Research, Development & Innovation, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
Warwick Medical School (WMS), The University of Warwick, Warwick, UK.
BMJ Open. 2019 Jul 24;9(7):e030679. doi: 10.1136/bmjopen-2019-030679.
Patient and staff experiences are strongly influenced by attitudes and behaviours, and provide important insights into care quality. Patient and staff feedback could be used more effectively to enhance behaviours and improve care through systematic integration with techniques for reflective learning. We aim to develop a reflective learning framework and toolkit for healthcare staff to improve patient, family and staff experience.
METHODS & ANALYSIS: Local project teams including staff and patients from the acute medical units (AMUs) and intensive care units (ICUs) of three National Health Service trusts will implement two experience surveys derived from existing instruments: a continuous patient and relative survey and an annual staff survey. Survey data will be supplemented by ethnographic interviews and observations in the workplace to evaluate barriers to and facilitators of reflective learning. Using facilitated iterative co-design, local project teams will supplement survey data with their experiences of healthcare to identify events, actions, activities and interventions which promote personal insight and empathy through reflective learning. Outputs will be collated by the central project team to develop a reflective learning framework and toolkit which will be fed back to the local groups for review, refinement and piloting. The development process will be mapped to a conceptual theory of reflective learning which combines psychological and pedagogical theories of learning, alongside theories of behaviour change based on capability, opportunity and motivation influencing behaviour. The output will be a locally-adaptable workplace-based toolkit providing guidance on using reflective learning to incorporate patient and staff experience in routine clinical activities.
ETHICS & DISSEMINATION: The PEARL project has received ethics approval from the London Brent Research Ethics Committee (REC Ref 16/LO/224). We propose a national cluster randomised step-wedge trial of the toolkit developed for large-scale evaluation of impact on patient outcomes.
患者和员工的体验深受态度和行为的影响，为了解护理质量提供了重要的见解。患者和员工的反馈可以通过与反思性学习技术的系统整合，更有效地用于增强行为和改善护理。我们旨在为医护人员开发一个反思性学习框架和工具包，以改善患者、家属和员工的体验。
包括来自三个国民保健服务信托基金的急性医学病房（AMU）和重症监护病房（ICU）的员工和患者在内的当地项目团队将实施两项源自现有工具的体验调查：一项是连续的患者和亲属调查，一项是年度员工调查。调查数据将辅以工作场所的民族志访谈和观察，以评估反思性学习的障碍和促进因素。当地项目团队将利用便利的迭代共同设计，用他们的医疗保健经验补充调查数据，以确定通过反思性学习促进个人洞察力和同理心的事件、行动、活动和干预措施。中央项目团队将整理这些产出，以开发一个反思性学习框架和工具包，并将其反馈给当地团队进行审查、改进和试点。该开发过程将映射到一个反思性学习的概念理论，该理论结合了学习的心理和教学理论，以及基于能力、机会和动机影响行为的行为改变理论。该成果将是一个适用于当地环境的基于工作场所的工具包，提供关于如何将患者和员工体验纳入常规临床活动的反思性学习指南。
PEARL 项目已获得伦敦布伦特伦理委员会的伦理批准（REC 参考号 16/LO/224）。我们提出了一项针对该工具包的全国性群组随机阶梯式试验，该工具包是为大规模评估对患者结果的影响而开发的。
