27–37
245
British Journal of Nursing. Downloaded from magonlinelibrary.com by 165.123.034.086 on December 3, 2015. For personal use only. No other uses without permission. . All rights reserved.
