Assessing contextual readiness: the first step towards maternity transformation.

Background: Health policy endorses best practice in maternity services as the quality triad of personcentred, safe and effective care. However, repeated inquiries into the quality of maternity services continue to identify concerns about culture, leadership and teamwork. Therefore support is needed...

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Publicado en:International Practice Development Journal Vol. 9; no. 2; pp. 1 - 21
Autores principales: Crowe, Ciaran, Manley, Kim
Formato: research tables/charts Journal Article
Publicado: Foundation of Nursing Studies Nov2019
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Nov2019
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      pub: Foundation of Nursing Studies
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        atl: Assessing contextual readiness: the first step towards maternity transformation.
      aug:
        au:
          Crowe, Ciaran
          Manley, Kim
        affil: (MBBS, MRCOG, FAcadMEd), Visiting Scholar, England Centre for Practice Development, Canterbury Christ Church University, Kent, England
      sug:
        subj:
          Maternal Health Services England
          Quality Improvement
          Professional Development
          England
          Implementation Science
          Patient Centered Care
          Conceptual Framework
          Collaboration
          Maternal-Child Care
          Intensive Care Units, Neonatal
          Thematic Analysis
          Language
          Leadership
          Learning
          Human
      ab: Background: Health policy endorses best practice in maternity services as the quality triad of personcentred, safe and effective care. However, repeated inquiries into the quality of maternity services continue to identify concerns about culture, leadership and teamwork. Therefore support is needed to implement best practice. The Promoting Action on Research Implementation in Health Services framework (PARiHS) has the potential to inform the implementation of quality through an initial exploration of contextual readiness. Aims and objectives: This paper describes the first phase of a quality transformation programme in a maternity service in England. It aims to assess the service's context, using the PARiHS framework to identify enabling factors to guide the implementation of best practice. Methods: Collaborative and participative analysis, underpinned by practice development methodology, used reflective insights from diary entries and meeting notes, combined with analysis of national data, local metrics and a staff culture survey. Inductive themes generated were mapped to the 'context' elements of PARiHS to assess contextual readiness. Results: Four themes emerged: language, leadership, learning and variability. Context mapping, showed low levels of leadership and culture and a medium level for evaluation. 'Learning' underpinned each contextual element and was described as: 1) a shared value needed for high-functioning learning cultures; 2) an attribute of collective leadership; and 3) key to evaluating what matters to women using the service and staff. the service and staff. Conclusion: The PARiHS framework can help maternity services consider their contextual readiness to implement best practice. Assessing readiness is essential to prepare for successful transformation. Learning is the cornerstone of person-centred, safe and effective maternity care. Implications for practice: • Using the PARiHS framework helps maternity services consider their contextual readiness to implement best practice • Leadership development and quality improvement knowledge are essential in helping maternity services to implement the quality triad of person-centred, safe and effective care • Collective learning in organisations influences teamwork, leadership and evaluation to reduce the occurrence of safety-related incidents • Maternity providers should be encouraged to see women as assets for collaborative learning.
      pubtype: Academic Journal
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    language: English
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