bluuebunny/crossref_metadata_2025_split huggingface dataset:
The responsive needs tool – unlocking communication of end of life care needs
Authors: Johnson Bronia , Ball Barbara , Bake Jane 
Published: September 2011

IntroductionThe Lincolnshire Home Deaths Project Group brought together organisations from across the county to develop new ways of working that were patient focused and to ensure that end of life services dovetailed. This included a night care pilot which identified the need for an assessment and communication tool endorsed by the health and social care community to enable the needs led prioritisation of resource in end of life care.AimsTo enable clear, accurate and effective communication of need across organisations to support the allocation and re-allocation of available night care resources for patients at the end of life based on their clinical need.MethodThe ‘responsive need’ tool was devised by members of the group using the work of two organisations, St Barnabas Lincolnshire Hospice and Marie Curie Cancer Care and the Gold Standards Framework prognostic indicators as a resource.Results▶The tool has become the common ‘currency’ of Communication County wide and is incorporated into SystmOne palliative care template.▶It has enabled the provision of End of life care according to need, and stopped unmet need for complex patients in the pilot area.▶Given clinicians confidence that the care will be there when the patient needs it; releasing care and supporting new ways of working.DiscussionThis tool has given us a shared language and supported the clinician in their decision making. It has enabled us to achieve the aim of allocating care on the basis of need and urgency.ConclusionThe responsive needs tool has supported choice at end of life for patients and would be of interest to both those commissioning and providing end of life care.
Supporting people with learning disabilities who are affected by a relative or friend with cancer
Authors: Giatras Nikoletta , Tuffrey-Wijne Irene , Butler Gary , Cresswell Amanda 
Published: September 2011

IntroductionAround 2.5% of the population have LD. 55% of people with LD live with parents; significant numbers have become carers of elderly parents. Around 15% of people with LD live in residential care homes, often with an ageing population of peers. Most people with LD will therefore be affected by cancer of family or friends at some point in their lives. Their support needs are insufficiently understood.Aims▶To explore the experiences and support needs of adults with LD who have a relative or friend with cancer▶To make recommendations for practice.Methods22 people with LD took part in focus groups and face-to-face interviews. All participants had experience of having a close relative/friend with cancer. The groups were co-facilitated by two co-researchers with LD; each group met four times, using a range of methodologies (including story-telling, role play and Nominal Group Technique) to extract participants' experiences and views. Data were analysed using content analysis.Results▶Being protected from information (as many participants were) negatively affected their coping.▶Participants worried about their relative/friend's illness and the impact on both the patient and on themselves; but had not shared their worries or questions with others.▶The greatest need was for “someone to talk to”; this need was not met by either families or professionals.▶There was a lack of understanding about cancer itself, and a lack of access to cancer information; participants wanted such information.DiscussionThe needs of people with LD who are a relative/friend of someone with cancer are often overlooked. This group does not ask for support, and therefore pro-active support is needed from cancer- and palliative care professionals as well as from LD professionals. This includes emotional support and the provision of accessible information about cancer.
Determining & prioritising key factors of care needs for patients & carers known to Hospice@Home
Authors: Greene Kay , Evans Tricia , Doherty Tracey , Tongue Nicola 
Published: September 2011

IntroductionEnsuring optimal use of resources can be very challenging for Hospice at Home services frequently faced with deciding which patient and carer situations at the very end of life are most in need. An approach was taken combining clinical practice experience with knowledge of existing scoring aids to formulate a tool to assist in prioritising service allocation.AimsEnable timely and efficient allocation of care visits to those determined as most in needProvide a transparent audit trail of resource and service allocation for commissioners when service faced with multiple demands.MethodConsideration was given to the common factors known to affect patients/carers at the very end of life and developing a scoring system which aligned closely with the Gold Standards Framework Prognostic Indicator Guidance model. The tool was refined during a 6 month pilot change and as service changes ensued.ResultsClinical staff found the tool to work well in practice and supported clinical decision making. They found using the tool particularly useful when demand for service exceeded resource availability and enabled the clinical team and commissioners to be assured patients/carers most in need received priority.DiscussionThe outcomes of the project concurred with the aims. We have found a way of prioritising our service allocation.ConclusionThe concept of developing the Prioritisation Tool for Hospice at Home care was driven by needing to establish a system and process which would optimise service allocation relevant to the local population needs. Many factors influence the needs of each patient and carer scenario and these were all included in the tool. Using the tool across two collaborative providers has been positive and enhanced partnership working and service provision. Other providers may find this tool useful.
“LIP” the Living with illness programme
Authors: Argent Ian 
Published: September 2011

IntroductionFor around 3 years, St Helena Hospice's LIP programme has brought together patients and carers to an informative, supportive forum. The rolling programme of semi-structured sessions is intended to enhance awareness and choice by raising important issues early on in the ‘journey’.AimsThe programme has three main aims: to provide information on key ‘Quality of Life’ issues for those coping with illness; to facilitate discussion and understanding between patients and carers around these key issues; and to provide support from professionals and other group members. These aims tie in well with NICE guidance for psychosocial support, and with the NCPC's initiative “Dying Matters”.MethodThe 6-week LIP is built around themes identified from previous groups at the Hospice (eg, Families and Feelings, Intimacy and Sexuality, Lifestyle and Coping, and Planning for Future Care). Each 90-min session is run by a relevant professional, with a co-ordinator/facilitator present throughout for continuity. The theme for each session is used as a starting-point for information and discussion. What follows is a more open, free-flowing group time, where issues important to the group members are shared and reflected upon. An anonymous feedback questionnaire is sent to participants after the programme's end.Results and discussionGroup numbers vary from 8 to 20+, with a good mixture of patients and carers. The weekly themes certainly provide a stimulus for group discussions in-session. There is an important added effect of more conversations taking place at home, within couples and families.Feedback has prompted some changes, but in general the programme is well-received by participants. Anecdotal evidence suggests that patients and carers have benefited from the early input of appropriate material, as this enhances their informed decision-making later on in areas such as Preferred Priorities of Care, funeral planning, etc.
Developing and implementing a model for multi-disciplinary clinical supervision for staff within a hospice
Authors: Watmore-Eve Jenny 
Published: September 2011

IntroductionThe development of a model for the internal provision of clinical supervision in which both the supervisors (staff at AFC band 7 and above) and supervisees are well informed staff members of the multi disciplinary team, who use this process of reflection to understand and enhance their work while being supported by the management structure of the organisation.AimsTo introduce a sustainable model that works successfully across multi disciplinary boundaries.To provide supervisors with training and ‘supervision of their supervision’ support groups facilitated by an external person/s.To promote the importance of clinical supervision as a staff support mechanism from the top of the management structure down.To assist staff to recognise the value for themselves personally and professionally of both accessing clinical supervision, AND providing it for others.Results and discussion (pro's and cons)Pros; Supervisors are widely reporting enjoyment and satisfaction from their new roles, and the diversity it brings to their work, as well as the useful insights it gives to the working roles of their supervisees which may previously have been misunderstood.Supervisees are reporting the benefits of having ‘quality time’ for reflection in their busy working schedule.And cons; Take - up from trained nurses was slow due to inherent misunderstandings/mistrust of the purpose of supervision. There were also fears regarding the maintenance of confidentiality in a small organisation, and difficulty dividing supervisors into peer support groups avoiding conflicting professional relationships. Sustainability relies in part on the management of the systems and register of supervisors and constant encouragement and promotion regarding the role and importance of ‘supervision’ for individuals, teams and the wellbeing of our patientsConclusionOther hospices may be interested in implementing a similar model and can learn from our experience.
Doing different things not doing things differently
Authors: Boosey Claire , Mowle-Clarke Kaye , Stewart Annie , Veli Alison , Widlake Jutta 
Published: September 2011

IntroductionMajor business change is a complex process requiring clear direction, planning, specialist resources and above all a massive commitment from the organisation. Our Hospice has achieved such transformational change.AimsTo do different things and to not just do the same things differently.MethodsFor hospices to prevail in the 21st century the original vision of the hospice movement needs aligning with the changes in health/social care communities. Methods were the development of strategic aims, a business plan and sharing this with managers. Time was given to understand this plan, its key messages (integration, innovation, workforce development, excellence, education and support, initiative and public involvement). Buy in was achieved.ResultsAn electronic patient record system that allows better integration across sites Unexpected results were a new culture overnight of computer literacy, transparency of who thinks what about a patient and improved role profile as all staff can see what each are doingIncreased bed occupancyRedesign of social care services which were based on a new model of careClinical Governance requirements were followed up via a Falls Audit completed by the Physiotherapist. The recommendations achieved new approaches in falls management, that is, intentional rounding and purchase and use of sensor alarms for patients at high risk of falls.DiscussionTime was given to develop trust in the process of business planning via a newly formed management level. The question is how this is now embedded further across all staff groups.ConclusionWe are on a track rather than just moving. True engagement with the public and with our users is needed. Priorities are quality in our services; to assert this when the competition approaches and to build on the trust placed in us by the local community.
Improving renal and palliative care services for patients – a staff exchange programme
Authors: Heatley Sue , Sigsworth Elaine , Braybrook Jan , Robinson Hilary 
Published: September 2011

Effective end of life care for patients with advanced kidney disease requires a co-ordinated and collaborative approach between renal and palliative healthcare teams. The Greater Manchester Renal /Palliative Care Action Learning Set was introduced in 2005 to address this need. An initial scoping questionnaire identified potential gaps in the provision of palliative care to patients with end stage renal disease. Key issues identified were lack of both confidence and competencies for caring for patients with end stage renal disease.Hence, a renal exchange programme was developed over 12 months, including pre-placement education/information packs which also included professional development plans, evaluation forms and liability insurance (honorary contracts). One week exchanges commenced in 2007 with a structured timetable which reflected the patient pathway.The hospice-hospital staff exchange programme has successfully promoted multi-professional collaborative working across boundaries -linking kidney care/acute care, primary care, and palliative care services. Staff evaluated their exchange experience positively via annual reflective multidisciplinary meetings, attended by both healthcare teams. Renal staff expressed heightened awareness of the importance placed upon spiritual and psychological care and the availability of end of life care services. Hospice staff gained a greater understanding of the complexity of living and dying withend stage renal disease, and the long term implications of renal disease on patients and their families.The programme is successfully addressing Government recommendations to promote collaborative working outlined in The End of Life Care strategy (DH 2008) which highlights the need for generic nursing staff to gain knowledge and skills in palliative care. Furthermore, the now established exchange programme meets the recent recommendations from the End of Life Care in Advanced Kidney Disease which states that ‘staff exchanges between kidney units and hospices should be developed to improve knowledge and skills of their respective services.’
Legal surgery scheme
Authors: Lee Margaret 
Published: September 2011

IntroductionIn 2009 18 local solicitors agreed to take part in a free Legal Surgery pilot scheme. This was successful and now it is an integral part of the support services the hospice offers.Aim‘Peace of mind’ and ‘putting one’s house in order' were the main drivers with a focus on accessibility for all patients and family members. It would also avoid the inconvenience and expense of an appointment at a solicitor's office.How the Legal Surgery operatesThe Surgery takes place once a month for an hour with a different solicitor each time. Day Therapy takes place at this time so people do not have the inconvenience of ‘another’ visit. Clients can either make an appointment in advance or just turn up. The solicitor sets up in our main public area for people dropping by and a room is available for private discussion. The solicitor can telephone those who are unable to travel and staff can ask questions on behalf of patients. There are usually about two or three clients each month.Administration of the SchemeThe rota is set up 6 months in advance and each solicitor holds one surgery every 18 months. Each solicitor signs an agreement setting out the points of the scheme but there is no obligation by the hospice to ensure there are any clients for them to see. The solicitors also sign a Self-Declaration of Criminal Record and are made aware of our Health and Safety, Vulnerable Adults and Complaints policies. No one firm is given preference over another. The arrangements are made by our Legacy Officer – a non-clinician.Advertising the SchemeThere is a leaflet for patients outlining the scheme and posters around the Hospice; most recommendations arise from the social workers and nurses.
Managing a deficit
Authors: Gale Barbara 
Published: September 2011

IntroductionIn 2009, a year of global financial uncertainty, a hospice faced a £500k deficit. Trustees and management agreed that this was not sustainable and that spending needed to match income.ProcessBefore deciding where to cut costs the management team undertook a mapping process for all the service activities required by patients and families. The key activities were then analysed in relation to cost.Staff piloted two methods of activity mapping – a service blueprint and a resource activity map. The service blueprint was found to be more user friendly and facilitated cross department discussions. In addition to this the last 3 years cost and activity data was examined.MethodsThe process of mapping services highlighted how some activity could be done by different staff or even volunteers, and it encouraged cross departmental discussions rather than silo thinking. Gaps in IT systems and processes were clear.The results showed a trend of increasing costs but not matched by increasing income. If the trend continued it was clear the organisation risked running out of cash within 4 years.Trends in activity data showed increasing community activity and home deaths alongside increasing ward costs in decreasing hospice ward deaths.The whole process was underpinned by a complex communications strategy externally and internally.ResultsThis evidence enabled the management team to make £500 000 of savings by closing four beds, making three redundancies, terminating fixed term contracts, freezing vacancies, all non-essential training and expenditure.Surplus ward staff were transferred into the community team.The hospice is now in a strong financial position and is investing in new posts in fundraising and clinical areas.
Social media – the twilight years of fundraising
Authors: Clements Kevin 
Published: September 2011

IntroductionIf trends in fundraising have proven anything, it's that all non-profit organisations need to be quick to adapt in order to continue reaching and inspiring large audiences to give.Regional press sales have been steadily declining for the last 15 years, with many local titles at an all time low.In contrast, the mass popularity of social media such as Facebook and Twitter offers charities an opportunity to deliver messages, sign people up for fundraising initiatives and become more interactively involved.Our organisation is about to embark on a number of strategically targeted social media campaigns to raise more money and make full use of the marketing opportunities this can offer. This will include a viral campaign, centred around the open air screening of the movie ‘Twilight’ locally.MethodsTwilight has over 19 million Facebook followers which means that we can use well targeted advertising on Facebook as a key method to sell tickets online for the event. People click on the advert, which will be displayed on their own Facebook page, to take them through to an event page where they can buy a ticket online.ResultsDesired results for a project of this nature are clear – to sell all tickets and create an exciting fundraising event without the traditional hard hitting charity campaign attached. In the current economic climate, there is a sense – even if not scientific, that donor fatigue will set in, especially with the high profile campaigns that have been operational recently.This kind of fundraising avoids ‘over selling’ the need to raise money for charity. Instead, it markets a hugely exciting event to a massive audience via the various social media channels available, while raising money.Discussion / conclusionTBC
Time & support – the essential ingredients for the development of the healthcare assistant
Authors: Schrikker Tara , Bacon Ruth 
Published: September 2011

IntroductionA competency framework was implemented for band two and three Healthcare Assistants (HCA's) in 2010. This highlighted areas of extended practice outside of the core competencies.AimThe HCA's expressed a strong desire to enhance their role, increase job satisfaction and feel valued within the organisation. A training and support structure was implemented to enable them to achieve this.MethodThe HCA's self assessed their performance against the competency framework and then had a 1:1 meeting with their manager to discuss:▶Individual strengths and interests▶Professional development▶Training needs.The competency workbooks provided information which helped the planning and implementation of a bespoke training programme for HCA's.To ensure the staff were able to take on additional roles, protected time for education and peer support was introduced.ResultsAs a direct result of these initiatives, the HCA's have been able to enhance their job role. Some examples include participation in audit, presenting patients at multi professional team meetings and a more active role during handover. Specific new roles have also been introduced for them including responsibility for fire prevention and training, moving and handling, NVQ assessing, external presentations around End of Life Care, infection control, nutrition, and IT champions.DiscussionThe general consensus from the team of HCA's is that they feel happier with the new aspects of their role and they sense that their presence in the organisation is greater.ConclusionHealthcare assistants perform better by being offered variety within their roles without extra financial budgetary implications. They feel empowered, valued and supported and this is echoed in feedback from other professionals within the organisation and external partners.
Practice development unit – every person makes a difference
Authors: Norris Ann 
Published: September 2011

Practice Development has become an established element of nursing clinical development in the UK. While hospices may employ individuals to facilitate clinical practice developments, a wider organisational approach to practice development is less evident. Over the last 2 years St Ann's Hospice, Manchester embarked on an organisational approach to Practice Development through accreditation with Leeds University.The purpose of this initiative was to encourage an ethos of Practice Development throughout the organisation, across all services (paid and voluntary) and professional groups (clinical and non-clinical). The key aim was to encourage wider organisational engagement and empowerment, in the development of quality care and service provision for patients and carers.The accreditation process began with the formation of Practice Development Lead and Steering Groups. Lead group membership had representatives from different levels and disciplines within the Hospice. The Steering Group membership involved some key Hospice personnel, representatives from local Community Palliative Care Services, Manchester University School of Nursing, business expertise and service users. Accreditation included developing a Practice Development framework, sourcing evidence to achieve the 15 core criteria set by Leeds University, and interim and final on site assessment from a diverse accreditation team.Examples of projects undertaken over the 2 years that positively influence patient care are:▶The provision of laundry net bags for patients clothes, that can be clearly labelled to prevent loss▶A new recycling scheme throughout the organisation which reduces waste and cost▶The production of a physiotherapy DVD for patients to be used by their bedside.The initiative has proven its worth as a mechanism for harnessing the creativity of staff and volunteers from across the whole organisation, particularly with groups that previously perceived their roles to be less involved in the development of quality patient focused care.