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共同制定转变以人为本文化的策略。

Co-creating a strategy for transforming person centred cultures.

作者信息

Tuqiri Karen, Murray Suzanne, Shaw Dan, Hackett Kate, McCance Tanya

机构信息

Nursing & Midwifery, South Eastern Syndey Local Health District, Sydney, NSW, Australia.

Prince of Wales Hospital, University of Technology, Sydney, NSW, Australia.

出版信息

Front Health Serv. 2025 Jun 4;5:1574632. doi: 10.3389/frhs.2025.1574632. eCollection 2025.

DOI:10.3389/frhs.2025.1574632
PMID:40535203
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12175153/
Abstract

INTRODUCTION

Transforming healthcare systems to support person-centred practice reflects environments where individual values and beliefs are respected and where healthful cultures can flourish. However, there are significant challenges within healthcare systems that impact on the development of healthful workplace cultures. The nursing and midwifery professions need to play an influential role in formulating health policy and decision-making to contribute to health and social care systems that are underpinned by person-centredness. This paper reports the use of a practice development approach underpinned by the Person-Centred Practice Framework to co-create a strategy for nurses and midwives that will enable the development of person-centred healthcare practices. The key objectives are to demonstrate the processes that support co-creation to build consensus on what is strategically important to nurses and midwives; to gain an understanding of the value of external facilitation throughout the process and exploring the challenges encountered during the development of the strategy.

METHODS

Practice Development methodology was the approach used with skilled facilitation adopted to enable the working with values and beliefs, defining purpose and vision and establishing agreed working principles and behaviours. Consensus building methods were used to co-create draft strategy priorities further defined by wider stakeholder engagement.

RESULTS

A 5-year strategy was co-created with senior nursing and midwifery leaders, inclusive of key strategic priority areas and strategic actions. The seven priority areas align to the Person-Centred Practice Framework with underpinning shared purpose and values. (1) Developing Person-Centred Cultures, (2) Creating a Supportive Practice Environment, (3) Building Research Capacity, (4) Building a Dynamic Workforce, (5) Fostering Leadership at all Levels, (6) Enhancing Digital Informatics and New Technologies, (7) Delivering High Quality, (8) Safe Person-Centred Care. Together they provide a roadmap for implementation across the many nursing and midwifery contexts providing a solid foundation for leading and supporting person-centred practice across a large local health district with a focus on what matters most while continuing to be innovative in approaches to practice. The development of a clear shared purpose of person-centred practice and the exploration of values were critical first steps in the development of the strategy and provided a clear foundation from which the nursing and midwifery leaders could utilise for the ongoing strategic priorities and action discussions.

IMPLICATIONS FOR PRACTICE

The development of nursing and midwifery strategy using Practice Development Methodology and the Person-centred Practice Framework enables critical dialogue that supports nursing and midwifery leaders identify key influences over nursing and midwifery practice. This approach not only fosters a sense of ownership and engagement among nurses and midwives but also ensures that their values, beliefs, and professional insights are integral to the strategic direction of healthcare practices. By aligning the strategy with the Person-Centred Practice Framework, nurses and midwives are better able to develop a shared understanding of person-centred practice where the individual needs and preferences of patients, families and staff are acknowledged. Overall, this strategy represents a significant step forward in supporting the professional development of nurses and midwives, enhancing the quality of patient care, and fostering a healthful culture where continuous improvement and innovation are at the forefront of the healthcare system.

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b62/12175153/05a438e3f30b/frhs-05-1574632-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b62/12175153/db0a8eb4085c/frhs-05-1574632-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b62/12175153/a948b910a4f5/frhs-05-1574632-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b62/12175153/5c2c385a9f14/frhs-05-1574632-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b62/12175153/05a438e3f30b/frhs-05-1574632-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b62/12175153/db0a8eb4085c/frhs-05-1574632-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b62/12175153/a948b910a4f5/frhs-05-1574632-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b62/12175153/5c2c385a9f14/frhs-05-1574632-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b62/12175153/05a438e3f30b/frhs-05-1574632-g004.jpg
摘要

引言

转变医疗保健系统以支持以人为本的实践反映了这样的环境,即个人价值观和信念受到尊重,有益健康的文化能够蓬勃发展。然而,医疗保健系统内部存在重大挑战,影响着有益健康的工作场所文化的发展。护理和助产专业需要在制定卫生政策和决策中发挥有影响力的作用,以促进以人为本的卫生和社会护理系统的发展。本文报告了一种以以人为本的实践框架为基础的实践发展方法的应用,该方法用于共同制定一项针对护士和助产士的战略,以促进以人为本的医疗保健实践的发展。关键目标是展示支持共同创造的过程,以就对护士和助产士具有战略重要性的事项达成共识;了解外部促进在整个过程中的价值,并探索战略制定过程中遇到的挑战。

方法

采用实践发展方法,并运用熟练的促进手段,以处理价值观和信念、界定目的和愿景以及确立商定的工作原则和行为。采用建立共识的方法共同制定战略优先事项草案,并通过更广泛的利益相关者参与进一步明确。

结果

与高级护理和助产领导共同制定了一项为期5年的战略,包括关键的战略优先领域和战略行动。这七个优先领域与以人为本的实践框架相一致,具有共同的目的和价值观基础。(1)发展以人为本的文化,(2)营造支持性的实践环境,(3)建设研究能力,(4)打造充满活力的劳动力队伍,(5)培养各级领导力,(6)加强数字信息学和新技术,(7)提供高质量、(8)安全的以人为本的护理。它们共同为在众多护理和助产环境中实施提供了路线图,为在一个大型地方卫生区引领和支持以人为本的实践奠定了坚实基础,重点关注最重要的事项,同时在实践方法上继续创新。明确以人为本实践的共同目的以及探索价值观是战略制定的关键第一步,为护理和助产领导进行持续的战略优先事项和行动讨论提供了明确的基础。

对实践的启示

运用实践发展方法和以人为本的实践框架制定护理和助产战略,能够进行关键对话,支持护理和助产领导确定对护理和助产实践的关键影响因素。这种方法不仅能培养护士和助产士的主人翁意识和参与感,还能确保他们的价值观、信念和专业见解融入医疗保健实践的战略方向。通过使战略与以人为本的实践框架保持一致,护士和助产士能够更好地形成对以人为本实践的共同理解,承认患者、家庭和工作人员的个人需求和偏好。总体而言,该战略在支持护士和助产士的专业发展、提高患者护理质量以及培育一种将持续改进和创新置于医疗保健系统前沿的健康文化方面迈出了重要一步。

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