Clinical Leadership Pilot Evaluation Report
Nursing & Midwifery Planning & Development UnitHSE West (Limerick, Clare & North Tipperary)
Acknowledgements
• I would like to acknowledge the clinical leaders who undertook the pilot
projectfortheirmotivationanddedicationtobetterpatient/clientcare.
• Sincerethanksandappreciationtothelinemanagers,mentors,Directorsof
NursingandMidwifery,generalmanagersandmulti-disciplinarycolleagues
within the services for their support to programme participants and the
project.
• The Clinical Leadership Steering Committee members chaired by Pat
Harvey(formerCEOoftheNorthWesternHealthBoard)fortheirongoing
commitment to developing clinical nurse/midwife managers in improving
safequalitycarewithintheHSEWest(Limerick,ClareandNorthTipperary).
• The National Council for the Professional Development of Nursing and
Midwifery for part funding the pilot project and the subsequent National
ClinicalLeadershipProject.
• The Royal College of Nursing UK and Geraldine Cunningham, Head of the
RCNInstitutefortheirsupportandguidance.
• MichelleFrawley(ClericalOfficer-NMPDU)forherhardworkanddiligence
throughouttheproject.
• DrSarahMacCurtainandDrJulietMacMahon,CollegeofBusiness,University
ofLimerickfortheircollaborationonindependentlyevaluatingtheoutcomes
oftheprogramme.
• FrancisRogers-AssistantNationalDirectorHumanResourcesHSEWestfor
hisguidanceandcommitmenttotheproject.
• Finally, Many thanks to Nora Irwin-Area Director-Nursing and Midwifery
PlanningandDevelopmentHSEWest,GillianConway-ActingDirector-Nursing
andMidwiferyPlanningandDevelopmentUnitandmyNMPDUcolleaguesfor
theirongoingsupport.
CoraLunn
Project Manager-National Clinical Leadership Project
NursingandMidwiferyPlanningandDevelopmentUnit
HSEWest,31/33CatherineStreet,Limerick
Authors:CoraLunn,MSc,ProjectManager-NationalClinicalLeadershipProject,NursingandMidwiferyPlanningandDevelopmentUnitDrSarahMacCurtain,LecturerinOrganisationalBehaviour,UniversityofLimerickDrJulietMacMahon,LecturerinHumanResourceManagementandIndustrialRelations,UniversityofLimerick
contents
FOREWORD 2
INTRODUCTION 3
PROJECTCONTEXT 3
PROGRAMMESTRUCTURE 4
EVALUATIONMETHODOLOGY 8
PROJECTOUTCOMES 9
OverallPostProgrammeFeedback 9
EarlyProgrammeFeedback 10
OverallProgrammeEffectiveness 10
SteeringCommitteeFocusGroup 12
LineManagersFocusGroup 12
OUTCOMESATTRIBUTEDTOPARTICPANTSBEINGONTHEPROGRAMME 13
Changestoleadershipcapability 13
Changestopatient/clientcare 15
Changestothewaycareisorganisedanddelivered 16
Changestotheclinicalenvironment 17
Changestostaffdevelopmentandsupport 18
Changesincommunication–patientandteam 19
Changesinpolicydevelopment 19
Organisationlevelbenefitfromtheprogramme 21
Satisfactionwithprogrammecontent 22
PILOTEVALUATIONRECOMMENDATIONS 26
CONCLUSION 28
REFERENCES 29
APPENDICES 30
Appendix1-ClinicalLeadershipSteeringCommittee 30
Appendix2-PreProgrammeQuestionnaireforclinicalleaders 31
Appendix3-MidProgrammequestionnaireforclinicalleaders 35
Appendix4-PostProgrammeQuestionnaireforclinicalleaders 37
Appendix5-RCNClinicalLeadershipProgramme-WorkshopEvaluationForm 41
Appendix6-ActionLearningLogTemplate 42
Appendix7-ServiceImprovementProjectundertakenintheHSEWest 43
LISTOFTABLES
Table1ParticpantDetails 4
Table2Source:Finalparticipantevaluationform 11
Table3Satisfactionwithprogrammecontent 22
foreword1The implementation of the RCN framework for the pilot ClinicalLeadership Programme in the Mid West has been a significantachievement for both the clinical leaders and Cora Lunn theProgrammeFacilitator,theyarealltobecongratulated.
The Clinical Leadership Programme has provided an ability to work with clinicians in the
developmentofskillsandknowledgethatenablesNursesandMidwivestobeempoweredandto
contributetoimprovementsinpatientorclientoutcomes.Thisevaluationreportdemonstrates
thatthemajorityofparticipantshavebeenverypositiveabouttheirinvolvementandtheirself
development.Commentsfromnurseandmidwifemanagersindicatethatinanumberofcases
demonstrablechangehasbeenobservedinthosewhohaveparticipated.
The model of action learning conducted over the course of the programme supported the
embeddingofnewbehavioursinboththeacuteandprimary,communityandcontinuingcare
(PCCC)servicesandhasensuredthatbothindividualandorganisationalchangeismaintained
intothefuture.
Priortothedevelopmentofthispilotprojecttherewerelimitedprogrammeswithdirectpatient
orclientinterventions;fornurseandmidwifemanagerswhowishedtodevelopleadershipskills
intheclinicalenvironment.Theevaluationofthispilotprojectrecommendsthatnationalclinical
leadershipstrategiestosupportfrontlinestaffshouldbefurtherdeveloped,particularlyasthe
contextofIrishnursingandmidwiferyischangingandnewwaysofworkingareessential,inthis
currenteraofhealthcaretransformation.
Thedeliveryofthepilotprojectwouldnothavebeenpossiblewithoutthefinancialsupportfrom
theNationalCouncilfortheProfessionalDevelopmentofNursingandMidwifery,theguidanceand
supportoftheSteeringCommittee,localDirectorsofNursingandMidwiferyandtheevaluation
expertiseoftheKemmyBusinessSchool,UniversityofLimerick,thankyou.
Finally, sincere thanks are offered to Cora for her commitment to the development and the
progressingofclinicalleadershipdeliveryintheMidWestRegionandNationally.
GillianConway
Acting Director
NursingandMidwiferyPlanningandDevelopmentUnit
HSEWest,31/33CatherineStreet,Limerick
page 02 Clinical Leadership Pilot Evaluation Report November 2008
introduction 2
November 2008 Clinical Leadership Pilot Evaluation Report page 03
NursesandmidwivesintheRepublicofIreland,likethoseinmanyothercountries,work inahealthcaresystemthathasundergonedramaticchangeinthepastfiveyears.
TherecenttransformationoftheIrishhealthcaresystemrepresentsthebiggestreformprogramme
thecountryhasseenin30years. Ithasbroughtabouttherestructuringofservices,agreater
emphasisonthedevelopmentofprimarycare,thedownsizingofpersonnelandareductionin
spending.Thesedevelopmentshavechangedthecontextofclinical leadership innursingand
midwifery(Baumannetal2001,Clifford1998,Havens2001),precipitatingthelaunchofvarious
clinicalleadershipdevelopmentstrategiesfornursesandmidwives.Thesestrategiesareneeded
tosupport the requiredtransition tonewandexpandedwaysofdeliveringpatientandclient
care.Meanwhile,theNationalCommissiononNursingHoursReport(unpublished2009)which
willreportshortly,willhaveanticipatedcallsforchangesinleadershipdevelopmenttosupport
increasedcapacitywithintheprofession(Bakeretal2004).
ProjectContext
Thecurrentneedtodevelopspecificclinicalleadershipdevelopmentstrategiesforallnursingand
midwiferygrades,hasbeenhighlightedinthispilotprojectevaluationstudy.Theprojectutilised
theRoyalCollegeofNursing’s(RCN)ClinicalLeadershipProgrammeasframeworkforexploring
clinicalleadershipdevelopment.TheaimoftheprojectwastoevaluatetheimpactoftheRCN
ClinicalLeadershipProgramme(CLP)onenhancingleadershipdevelopment,initsparticipants
andinimprovingpatient/clientcarewithinanIrishcontext.
TheRCNClinicalLeadershipProgrammeisatwelvemonthexperientialbasedprogrammethat
aims to develop transformational leadership behaviours in its participants. It concentrates on
selfdevelopmentoftheparticipants,closelylinkedwithpatient/clientinvolvementandquality
improvement.
TwentytwoClinicalNurseandMidwifeManagersenrolledinthepilotprojectoftheRCNClinical
LeadershipProgrammeintheHeathServiceExecutive(HSE)West,(Limerick,ClareandNorth
Tipperary).Twentyoneparticipantscompletedtheprogrammeandonedidnotcompletethe
programmesuccessfullyduetopersonalcircumstances.Participants(Table1)wererecruitedfrom
acuteandprimary,communityandcontinuingcare(PCCC)servicesacrosstheMid-Westregion.
Nineteen out of twenty two participants responded to the pre, mid and post questionnaires.
Fortyfivestakeholdersattendedfocusgroupstoevaluatetheproject.
page 04 Clinical Leadership Pilot Evaluation Report November 2008
Grades No.ofParticipants No.ofTeamMembers AreaofResponsibility (Fulltimeandparttime)
CNM/CMM’s3 4 47 LabourandTheatreUnit
72 PaediatricUnit
43 NeonatologyUnit
110 HospiceCare
CNM/CMM’s2 12 26 OrthopaedicWard
37 OrthopaedicWard
24 OrthopaedicTheatre
9 AccidentandEmergency
18 IntellectualDisabilityUnit
19 OlderPersons-residentialcare
25 OlderPersons-residentialcare
3 MentalHealth
2 OutpatientsDepartment
22 CoronaryCareUnit
9 EyeTheatre
23 MedicalWard
CNM/CMM’s1 5 12 Oncology
31 OlderPersons-residentialcare
34 OlderPersons-residentialcare
26 OlderPersons-residentialcare
19.5 OlderPersons-residentialcare
CNS 1 0 MentalHealth-olderpersons
Total 22 611.5TeamMembers
Table1-ParticpantDetails
ProgrammeStructure
TheRCNClinicalLeadershipProgrammewasdevelopedfromawardnurses’leadershipproject
toaninternationallyrecognised,multidisciplinaryclinicalleadershipdevelopmentprogrammein
theUnitedKingdom.Theoriginalresearchfocusedonthelinkbetweenleadershipandpatient/
client outcomes. The theoretical framework (Cunningham and Kitson 2000) supporting the
programmeisfocusedon:
• Learningtoselfmanage
• Developingeffectiverelationships
• Patientfocus
• Networking
• PoliticalAwareness
November 2008 Clinical Leadership Pilot Evaluation Report page 05
The programme engages participants in reflective and experiential learning. Its central focus
is to enhance patient/client care. The programme is aimed at Clinical Nurse and Midwife
Managers(CNM’s/CMM’S)astheyarekeyindrivingtransformationincare.Itgivesparticipants
theopportunitytopractisecopingwithchangeinasafeenvironmentandtotryoutdifferent
approachestoclinicalleadershipandmanagement.Theparticipantsaresupportedbyafulltime
ClinicalLeadershipFacilitator (Cora Lunn-NMPDU)throughoutthedurationofthetwelvemonth
programme. The programme is facilitated to encourage participants to consider their clinical
environments and enable participants to develop their teams and care delivery. It empowers
themtocreatepersonalisedactionplans thatcanserveasasteppingstoneto implementing
changesinclinicalpractice.Theprogramme’sinterventionsincluded:
Workshops
Thepurposeofthecoreworkshopswastointroduceparticipantstothekeyinterventionsand
activitiesusedontheprogramme:
• twodayIntroductoryLeadershipWorkshop
• onedayTeamBuildingWorkshop
• twodayPreparationforpatient-focusedactivitiese.g.
Patientstoriesandobservationsofcare
• onedayPoliticalAwarenessandNetworkingWorkshop
• onedayNeedsLead-ArticulatingImpactWorkshop
• onedayNeedsLead-ConflictManagementWorkshop
• onedayNeedsLead-SelfDevelopment-PersonalityTypes-MBTI
• onedayServiceFeedbackandEvaluationDay
Theneeds-ledworkshopsaredevelopedaroundtheparticipantsneeds.
Personaldevelopment
PersonaldevelopmentisanintegralpartoftheCLP,andisseenascrucialindevelopingleaders.
Thereareanumberofopportunities forparticipants todeveloppersonally,byundertakinga
360degreereviewandaclinicalleadersprofile.Eachparticipantisresponsiblefordevelopinga
PersonalDevelopmentPlan(PDP)andidentifyingareasofstrengthandareasfordevelopment.
ClinicalLeadersProfiles
Allparticipantscompletedthisin-depthquestionnaireaboutthemselves,theirteam,patientsin
theirareaandtheirorganisation.ItspurposewastoinformtheirPDPbyhelpingthemthinkabout
theenvironmenttheyworkin,whatknowledgetheyhaveandwhatareastheyneedtodevelop.
Personaldevelopmentactivitiesalsoinclude
Mentoring:Eachparticipantwasencouragedtosourceamentor.Thementorprovidesastrong
leadership rolemodel toworkcloselywith throughout theprogramme;mentorsalsoprovide
goodnetworkingandpoliticalopportunities.
Shadowing:Shadowingprovidesauniqueopportunityforparticipantstodeveloptheirleadership
skillsbyspendingtimeobservingsomeoneelseinactionduringtheirday,learningmoreabout
howtheyworkandthewaytheyworke.g.BedManagers,BusinessManagers,DischargePlanning
Co-ordinatorsandDirectorsofNursing/Midwiferyetc.
page 06 Clinical Leadership Pilot Evaluation Report November 2008
Onetoones:Eachparticipanthadone-to-one(1:1)sessionsthroughouttheprogramme,lastingfor
atleastanhourintheirclinicalarea.ThesewerefacilitatedbytheClinicalLeadershipFacilitator.
Thesessionsensuredtheparticipantswereexperiencingtheprogrammetothemaximum,getting
thetimetoparticipateandanopportunityforfurtherchallengeandsupportwhichcontributed
totheirpersonaldevelopment.
ActionLearning
An‘actionapproachtolearning’,enablespersonal,professional,managerialandorganisational
development.Itisbasedonthebeliefthatthemosteffectivelearningtakesplaceinthecontext
in which people are working, learning from experience. Action learning allows questioning,
challenging,supportingandreflectingwithothersonexperiencestogainfurtherinsight,agree
actionsandlearnfromtheactionstaken.Eachparticipantcompletedtwelvefacilitatedaction
learningdayson theprogramme.Therewere fouraction learninggroups running throughout
thecourseoftheprogramme,withtheaimofhavingthemsustainedoncetheprogrammewas
finished.All fourgroupsare self facilitatingandhavebeen sustained in the service since the
programmehasfinished.
PatientCentredActivities
ObservationsofCareandPatientStoriesarethetwopatient-focusedactivitiesundertakenon
theprogramme.Thesegaveparticipantsanopportunityto:
• reallyseewhatishappeningintheirclinicalarea
• reallyhearandlistentowhatpatientsexperience
• celebratethegoodpracticesthatoccur
• developactionplanstoenhancepatient/clientoutcomes
Observationsofcare
Observationsofcareareasimple,qualityimprovementandpersonaldevelopmenttoolthatholds
animportantmessage:‘seeing’and‘observing’arenotthesame.Theapproachtoobservationof
careontheprogrammewascreatedfromtheoriginalpieceofactionresearchbyRoyalCollege
ofNursing(1997).
Thisinvolvestwoobservers:aninsiderandanoutsider.Theclinicalleader(insider)andanoutsider
(anotherclinicalleader)observeandrecordtheinsider’sclinicalareaforthirtyminutes.
Patientstories
Patientstories,alsoknownaspatientnarratives,areaudiotapedinterviewswithpatientsabout
theirexperienceofbeinginhospitalorreceivingcare inothersettings.Patientsarerandomly
selectedandinvitedtotelltheirstoryabouttheirexperienceofreceivingpatientcare.Thestories
areaudiotaped,and‘mindmapped’.
Actionplansaredevelopedfrombothqualityimprovementactivities.
TeamBuilding
The programme helps participants develop creative ways of developing their teams. This
workshopisfacilitatedsothatparticipantsareenabledtoundertaketeambuildingtechniques
with theirclinical teams. Ithelps themtoestablishhowagroupof individualswork together,
howthestrengthsandareasfordevelopmentofindividualscontributetojointworking,andhow
teamscanworkmoreeffectivelytogethertoachievetheirprimarytask.
November 2008 Clinical Leadership Pilot Evaluation Report page 07
PoliticalAwarenessandNetworking
Developingcapacityandskillsinpoliticalawarenessiscrucialtodevelopingtheabilitytoinfluence
keystakeholderswithinanorganisation,sothatparticipantscanintroduceresources,structures
andsystemstopromotepatient-focusedcare.Theprogrammeencouragesparticipantstobuild
networks,bothinsideandbeyondtheirorganisation.Networkingstrengthensthecorevalueof
workinginthehealthservice.
OrganisationalSupport
Tomakeapositiveimpactontheorganisation,itwasessentialtohaveappropriatesupportand
communicationabouttheprogrammewithintheorganisation.TheClinicalLeadershipSteering
Committeeplayedamajorroleinthis,bysupportingtheimplementationoftheprogramme.The
committeeinfluencedchangeswithintheorganisationthroughtheprogramme,particularlywith
regardstoqualityimprovementinitiativese.g.patientstories,serviceimprovementprojectsand
observationsofcare.AlistofsteeringcommitteemembersisincludedinAppendix1.
evaluation methodology3
page 08 Clinical Leadership Pilot Evaluation Report November 2008
Realisticevaluation(PawsonandTilley1997)providedthetheoreticalunderpinningfortheevaluationoftheproject.
This approach to evaluation is seen as being particularly suited to evaluations of complex
interventions,whereissuesofcontextandprocessaswellasoutcomeareofsignificance(Redfern
et al 2003). Realistic evaluation examines the relationships between context, mechanism and
outcome.Inthisinstance‘mechanism’referstotheinterventions(e.g.actionlearningandpatient
stories)oftheCLP.
Datawascollectedfromthefollowingsources:
• InformationgatheredfromClinicalLeadersApplicationFormsandClinicalLeaderProfiles
• Pre-interviewswithDirectorsofNursing/Midwiferytoidentifyimpactmeasures
• Pre,Mid&PostEvaluationquestionnairesofClinicalLeadersProgress
(Appendix2,3&4)
• WorkshopsEvaluationQuestionnaires(Appendix5)
• TwelveMonthActionLearningLog(Appendix6)
• Threefocusgroupswithparticipants,DirectorsofNursingandMidwiferyandClinical
Leadershipsteeringcommitteemembers
• Eightyeightpatientstoriesandsixtysixobservationsofcareactionplans
• StakeholderMeetings
• PDPObjectives
• Posterpresentationsoftwentyoneserviceimprovementprojects(Appendix7)
DatawasindependentlyanalysedandfindingreportedbyKemmyBusinessSchool,Universityof
Limerick,Ireland.
EightinterviewswereundertakenwithDirectorsofNursingandMidwiferyinservicespriorthe
commencementoftheproject.Theaimoftheseinterviewsweretoidentifythemostcommon
impactmeasuresthatDirectorswanteddevelopedinservicesthroughoutthedurationofthe
programme.Thedatafromtheseinterviewswereanalysedusingthematicanalysis.Thefollowing
fourthemesemergedtobefocusedonduringtheprogramme:
• Qualityimprovement
• Developingparticipantstotakeonresponsibilityandaccountability
• Enablingparticipantstoexertauthority
• Developingserviceprioritiese.g.infectioncontrol,medicationmanagement,team
developmentandactivationprogrammes
project outcomes
November 2008 Clinical Leadership Pilot Evaluation Report page 09
Overall-PostProgrammeFeedback
Nineteen out of twenty two participants responded in a very positive manner to the overall
experienceoftheRCNClinicalLeadershipProgramme.Threecommonthemesofbenefitemerged
fromtheevaluationsandfocusgroups:
• theenhancementofleadershipskillsofparticipants
• growthinthepersonaldevelopmentoftheparticipants
• positiveoutcomesinpatientandclientcare
Otherbenefitsincludedthedevelopmentof‘managingthemanager’skills,conflictmanagement,
networkingandchangemanagementskills.Thefollowingquotesarerepresentativeoftheoverall
experienceoftheprogramme:
4
“Thisprogrammewasfantastichavingjust
taken up a new role/position, the course
assistedmeinbecominganeffectiveleader
ofateamandalsogainingtheabilitytobe
moreassertiveandabettercommunicator
withintheteam”.
“It helped me develop and it definitely
helped me deal with team conflict. The
actionlearninghelpedmeexploreongoing
conflictwithpeopleandworkproblems.The
patient stories are a very good feedback
mechanism which we have been adopted
on a continual basis. The networking part
of the course is excellent. Hopefully good
supportsformanyyears”.
“Amostpracticalexperienceencompassing
facets of clinical leadership in a way that
has been both stimulating and calming;
informativeandinfluencing;reassuringand
supportive. That I can influence behaviour
through my own and learned leadership
skillsandtherebyinfluencecareandpolicy
is very empowering. This programme has
beenavaluabletoolformetoachievethis
andtoreflect”.
“The Clinical Leadership Programme has
definitelymademeseethingsmoreclearly
whichforthemostparthasbeengoodand
productive; but there is a part of me that
feelssomewhatfrustratedasIamreflecting
onincidents/thingsalotmoreandstriving
to get results but not always succeeding.
It has definitely made me more aware of
the leadership skills of my line managers
colleaguesaroundmeandindeedmyown.
Reflection has definitely become part of
my working day; and for the most part
is proving positive but there is also the
negativeelementwhichIfinddifficult.But
throughactionlearningandsuchsupportive
clinical leaders and facilitator, it is getting
somewhateasier.Theprogrammehasalso
given me the confidence and courage to
address issues with my line managers if I
feel absolutely necessary, i.e. not just the
positives”.
page 10 Clinical Leadership Pilot Evaluation Report November 2008
EarlyProgrammeFeedback
It isusefultocomparefinalfeedbackwithearlyfeedbackfromparticipants. Inthiscaseearly
feedbacktakenatthebeginningofthecoursewaslargelypositivewithallparticipantsdelivering
positivefeedbackcommentssuchas
Howevertherewereindicationsthatsomeparticipantswereexperiencingaleveloffearandanxiety
attheearlystageoftheprogramme,intermsofanticipatedworkloadandtimemanagement.
Theneedtoprovideparticipantswithreassuranceandinitialsupportinmanaginganxieties;in
facilitatingsuchorsimilarprogrammescannotbeunderestimatedparticularlybeingmindfulof
attritionrates.
OverallProgrammeEffectiveness
Theeffectivenessoftheprogrammewasmeasuredinanumberofways.Participantswereasked
tocompletedpre,midandpostquestionnaires.Participantsalsoratedeachmoduleseparately.
Focus groups were undertaken with programme’s stakeholders. Stakeholders included the
programme’sclinicalleadershipsteeringcommittee,theparticipantsandtheparticipants’mentors
andlinemanagers.Overall,allstakeholdersfelttheprogrammehadachieveditsobjectives.The
followingsectionpresentsthefindingsfromtheparticipants’evaluationformsandfocusgroups.
Nineteenrespondentsratedtheoveralleffectivenessoftheprogrammeasbeingveryhigh.See
table2overleaf.
“Iamreallyenjoyingthecourse.IfeelIamon
aself-discoveryjourneywhichissometimes
goodandsometimesnotsogood.Learning
lots from other colleagues on the course.
Wishallnursescoulddoacourselikethis”.
“Enjoying the course and I am finding it
great, it is helping me to grow – in every
sense of the word. Action learning days
havebeensobeneficialI’mlookingforward
toawinteroflearning.”
“I am happy with the programme so far
andfindthefacilitatorverysupportiveand
approachable. I feel the programme has
refocused my attention on how we can
improvethequalityofcareforourservice
users”.
“TheprogrammeisahugesupportforCNM’s.
Thetheoryispracticalandcanbebrought
backtotheworkplace.Thepatient’sstories
andobservationsofcarearepowerfultools
forimprovingpatientcare”.
“Greattohavetheopportunitytoparticipate.
Timetodohomeworkvery limitedthough
due to work and home commitments.
Inclined to worry too much about written
work–causingstress”.
“Iamfindingtheprogrammeveryhelpfulto
meinmydevelopmentasaleader.However
I find I have to complete the work on off
dutytimeduetopressuresonthewardi.e.
nooffice,inadequateI.T.andnoCNM1”.
“At times found it very time consuming
while doing a full time job. Even though I
amlearningfromandenjoyingthecourseI
sometimesfeelabitunderpressure”.
HowwouldyouratetheRCNClinicalLeadershipProgrammeonthescalebelow:
VeryPoor Poor Neutral Good VeryGood
1 19
November 2008 Clinical Leadership Pilot Evaluation Report page11
Table2:Source:finalparticipantevaluationform
Levelsofjobsatisfactionamongparticipantswerealsoaffectedbyparticipationonthecourse.
Fourteenoutofnineteenparticipantsreportedthattheirsatisfactionwiththeircurrentjobhad
improvedoverthecourseoftheprogramme.
Eighteenoutofnineteenparticipants felt thatmoraleandsatisfactionof staff in theirclinical
areahad improvedthroughout thedurationof theprogramme.Thefindings indicate that the
differentexpectationsofallstakeholdergroups(steeringcommittee,participants,mentorsand
linemanagers)werefulfilled.
Nineteenparticipantsfeltthattheprogrammemettheirexpectations,whilesevenparticipants
indicateditsurpassedtheirexpectations.Fouroftherespondentsreferredtotheactionlearning
componentasbeingparticularlyvaluable.Observationsofcare,patientstoriesandtheservice
improvementprojectswerementionedas importantaspectsof theprogramme.Thepractical
andappliednatureoftheprogrammewasalsoseenasahugestrength.Thefollowingquotes
accuratelycapturethenineteenresponses.
“Practical way the course is run/taught
–not liketheusualtextbookmanagement
courses,it’sverydifferentinitsdeliverybut
muchmoreeffective”
“Yesevenmorethanfulfilledthem!! Ihave
grownonapersonallevel,ithasbeenagreat
learningopportunityandIhaveachievedso
much from patient stories/observations of
care/tomanagingteams/settingobjectives/
PDP/ Myers briggs/360 report, I could go
on!! I found action learning invaluable, it
hasbeenverybeneficialtomygrowth.The
supportmechanismwasexcellentandour
group worked well. The different clinical
experiencefromdifferentserviceswasvery
educational it has certainly encouraged
networkingacrosstheservice”.
“Yes, the programme has fulfilled my
expectations; I wanted to improve my
clinical leadershipskills. I feel Iamamore
effective clinical leader. Action learning
dayshavehelpedmetoaddressandresolve
anumberofissues.Theseincludeabetter
workingrelationshipwithCNM1anddealing
withstaffconflict”.
“Absolutely.InitiallyIwasveryapprehensive
about undertaking the course but it is
so practically based it is exactly what I
needed”.
“Yes,unsureatthebeginning,howitwould
help me develop. Through action learning
it helped me realise that the conflict we
wereexperiencinginourarea,wascommon
to most other areas. It helped to explore
solutionstotheaboveinasafeenvironment
through the (Action Learning) group – at
firstgentleprobingandthenmoreindepth
probingwhichhelpedmereflectonmyrole
within theconflictand therebyhelp reach
realsolutions”.
page 12 Clinical Leadership Pilot Evaluation Report November 2008
“YES!!! 110% I have learned and shared so
much. It has been a career saver as I was
having doubts and my motivation and
direction were waning and unclear. A
wonderfulprogrammeforCNMs.Certainly
boosts morale and encourages us to
celebrateourachievements”.
“SurvivalGuideforWardManager”(Thomas
2006) Full of hints and tips on how to
survive, It has given me encouragement
andresourcestobuildon–madememore
emotionally aware of myself and my own
behaviour.Mentoringsystemverypositive.
Action learningsetsveryuseful to resolve
problems. Helped me to re-establish the
importance of the patients in service
delivery”.
“The CLP has definitely re-energised me.
Through the Clinical Leader Profile, PDP,
360degreefeedbacketc,theopportunity
tojusttaketimeouttoreflectonmyselfas
a clinical leader has been very beneficial.
TobehonestitisnotsomethingIdidvery
often. To be able to link the programme
to local/nationalpolicies andagendashas
been enlightening e.g. transformation.
THANKYOU”
SteeringCommitteeFocusGroup
Theresponsefromallsteeringcommitteememberswhoattendedtheevaluationfocusgroup
was very positive. There was general agreement that the CLP had met its stated objectives.
Theyreportedthattheycouldidentifyreal,daytodaychangesthattheycouldattributetothe
programme.Thisgrouphighlightedthattheserviceimprovementprojectswereakeydriverof
change.Theyhighlightedimprovementsintermsof:
• networkingbetweenparticipantsandmulti-disciplinaryteam
• improveddecisionmakingandlinkswithothergroupsthroughtheactionlearningsets
• enhancedpoliticalawareness-thegroupnoticedadifferenceinhowparticipantsdealwith
differentstaff,howtheyengagewiththeirownmanagersandimprovementintermsof
‘managingthemanager’
Onapracticallevelthesteeringcommitteefelttheprogrammeenhancedparticipants’personal
development,increasedselfawareness,confidenceandconflictmanagementskills.
LineManagersFocusGroup
Feedbackfromthisgroupwasverypositive.Overallthegroupfeltthattheprogrammehadvery
positiveoutcomesforparticipantsandtheirunits/organisations.Theyfeltthattheprogramme
hadhadacascadeeffectinmanycasesandproducedpositiveoutcomesformorepeoplethan
justtheparticipants.Therewasconsensusthattheprogrammeorsimilarprogrammesshouldbe
developedforClinicalNurse/MidwifeManagersanditcouldformatemplatefordevelopmentof
othernurse/midwifemanagerswithintheHSE.Itwasemphasisedthatsimilarprogrammeswere
longoverdueandthatthatthesecouldprovidedastructurefordevelopmentofCNM/CMM’sin
termsoftheirroleandprogression.
outcomes attributed to particpants being on the pogramme
November 2008 Clinical Leadership Pilot Evaluation Report page 13
5The following section outlines changes have been identified andattributedtotheRCNCLPaccordingtoparticipants,linemanagers,mentorsandsteeringcommitteemembers.Thesearedetailed inthefollowingsectionusingdatafromtheevaluationforms,focusgroups, questionnaires, action plans and service improvementprojects.
Changestoleadershipcapability
OneofthekeyobjectivesoftheCLPwastoenhancetheleadershipcapabilityofCNM/CMMs.
Nineteen respondents felt the CLP was instrumental in developing their leadership skills and
capability.Fourteenoutofthenineteenparticipantsspecificallymentionedan increase inself
confidence and awareness as being key to their development as a leader. Other leadership
capabilitiesmentionedwerecommunicationskills,conflictmanagementskills,problemsolving/
decisionmakingskills,abilitytoempowerteamandtheabilitytodevelopavision.Again,these
quotesbelowarerepresentativeofthenineteenresponses.
“I feelmoreconfident inaddressing issues
andusesomeaspectsofactionlearningby
challengingtheteammemberstocomeup
withsolutionstoproblems”.
“Yes,myleadershipcapabilityhaschanged.
I used to worry endlessly at what others
thought of me. . I was self conscious in
myroleasCNMandthatlimitedmeinmy
actions”.
“I often wondered why I didn’t get the
respectthatothersgot.Now,Idon’tworry
inthatsameway.Iamnotselfconscious,I’m
notafraidofbeingaCNM.Iamnotafraidto
saywhatIthink.IsaywhatIfeelandInow
feelthatIamgettingmorerespect”.
“Have been more confident in influencing
how the team works together more
effectively;throughabetterunderstanding
of team dynamics; self awareness and
emotionalintelligence.Openingupdialogue
and discussion about differences. Getting
individual team members more involved.
Promoting a genuine sense of shared
responsibility and accountability which is
benefitingtheserviceofcareprovided”.
page 14 Clinical Leadership Pilot Evaluation Report November 2008
Feedback from the participants’ focus group echoed the questionnaire responses with calls
for theCLPorsimilarprogrammestobemademandatory forCNM/CMM’s levelswithinHSE.
Participants felt that the programme had helped their self belief, confidence and they were
‘workingsmarter’.
Keyoutcomesidentifiedbyparticipantswere:
• Increasedconfidenceandabilitytoengagewithmanagers.Forexampleparticipants
indicatedthattheywouldnowcarryoutresearchinadvanceofmeetingmanagersand
presentthemwithevidence/auditresultsetcinordertopresentastrongerargumentand
tofeelconfidentinthemselves.
• Participantswerecomingupwithviableandusefulnewwaysfordeliveringpatientcare.
• Recognisingthevalueofpatientstories-participantsrespondedthattheyhavelearnedto
listenandlookatsituationsfrompatients/clientsperspective.
• Movingoutsideoftraditionalacceptedsystemsandtaking‘risks’inproposingorbeing
activeinlookingatnewwaysofworkingorseeingotherperspectives.
• Improvedabilitytomanagedifficultpeople/issues.Moreconfidentintakingresponsibility
andnotalwayslookingupwardsforsolutions.
• Betterselfawarenessofstrengthsandareasfordevelopment.
• Morereflective.
KeyoutcomesidentifiedbyLinemanagersandmentorswere:
• Anobservableincreaseinselfconfidenceamongparticipantsparticularlyintheirability
tobemanagersandnotpassconflict/issuesautomaticallyuptheline.
• Increasedroleclarity-participantshavealsobecomemoreconfidentinchallenging
managerswheretheyfeelitnecessary.
• Meetingskillsofparticipants,intermsof‘owning’meetingsandpersistingonpoints/issues,
managingconflictandresistance.
• Participantshavelearnedtostandbackandadoptedamoreanalyticalapproachto
situationsinsteadof‘jumpingin’.
• Evidenceofnetworkingcontinuingamongtheprogrammealumniandparticipants
engaginginhigherlevelsofnetworkinginownunits/organisations.
• Casesofacascadingofsustainableactionlearningsetsandrolloutofpatientstoriesto
othernonparticipantswithinclinicalteams.
• Participantshavegainedgreaterinsightinto‘mechanics’ofotherareas/units/disciplines
andhaveincreasedholisticunderstandingofoverallserviceandappreciationof‘bigger
picture’.
• Participantshavebeenreassuredthattheirunits/areasarenotexcessively‘bad’andthey
arenotexperiencingissuesorproblemsuniquetothem.Senseofperspective.
• Onemanagermaintainedthatincreasedconfidencehashadapositiveeffectonbody
languageandprojectedimageofparticipantswhichhasmadethemmoreapproachable
andenabledthemto‘bringstaffwiththem’.
• Greaterevidenceofteambuilding.
November 2008 Clinical Leadership Pilot Evaluation Report page 15
Changestopatient/clientcare
The elements of the programme that emerged as the main drivers of change are the action
learningsets,patient stories,observationsofcareand theservice improvementprojects.The
service improvement projects carried out by twenty one participants have led to real and
practicalchangeswithinparticipants’organisations.Thehavebroughtaboutbetterqualitycare
forpatientsandclients.FurtherdetailsontheseprojectscanbefoundinAppendix7.
Themajorityofparticipantsidentifiedchangesinpatientandclientcarethattheyattributeto
theprogramme.Aspreviouslystated,participantsprioritisedthreeaspectsasbeingparticularly
importantinthisarea:
• patientstories(50% of respondents referred to patient stories as specifically bringing
about changes in patient/client care).
• observationsofcare(48% of respondents referred to observations of care as specifically
bringing about changes in patient/client care).
• serviceimprovementprojects(36% of respondents referred to the service improvement
projects as specifically bringing about changes in patient/client care).
“Developing more women centred care,
patients’ stories, and observations of care
enhancingprivacyanddignity forwomen.
Perineal suturing - some midwives have
commencedsuturing”.
“We now have guidelines for family
involvementinthetransitionofcareintothe
unit.Thecarebeingdeliveredismuchmore
personcentredasaresultofobservations
of care and patient stories action plans
beingaddressed.”
“As a result of patient stories we have
increased activation and socialisation
sessionsforthepatients”.
“Yes the patient activation programme
is being drafted for the unit, in line with
HIQAStandard18.2. Ihaveworkedclosely
with those who coordinate activities and
theyhavegiven somuchover thepast 12
months. Most enthusiastic/motivated and
aremakingagreatimpactonthequalityof
life to the residents.Barewalls havebeen
furnishedwithbeautifulpaintingsenhancing
environmentforstaffandpatientsalike”.
“Observationsofcarehighlightedtheneed
to be observant of the small things that
makeadifferencei.e.noise,privacy,dignity
that may sometimes be overlooked in the
businessoftheday”.
“My service improvement project is to
review the admission of orthopaedic
patients to the trauma ward and to local
orthopaedic hospital. The rationale for
undertakingthisistoensurepatientsreceive
theoptimumorthopaediccare.Iwouldnot
have undertaken this project without the
support and guidance I received on the
programme.”
“IfeelIamnowmorefocusedonthequality
ofcarepatientsaregetting,particularly in
communication,inexplainingtothemwhat
to expect from me, what I will be doing
with them and If there are delays in their
treatment,whatthesedelaysareandwhy”.
page 16 Clinical Leadership Pilot Evaluation Report November 2008
“Wehavechangedthreeaspectsofourworkthroughpatientstories:
• wevisitallfamiliesonatleastoneoccasionafterthedeathofaclientwherewehave
activeinvolvement”
• patientstoriesidentifiedthatallclientsliketohaveamedicalreviewduringtheirjourney
inourservice.Thisisnowbeingintroduced”.
• patientstorieshavelongbeenadoptedaspartofourcustomerfeedbackprocess/
continuedimprovementonanannualbasis.”
“Supportstaffhaveembracedthekeyworker/careconceptwhichhasgreatlyimprovedand
Increased“relationshipbasedcare”–thisisdirectlyasaresultofmyserviceimprovement
project”.
Allmembersofthesteeringcommitteefocusgroupagreedthattheprogrammehadincreased
patient/clientengagementandprovidedachanceforpatient/clienttogivefeedback.Adopting
apatient/clientcentredapproachwasanimportantcomponentoftheprogrammeandthiswas
achievedaccordingtothegroup.Thegroupfeltthepatientstoriesplayedapivotalroleinthe
achievementofthisobjective.ThepatientstoriesprovidedtheCNM/CMM’swithanopportunity
toreceivepatient/clientfeedbackandledtoimportantchangesincare.Aconcernhighlighted
in theevaluationof theprojectwas the lackofappropriate structures locally to relayquality
improvementactionsacrossbothacuteandPCCCservices.
Changestothewaycareisorganisedanddelivered
The majority of clinical teams had no clear team objectives or performance management
frameworksinplace.Theprogrammeledtochangesinthewaycareisdeliveredaccordingto
sixteenoutofnineteenrespondents.Themajorityofthesechangeswereteambasedchanges.
Forexampleinsomeservicesthefollowingoccurred:
• teamreorganisation
• teamreviewandevaluation
• morefrequentteammeetings
• improvedproblemsolvingwithinteams
• clearerteamroles
• namednursedevelopment
• primarynursingintroduced
• keyworkerconceptdeveloped
November 2008 Clinical Leadership Pilot Evaluation Report page 17
“Care delivery is one aspect of our work
thatwouldalwaysbereviewedonaregular
basis”.
“Over the duration of the course we
have reorganised our work teams in my
departmentandfeedbacksofarispositive
fromstaff”.
“Willingnessoftheteamtoactonoutcomes
ofpatientstoriesandobservationsofcare.
Betterapproachtoproblemsolving”.
“We have 1. clearer roles 2. regular team
meetings3.settingteamtargets4.praising
and recognising achievements in better
outcomes”
“Puttingthebabybeforeroutine”.
“Our departmental philosophy is being
reviewed and ideas shared by all the
team to make it more patient centred.
Encouragingteamtotakeapatontheback
forexcellentpatientcare–toacknowledge
theirsuccess”.
Changestotheclinicalenvironment
Participants identified a number of changes in the clinical environment that they perceive as
directlylinkedtotheirparticipationontheprogramme.Themostcommonchangesweretothe
enhancementofthephysicalenvironment,moreprivacy,lessnoise,morepatient/clientcontact
and improvedhandhygiene.Theenhancedawarenessof theclinicalenvironmentwasmainly
attributed to the observations of care element of the programme. The following quotes are
representativeofthefindings:
“In light of current climate, hygiene audit
hasbecomeparamountinmyareaofcare.
Asa resultofCLP I ammoreempowered
to talk toandsupport staff through these
challenging times. Role modelling even
the basic hand washing techniques is so
important.Fromactionlearning,Iammore
aware of risk management, clinical audit,
healthandsafety”.
“Observations of care and patient stories
have highlighted issues that can be
addressed to improve patient care; these
include increased patient supervision,
addressing delays in patient discharge.
Staff adhering to infection control policy.
Thisincludeshandhygieneandusinglinen
trolleys”.
“Privacy and dignity upheld. Noise levels
keptminimal.Morepatientcontact.Fewer
errors”.
“From observations of care, we are
endeavouringtomaketheenvironmentless
clinicalandmorelivedin–morepictureson
thewalls,curtainsinsteadofblinds,personal
itemsforclients”.
“Health and safety: through developed
networks;achievedfunctionalfireescapeto
facilitateevacuationofpatientsontheatre
trolleys if necessary. Persistence +++
required.Teammoreawareofenvironment
fromobservationsofcare”.
“Working on decreasing noise levels and
turningoffunnecessarylights”.
page 18 Clinical Leadership Pilot Evaluation Report November 2008
Changestostaffdevelopmentandsupport
Themajorityofparticipantsrespondedthattherewerealreadyimprovementsinstaffdevelopment
andwhichwereattributabletotheprogramme.Themostcommonchangesinstaffdevelopment
identifiedbyparticipants focusedonthetrainingof teammembers.Otherchanges identified
were:
• improvedsupportmechanisms
• improvedcommunication
• morefrequentinteraction
• morerecognitionandempowermentofstaff
Thefollowingisarepresentativesampleofparticipantquotes:
“Havenegotiatedtrainingdaysforstaffand
realise the importanceofprofessionaland
personaldevelopmentforstaff–foundthe
workshoponteambuildingverybeneficial
Keystaffbeingtrainedindifferentarease.g.
infectioncontrol,nurseprescribing.”
“Fulleducationprogrammesetupsupport
and funding approved from line manager
forongoingcourses”.
“In my area of work the CLP has helped
me become more involved with staff
development,especiallytrainingandsupport
in the activation programme. I strongly
advise and encourage staff to nominate
themselvesfornexttrainingsessionssothey
canbecompetentactivationfacilitators”.
“Both CNM 1‘s are now taking more of a
leadership role. More involved in decision
makingandtakingtheleadindepartmental
service provision. They are taking a more
proactivepositionandthegrowingconfident
thattheydisplayiswonderful.Thisinturnis
influencingtheirteamcolleaguesandthey
now experience an authority within the
teamwhichhaspreviouslybeendifficult”.
“Yes, I have realised that when a staff
member is difficult a lot of time can be
focused on them to the detriment of the
otherstaff.Itisimportanttorememberthat
other staffneedenergyand timeput into
theirdevelopment,notjustthedifficultstaff
members”.
“I am encouraging other team members
to become involved in programmes, ie
fundamentalsofcare,infectioncontrol”.
“Have increased the frequency of staff
meetings which gives staff opportunities
to address issues. Have had some team
building sessions with staff to address
issuesontheunit”.
“Given thatpartofprogrammedeveloped
my own capabilities, I am now in a better
position to support my Clinical Nurse
Managers.Allowtimeforlistening.Conduct
clinical nurse managers meeting. Tackle
problems and issues as a team celebrate
whatisworkingwell”.
November 2008 Clinical Leadership Pilot Evaluation Report page 19
Changesincommunication–patientandteam
Seventeenoutofnineteenrespondentsfeltthatcommunicationimprovedsinceparticipatingon
theprogrammeparticularlycommunicationwithpatientsandteammembers.Thepatientstories
werehighlightedaskeytounderstandingpatientneeds.
“Improved communication – valuing the
client’sopinions.Enablingmembersofthe
team to develop themselves – in order to
enhancepatientcare......Dailyreportfornew
nursing staff. Use of daily communication
book”.
“Communication within the team has
improved. The patient stories gave the
patients familymemberanopportunityof
expressanyconcerns”.
“Patient stories gave me an opportunity
to listen to patients and understand their
experience inhospital.Giving feedback to
stafffromobservationsofcareandpatient
stories was an opportunity to engage
in effective communication with staff.
Meetingswithmulti-disciplinaryteamshas
developedmycommunicationskills”.
“Toolswereexploredduringtheprogramme
which enhanced communication with the
patientsandteammembers”.
“Greaterlinksdevelopedacrosscommunity
mental health teams. Greater interaction
withmultidisciplinaryteam.Linksdeveloped,
negotiation and political awareness
increasedwithsame”.
“Patientstories.Meetingwithvoluntaryand
statutorygroupsonanannualbasis.Some
documentedforISO.Monthlyreviewofhow
wearefunctioningasateam.MyersBriggs
and 360 degree feedback has helped me
whenworkingwithdifferentteammembers
withdifferentleadershipstyles”.
Changesinpolicydevelopment
Fourteenoutofnineteenrespondedtothissectionofthequestionnaires.However,themajority
ofthechangesidentifiedinpolicydevelopmentfocusedonreviewofpolicyratherthanactual
changes.
“Decontamination: Audit, policy and
guidelinedevelopmentongoing”.
“Reviewcurrentlyongoingofallpolicy’sin
thehospital”.
“Yes–wehavereviewedandupdatedsome
ofourdrugpolicies”.
“Working on trying to get care plans in
place.Havetodevelopapolicyaroundour
activitiesasregardsvolunteersandstudents
onworkexperience”.
“Iammoreinterestedinpolicydevelopment
andwhetherIcancontributetoitornot”.
“Patient stories improvements. Service
improvement project may change the
policiesofhowpeoplewithenduringmental
healthproblemsaccesstheservice”.
page 20 Clinical Leadership Pilot Evaluation Report November 2008
Hasbeingontheprogrammeaffectedyourrelationshipwithyourlinemanager?
Thevastmajorityofparticipants reportedan improvement in their relationshipwith their line
manager. Changes include improved communication, conflict management, open discussion,
increasedconfidence,provisionofskillstodebatewithandchallengelinemanagerinaconstructive
manner.Thefollowingquotesarearepresentativesamplefromtheevaluationforms.
“Yes. Action learning has helped me to
reflect on my role in our conflict – how I
contributedtothat–howIhavetoaccept
that I am not responsible for managers
actions – gave me the confidence to get
mymanagermoreinvolvedintheteamand
hopefully has increased overall morale in
somesmallway”.
“Yes. My line manager would have seen
changes in me that I was unaware of.
She feels that I have become much more
confident and more willing to become
involvedinnewchallenges”.
“Yesithasgivenmeframeworksandskills
to debate and challenge in a productive
manner.Veryaware that it is important to
workcloselywithallmanagersRelationship
withlinemanagershasalwaysbeinggood.
HoweverIwillnowquestionmore”.
“The programme has developed my
communicationskills.Thishasenabledme
to be more confident in decisions I make.
I have learned to be proactive and not to
bereactive.Thatistodealwithissuesand
anticipate problems. I feel my manager
appreciates this approach and know I will
seekadviceandsupportwhenIneedit”.
“360o feedbackhasmadememoreaware
of their opinion of me. Yes – I feel more
assertiveandfindIamabletoarticulatemy
concerns/issues in a constructive manner
withideasaroundissuesalreadymade”.
“Linemanagers–havealwayshadagood
relationship as far as I am concerned;
although the 360 degree feedback did
highlight some grey areas. Good to know.
These will be discussed and our mutual
perceptions.Otherrelationshipsarecalmer,
lessfrustrating”.
November 2008 Clinical Leadership Pilot Evaluation Report page 21
Organisationlevelbenefitfromtheprogramme
The majority of participants felt the programme brought about organisational level changes.
However,mostof theresponses indicatedthat theorganisationalchangesoccurred indirectly
by improving the individual leadership skills of the participants. The individual benefit of
the programme filtered through organisations, thereby bringing about wider changes and
improvements.
“Hasopeneddialoguewithothercolleagues
within the organisation eg. through
observations of care and patient stories
feedback. Increased patient involved is
alwaysapositivefortheorganisation”.
“Yes, the service improvement project
which I am undertaking will certainly
benefittheorganisation.Itwillhelpexplain
theservicesbettertothepatientsandthus
provideeasieraccesstothepatient. Itwill
alsohopefullycutdownonthenumberof
patientswhodonotattendtheserviceand
allow other patients to benefit from clinic
placesthatarenotgoingtobeavailedof”.
“Definitely patient stories, observation of
careandourprojectallhelpinahugeway
fromanorganisationalpointofview”.
“IbelieveIambetterabletocommunicate
withpeople.Politicalawarenesshashelped
meseetheoverallpicture.IbelieveIama
morepositivepersonandthisshouldbenefit
theorganisation”.
“Yes–therewereotherprojectshappening
within the hospital. The leadership
programmereinforcedanddovetailedwith
theseotherprojects”.
“The organisation has benefited by
improving leadership skills in a high risk
area therefore improving jobsatisfaction -
retentionofstaff”.
“For me – greater awareness of the
importance of political networking,
negotiating skills at senior management
levelwill impactthe largerorganisationas
good”.
“Safer paediatric service. More quality
focused. Highlighted need for paediatric
highdependencyunitatcorporatelevel”.
“Improved leadership skills hashelpedme
tolookatthebiggerpicture”.
page 22 Clinical Leadership Pilot Evaluation Report November 2008
SatisfactionwithProgrammeContent
This section concentrates on satisfaction levels with specific content of the programme.
Feedback is taken mainly from participants themselves utilising material from focus groups
whereappropriate.
Thefollowingtableillustratesthelevelofsatisfactionwiththeaspectsoftheprogrammefrom
theevaluationquestionnaires.Eighteenparticipantsrespondedhoweveroneparticipantdidnot
respondtothequestionson360feedback*.
NotSatisfied Neutral Satisfied VerySatisfied
ActionLearningsets 1 17
Personaldevelopmentplans 7 11
*360feedback 7 5
Workshops 5 13
Peersupportedlearning 4 14
Networking 7 11
Observationsofcare 2 16
Patientstories 1 3 14
Table3Satisfactionwithprogrammecontent
ActionLearning
Feedbackfromthefocusgroupsidentifiedactionlearningsetsaspectoftheprogrammeasa
corestrengthasitgavemeaningtotheprogramme.Onekeyaspectidentifiedbyparticipants
wasthediversityofassignedactionlearningsets.Therewasageneralconsensusthatbeingin
groupsnot fromtheirownworkplacegaveastrongsenseof safety toparticipants.They felt
safetodiscussissuesandengageinalevelofdiscussion/reflectionwhichtheywouldnothave
beencomfortabledoingwiththeirownworkgroup.Theyfeltthediversityofcolleaguesfrom
acuteandprimarycareservicesbroughtafreshperspectivestoissuesraised.Theyfeltthatthis
approachtoactionlearningshouldbemaintainedforfutureorsimilarprogrammes.
ThefollowingthreethemesemergedfromtheActionLearningLogasbeingthemostcommon
issuesdiscussedbyclinicalleadersacrossthe12monthperiod:
• Conflictandpeoplemanagementissues
• Teammanagementissues
• Servicedevelopmentissues
November 2008 Clinical Leadership Pilot Evaluation Report page 23
“I felt that Ibenefited from the fact that I
wastheonlypersonfrommyworkgroupin
myaction learninggroup. Iwouldbeslow
to participate if there was someone else
frommyareathereeventhoughtherewere
groundrulesputinplace”.
“The action learning study days have
developedmyproblemsolvingskills.Ihave
learned to reflect on my own experiences
and have learned from the experiences of
other members of the group. I benefited
from learning how to prevent conflict and
howtomanageconflict”.
“Action Learning sets and mentorship has
helpedmetotakeonanissueandfindways
myselftoresolvesame”.
360DegreeFeedback
The360-degreetechniqueinvolvesthesystematiccollectionofperformancedataonparticipants,
gathered from a variety of sources (the raters) in a confidential manner. The raters normally
include the participant’s line manager, peers and direct reports. Because each rater offers a
differentperspectiveontheparticipant’sskillsandabilities, the resultingappraisalprovidesa
well-roundedandcomplete(hence‘360-degree’)pictureoftheparticipantandhis/herstrengths
andweaknessesinassessedareas.TheprogrammeutilisedtheLeadershipQualitiesFramework
developedbytheNHS,tosupportthisprocess.The360DegreeFeedbackoccurredtowardsthe
endoftheprogramme.
Twenty one participants completed the process and responded positively to this in the
questionnaire.Key learningpointscitedweretheexperienceofreceivinghonestfeedback,an
awarenessofstrengthsandweaknesses,andtheprocesshighlightingareasfordevelopment.A
numberofparticipantssaidtheyfelttheprocesswasdauntingatfirstbutthat,onreflection,the
processwasverybeneficial.
“Reading in print other people views and
opinions of me as a clinical leader was
daunting and a new experience for me,
moving forward now and developing my
areasforgrowthismychallengeandIlook
forwardtosame”.
“Foundthe360degreeappraisalveryuseful
–ithasgivenmetheconfidencetobelieve
in myself as a leader. It highlighted areas
whereIcoulddevelopfurther”.
“Yes – very useful especially the Action
Planning section of the booklet – key
developmental needs. I am going to have
todoanactionplanofdevelopmentneeds
–bemoreawareoftheseandbeadaptable
tochangeaccordingly”.
“Yes–OnreflectionthecriticismIreceived
has made me stronger – it was hurtful
initially”.
“Yes,Iammoreawareofgettingonething
finished before starting another. Thinking
outsidetheboxandcooperatingmorewith
seniormanagement.Able toadmitwhen I
amwrong”.
page 24 Clinical Leadership Pilot Evaluation Report November 2008
“Yes it gave me the opportunity to look
at my leadership style through the eyes
of others. The feedback was invaluable in
identifyingareasforselfdevelopment.”
“Yes–allowedformetoreflectonmyown
practiceandimproveonareasidentifiedas
areasofweakness”.
“Ithelpedmereflectonmyownleadership
style and how this was impacting on the
team.ThepositivefeedbackIreceivedfrom
mymanagerandpeerswasappreciated.It
helpedmerealisethatIhavethetendencyto
commenceanewprojectbeforecompleting
thecurrentone.Helpedmetorecogniseto
say no to new work projects when this is
appropriate”.
There were some concerns raised in relation to timing and preparation for the 360 degree
feedback:
“The360oreviewmightbemorebeneficialatthebeginningoftheprogrammetohighlightareas
ofdevelopment”.
The participant focus group was also largely positive on this aspect of the programme.
Participantsfeltthatitwasusefulinbringinghometheimportanceofleadershipskills,increasing
selfawarenessandreflection,andinreassuringpeoplethattheyweredoingmanythingsright.
Itwasrecommendedthatthisprocessshouldbeatthestartoftheprogramme,inbeingableto
identifydevelopmentalneeds.This feedbackwasreflected inthesteeringcommitteeand line
management/mentorfocusgroupwherethetimingwasalsodiscussed.However,itwasnoted
that if the360degree feedbackoccurred tooearly theremaynotbe the requisite trust and
participantsmaynotbereadytoreceivedifficultfeedback.
Workshops
Theevaluationsoftheworkshopswereallverypositive–manyparticipantsremarkingonthe
excellent facilitationskills.Therewasverypositive feedbackonpresentations,especially from
speakersfromoutsidethehealthservice,forexamplebusiness,sportsandpolitics.Theworkshop
onconflictmanagementwasregardedasexcellentandverynecessary.
“MBTI helped me to manage my boss by
recognisingourdifferences”.
“Oneofmyfavouriteworkshopswasteam
building – I do mention some aspect of
thisday so regularly to the team–all the
literatureIgotonthesedaysalwaysavailable
to any team member. I’ve learned how to
managemeandhowtosetobjectives,how
todevelopandsustainteamsandofcourse
thenotionofinterdependence”..
“Getting to know your team, allowing
themtocontributeanddevelop issovery
important. As a leader not to shy from
askingforideas;andbeingsupportive”.
November 2008 Clinical Leadership Pilot Evaluation Report page 25
“PatientStorieshaveenabledustoensure
thatthecarewedeliverispatientfocused”.
“Have found the patient stories and
observations of care valuable frameworks
that Ihopetocontinuetousetomeasure
thequalityofcarethatweprovide”.
“Theuseofobservationsofcareandpatient
storiesdemonstratestheneedtoinvolvethe
teamandtotakeintoaccountthepatients
perspectivewhenmakingdecisions”.
“What I found the most difficult was the
patient interviews. I would have benefited
from observing a patient interview before
undertakingsame”.
pilot evaluation recommendations6
page 26 Clinical Leadership Pilot Evaluation Report November 2008
Therewasapositiveoverwhelmingresponsetotheprogrammefromallstakeholders.Certainareasforsimilarprogrammedevelopmentemergedbothintheevaluationsandthefocusgroupsthatcouldbeimprovedorbuiltuponforthefuture.
1. AllevaluationdatarecommendedthatsimilarprogrammesbecomemandatoryforCNM/
CMM’s.
2. ThedevelopmentofaseriesofstagedclinicalleadershipstrategiestosupporttheClinical
Nurse/MidwifeManagercareerpathway.
3. EstablishbettermentoringstructureswithintheHealthServiceExecutive,e.g.accessibilityto
personnelthatfocusonlongtermdevelopment.
4. Developmentofa360degreefeedbackmechanismforClinicalNurse/MidwifeManagersand
toreviewthetimingandreportingofthisprocessinprogrammestructures.
5. ExplorethesustainabilityofclinicalleadershipdevelopmentforClinicalNurseandMidwifery
Managerswithinanationalcontext.
6. Developexpertisetofacilitateclinicalleadershipdevelopmentwithinnursingandmidwifery-
howtheRCNclinicalleadershipprogrammewasfacilitatedwasseenofrealbenefit.
7. Developmechanismstodisseminationtheoutcomesfromclinical leadershipdevelopment
–focusonamoreco-ordinatedapproachtosharinginformationonservicedevelopmentand
improvedpractice.
8. Exploreaccreditationprocessesandenableparticipantsflexibilityinachievingaccreditation,
iftheysowish.
Thefollowingquotesfromparticipantsreflectsomeoftheabovepoints:
“Keepupthegoodwork.Istronglybelieve
thatthiscourseshouldbecompletedwithin
twoyearsofanynursebeingpromotedtoa
managementgrade”.
“The Clinical Leadership Programme
shouldbemandatory forallClinicalNurse
Managers, ideally undertaken prior to the
takingupofthepost”.
“IworkasaCNSandstronglybelievethat
inanearlierlifeasCNM2thiscoursewould
havebeeninvaluable.Ifeelthiscourseshould
bemandatoryforallnewlypromotedCNM
2’sandtheyshouldbeintegratedwithmore
experienced people to learn from them.
Alsotheycansharetheirexperiences”.
November 2008 Clinical Leadership Pilot Evaluation Report page 27
4“Would like to see a similar programme
developed for staff nurses to enable
them to work more effectively within the
complexities of the health system. If they
were empowered & enabled, they would
have a positive impact on issues within
nursingandhealth”.
“Could this CLP be developed further so
onecouldcontinuetheirleadershipjourney,
atdifferentlevelssothatonecouldbecome
veryproficient”.
“Would there be an opportunity to have
follow up days after completion of the
programme”.
“Iwouldlovetomeetthelargegroupover
the next year to re-visit aspects of the
programmeandhavethevalue/inspiration
fromourexcellentfacilitator”.
“Anexcellent facilitatorand I feel that the
programmeinthefuturewillbesuccessful
ifithastherightfacilitator”.
“The programme worked because of the
greatfacilitationskills”.
“Chooseamentorwhoisreadilyaccessible
and who will still be available when the
programmeiscomplete”.
Anumberof issuesemerged fromthesteeringcommittee focusgroup includingtheneedto
increaseparticipationonsuchprogrammesfrompublichealthandpracticenursing,particularly
withthedevelopmentofprimarycareteams.Thegrouphighlightedtheneedformoreinteraction/
communicationwithstaffunionslocallyandtheneedforculturalchange-“Leaderswillencounter
conflictwhenintroducingchangeandneedtobeabletodealwiththis”.Theyrecommendedthe
inclusionofaworkshopondealingwithunionandpartnershipissuesandthatthiswouldbean
importantadditiontotheprogramme-“enablingCNM’stounderstandwhothestakeholdersare,
identifyingstakeholdersindifferentorganisations,understandingthatstakeholdersmaychange
andfeelingempoweredtodealwiththestakeholders–areimportantpartsofanyprogramme”.
Akeyrecommendationwasthattheoutcomesfromclinicalleadershipdevelopmentshouldbe
collatedinanationalregister/databasetoinfluencethedisseminationofservicedevelopment
andinnovation.Itwasalsosuggestedthatthereshouldbemoreformalandfrequentmechanisms
tocapturepatient/clientvoicesgiventhesuccessofthiscompetentoftheprogramme.
Theissueofsustainabilitywasonethatemergedasanimportantconsiderationinallfocusgroups
andevaluationforms.Theimportanceofsustainingprogrammeactivitiese.g.actionlearningand
lifelonglearningaftersuchprogrammesshouldbeconsidered.
conclusion7
page 28 Clinical Leadership Pilot Evaluation Report November 2008
Thefindingsofthispilot,whichutilisedtheRCNclinicalleadershipprogramme as a framework for clinical leadership development,demonstratethattherearebenefitstosupportingandenhancingtheclinical leadershipskillsofclinicalnurse/midwifemanagersintheRepublicofIreland.
Itrecommendsthatnationalclinical leadershipstrategiestosupportfront linestaffshouldbe
developed,particularlyasthecontextofIrishnursingandmidwiferyischangingandnewways
ofworkingareneeded.
FurtherworkinenhancingleadershipcapacityintheRepublicofIrelandisrequiredtodevelopand
sustainaflexiblenursingandmidwiferyworkforce.Itisvitalthatimmediateactionsforenhancing
clinical leadership at all nursing and midwifery grades are identified. These national clinical
leadershipstrategiesshouldbeexperientialandworkbasedtoachievebettersafeoutcomesfor
clientsandpatients.Thislevelofinvestmentisnecessaryinsustainingimprovedperformancein
theIrishHealthService.Itcanmakeorbreakthedeliveryofatransformedhealthservice.
November 2008 Clinical Leadership Pilot Evaluation Report page 29
references 8BakerGR,NortonPG,FlintoffVetal(2004)TheCanadianadverseeventsstudy:theincidence
ofadverseeventsamonghospitalpatientsinCanada.CanadianMedicalAssociationJournal170,
10,1678-1686.
Baumann A, O’Brien-Pallas L, Armstrong Stassen M et al. (2001) Commitment and Care: The
Benefitsofahealthyworkplacefornurses,theirpatientsandthesystem.CanadianHealthServices
ResearchFoundation,OttawaON.
Clifford JC (1998) Restructuring: The impact of hospital organization on nursing leadership.
Jossey-Bass,SanFranciscoCA.
CunninghamG,KitsonA(2000a)AnevaluationoftheRCNClinicalLeadershipprogramme:part
1.NursingStandard.15,12.
CunninghamG,KitsonA(2000b)AnevaluationoftheRCNClinicalLeadershipprogramme:part
2.NursingStandard.13,15,13-15.
Havens DS (2001) Comparing nursing infrastructure and outcomes: ANCC magnet and non
magnetCNE’sreport.NursingEconomics.19,6,258-266.
DepartmentofHealthandChildren(unpublished2009)NationalCommissiononNursingHours
Report.
PawsonR,TilleyN(1997)RealisticEvaluation.Sage,London
RedfernS,ChristainS,NormanI(2003)Evaluatingchangeinhealthcarepractice:lessonsfrom
threestudies.JournalofEvaluationinClinicalPractice.9,2,239-249.
RoyalCollegeofNursing(1997)WardLeadershipProject:AjourneytopatientcentreLeadership,
London:RCN.
Thomas J (2006) Survival Guide for Nurse Managers, Sisters and Charge Nurses. Churchill
Livingstone,Elsevier:London.
appendices
page 30 Clinical Leadership Pilot Evaluation Report November 2008
Appendix1-ClinicalLeadershipSteeringCommitteeHSEWest(Limerick,ClareandNorthTipperary)
MembershipoftheGroup
1. IndependentChair-PatHarvey(Former CEO -North Western Health Board)
2. MargaretMurphy-PatientRepresentative-IrishPatientAssociation
3. JohnHennessey-A/NetworkManagerAcuteServicesHSEWest
4. BernardGloster–LocalHealthManager-NorthTipperary/EastLimerick
5. NoraIrwin-Director,NursingandMidwiferyPlanningandDevelopmentUnit
6. MaryKenehan-HumanResourceSpecialist.HSEWest
7. MarieO’Haire-PartnershipFacilitatorHSEWest
8. MauraFitzgerald–DeputyDirectorofNursing,MidWesternRegionalHospital,Limerick.
9. GeraldineRyanDelaney-DirectorofNursing,HospitaloftheAssumption,Primary,Community
andContinuingCare
10. MargaretQuigleyDivisionalMidwifeManager,MidWesternRegionalMaternityHospital,
Limerick
11. MaryFogarty–IndustrialRelationsOfficer-IrishNursesOrganisation
12. JeaneMoloney-ProgrammeParticipant-ClinicalNurseManager3-MidWesternRegional
Hospital-LimerickAcuteServices
13. BredaO’Connor-ProgrammeParticipant-ClinicalNurseManager2-DaughtersofCharity,
Lisnagry,Primary,CommunityandContinuingCare
14. MichelleFrawley-ClericalOfficer,NursingandMidwiferyPlanningandDevelopmentUnit,
HSEWest(Limerick,ClareandNorthTipperary
15. CoraLunn-ClinicalLeadershipFacilitator,NursingandMidwiferyPlanningandDevelopment
Unit,HSEWest(Limerick,ClareandNorthTipperary).
November 2008 Clinical Leadership Pilot Evaluation Report page 31
Appendix2-PreProgrammeQuestionnaireforclinicalleaders
1. Biographicaldetails
Whatageareyou?
Whatareyourqualifications?
Describeyourclinicalarea (i.e.typeofclinicalarea andtypeofpatients)
Describeyourorganisation
2.Values,patientcareandprofessionaldevelopment
Howisthenursingcarein yourclinicalareaorganised?
Doyouhaveawritten Please elaborate
philosophyofpatientcare?
Dostaffworktoaphilosophy ofpatientcare?
Dostaffunderstandthe philosophyofpatientcare?
Howwouldyoudescribethe qualityofcareinyourclinical area?
Howdoyoumeasurethequalityofcareinyourclinicalarea?
List3waysinwhichthequality ofcarecouldberaised?
page 32 Clinical Leadership Pilot Evaluation Report November 2008
3.ClinicalLeadershipexpectations
Howwouldyoudefine
leadership?
Howwouldyoudescribeyour
currentleadershipattributes?
Whatdoyoubelieveareyour
currentstrengthsasaleader
andwhatdoesthismean
inpractice?
Namethreespecificskillsyou
hopetodeveloporbuildon
overthecourseoftheRCN
ClinicalLeadershipProgramme.
Arethereanypatient YES NO involvementinitiatives currentlytakingplacein IfYESpleasedescribeit yourclinicalarea?
Haveyouidentifiedany Pleasedescribe particularproblemsinthe clinicalareainthewaythat careisorganisedordelivered thatmayhaveadetrimental effectonpatientcare?
Doyoubelieveyouhave YES NO goodteamworkinyour clinicalarea? Pleasegiveexamplesofteamwork?
Doyouworkwellwithallthe othernon-clinicalareabased healthcarestaffthatare involvedwithcare? Giveexamples.
Arethereanycurrentresearch initiatives/projectsunderway inyourclinicalarea? Whatprofessionaldevelopment programmesarethereforstaff fromyourclinicalarea?
November 2008 Clinical Leadership Pilot Evaluation Report page 33
Canyouexplainwhyyouwould liketodeveloptheleadership skillsidentified?
Howwouldtheleadershipskills identifiedbenefit a)patientcare, b)theclinicalareaand c)theorganisation? Doyoubelieveclinicalareais opentochangeandkeeping pacewithdevelopmentsin clinicalpractice–ifsohow? Arethereanyparticularbarriers tochangethatyoucanidentify?
4.JobSatisfaction
i. Doyoufeelsatisfiedwithyourjob?Pleasetick?
NotSatisfied Neutral Satisfied VerySatisfied
ii. ifnotwhy?
iii. Doyoufeelsatisfiedwithyourabilitytoinfluencetheorganisationofpatientcare?
NotSatisfied Neutral Satisfied VerySatisfied
iv. ifnotwhy?
v.
Dootherstaffinyourclinicalareaofworkfeelsatisfiedwiththeirjob?
NotSatisfied Neutral Satisfied VerySatisfied
vi. ifnotwhy?
page 34 Clinical Leadership Pilot Evaluation Report November 2008
5.Follow–upinterview
Willyouagreetocomplete YES NO anotherquestionnaireduring andattheendoftheRCN LeadershipProgramme?
6.Opportunitytocommentgenerally
Wouldyouliketheopportunity tosayanythinginrelationtothe RCNClinicalLeadership Programme?
Thankyouverymuchforyourtime.
November 2008 Clinical Leadership Pilot Evaluation Report page 35
Appendix3-MidProgrammequestionnaireforclinicalleaders
1. WhathaveyoulearnedsofarfromtheRCNCLP?
2.Howhastheprogrammecontributedintheareasoflearningyouhaveidentified?
3.Whathasnotbeenbeneficialtoyouwithregardstoyourinvolvementwiththe
RCNCLP?(Pleaseexplain).
4.Howcouldtheseareasbeaddressedforthefutureprogrammes?
5.Pleaserateyoursatisfactionwiththefollowingkeyprogrammeinterventions:
• Personaldevelopmentplans
NotSatisfied Neutral Satisfied VerySatisfied
• 360oFeedbackTool
NotSatisfied Neutral Satisfied VerySatisfied
• ActionLearningSets
NotSatisfied Neutral Satisfied VerySatisfied
• Workshops
NotSatisfied Neutral Satisfied VerySatisfied
page 36 Clinical Leadership Pilot Evaluation Report November 2008
• One–to–Ones
NotSatisfied Neutral Satisfied VerySatisfied
• Peersupportedlearning
NotSatisfied Neutral Satisfied VerySatisfied
• Networking
NotSatisfied Neutral Satisfied VerySatisfied
• Observationsofcare
NotSatisfied Neutral Satisfied VerySatisfied
• Patientstories
NotSatisfied Neutral Satisfied VerySatisfied
6.Whathasbeentheimpactintermsof
•PatientCare
•PersonalLeadership development
•ClinicalEnvironment
•Servicedevelopment
•Quality
7.Doyouthinkthecareinyourclinicalareahasorischanginginanyway,asaresult
ofyourparticipationontheRCNCLP?
Ifso,isthataresultofyourparticipationontheRCNCLP?
(Ifyes,how?)
8.Hasyourdevelopmentplanstartedtoaddressthegoalsyouidentifiedatthebeginning
oftheprogramme?
Thankyouverymuchforyourtime
November 2008 Clinical Leadership Pilot Evaluation Report page 37
Appendix4-PostProgrammeQuestionnaireforclinicalleaders
1. HowwouldyoudescribeyouroverallexperienceoftheRCNClinicalLeadershipprogramme?
2.HowwouldyouratetheRCNClinicalLeadershipProgrammeonthescalebelow:
VeryPoor Poor Neutral Good VeryGood
3.Hasyourleadershipcapabilitychanged?Pleasedescribe:
AretheleadershipattributesyouidentifiedhighlightedinyourPDP?
4.Wasthe360degreeappraisalusefulinidentifyingareasofsubsequentchange?
a.Howwouldyounowdescribeyourselfasaleader?
b.Didundertakingtheprogrammefulfilyourexpectations?
c. Isthereanyaspectsoftheprogrammethatcouldbeimproved?
d.Aretherechangesdirectlyattributabletoyoubeinginvolvedinthe
RCNClinicalLeadershipprogramme:
page 38 Clinical Leadership Pilot Evaluation Report November 2008
i. Patientcare
ii. Changesinorganisingthewaycareisdelivered
iii.Clinicalenvironment
iv.Staffdevelopment
v. Staffsupport
vi.Clinicalgovernance
vii. Quality/Fundamentalsofcare/clinicalgovernance
viii.Communication–patient,teamorwiderteam
ix.Policydevelopment
November 2008 Clinical Leadership Pilot Evaluation Report page 39
e.Arethereanychangesinthewaytheteamworkstogetherinyourclinicalenvironment?
Ifso,arethesechangesinanywayconnectedtoyourinvolvementintheRCNClinical
LeadershipProgramme?
f. HaveyouchangedyourpostwhilstbeingontheRCNClinicalLeadershipProgramme?Hasthis
changealteredyourperceptionsoftheappropriatenessoftheprogrammehelpedorhindered?
g.Hasbeingontheprogrammealteredyourcareerfocusordirection?Ifso,how?
h.Howsatisfiedareyouwithyourcurrentjob?Pleaseindicateonthescalebelow:
Verydissatisfied Dissatisfied Neutral Satisfied VerySatisfied
5.Hassatisfactionwithyourcurrentjobchangedoverthecourseoftheprogramme?
Ifso,pleaseexplain.
6.Haveyouobservedanychangeinthejobsatisfactionofstaffinyourclinicalarea?
7. Hasbeingontheprogrammeaffectedyourrelationshipwithyourlinemanager?
• Othermanagersinyourorganisation?Ifso,pleaseexplain.
page 40 Clinical Leadership Pilot Evaluation Report November 2008
8.Wehavesofarbeenexploringimpactonyourpersonaldevelopment,thepatient,theteamand
theclinicalenvironment.Doyouthinkthereisanyorganisationlevelbenefit?
9.WouldyouliketoaddanythingyouthinkImayhavemissed?Wouldyouliketheopportunity
tosayanythinginrelationtotheRCNClinicalLeadershipProgramme?
Thankyouverymuchforyourtimeandsupportincompletingthisquestionnaire.
November 2008 Clinical Leadership Pilot Evaluation Report page 41
Appendix5-RCNClinicalLeadershipProgramme-Workshop
Name: Organisation: Date:
1. ThethingsIhavelearntfromtoday’sworkshopare:
2.ThemostimportantthingIhavelearntaboutmyselftodayis:
3.Myactionplantotakebacktomyworkplaceis:
4.Theonethingthatstandsoutformetodayis:
5.Theworkshopcouldhavebeenimprovedif:
6.ThethingsIenjoyedmostabouttheworkshop:
7. Thestyleoffacilitationwas:
8.Theimpactonmewas:
page 42 Clinical Leadership Pilot Evaluation Report November 2008
Appendix6-ActionLearningLogTemplate
IdentifiedIssue IdentifiedAction Impact
November 2008 Clinical Leadership Pilot Evaluation Report page 43
Appendix7-ServiceImprovementProjectundertakenintheHSEWest
(Limerick,ClareandNorthTipperary)
AcuteHospitalNetworkServices
1. IntroductionofcannulationinA/EDepartmentinimprovingcaretoclients-MidWestern
RegionalHospitalNenagh.
2. IntroductionandthedevelopmentofPerinealSuturingbymidwivesforwomen-Regional
MaternityHospital.
3. Thedevelopmentofaneonatalunitinformationbookletforparents-RegionalMaternity
Hospital.
4. Developmentofbedmanagementpolicy/guidelinesfortheacuteTraumaOrthopaedic
ward-MidWesternRegionalHospitalLimerick.
5. Developmentofamorepersoncentredschedulingsystemforpatientsattendinga
haematology/oncologydayunit-OncologyUnit,MidWesternRegionalHospitalLimerick.
6. Thedevelopmentofamultidisciplinaryintegratedcarepathwayforpatientsbeingadmitted
foreyesurgery-MidWesternRegionalHospital,Limerick.
7. Development,implementationandevaluationofaCriticalCarePathwayinaCoronaryCare
Unit-MidWesternRegionalHospital,Limerick.
8. Thedevelopmentofapackageofpatienteducationandinformationinoutpatients
Department-MidWesternRegionalHospitalNenagh.
9. Thedevelopmentofamultidisciplinarypre-operativefastingguidelineforadultand
childrenonanorthopaedicward-MidWesternRegionalOrthopaedicHospital,Croom,
Limerick.
10. Thedevelopmentofamoreeffectivetheatreschedulingsystemtomaximisetheatre
capacityinmeetingtheneedsofpatients-MidWesternRegionalOrthopaedicHospital,
Croom,Limerick
11. Develpmentofapainmanagementserviceinaacuteservices-PaediatricDept,
MidWesternRegionalHospital,Limerick.
page 44 Clinical Leadership Pilot Evaluation Report November 2008
Primary,CommunityandContinuingCare
12. Establishmentofasystemwherethemostappropriatehealthprofessionalwouldassess
newclientsattendingmentalhealthservices-ShannonDayHospital,MentalHealthServices-
CoClare.
13. Supportandeducationfortheestablishment/implementationoftwoadditional
intermediatePalliativeCarebedsinanursinghome-MilfordNursingHome,Castletroy,
Limerick.
14. Thedevelopmentofguidelinesforthetransitionofclientsfromhome/acuteserviceto
residentialcare-HospitaloftheAssumption,Thurles,CoTipperary.
15. IntroductionofamodifiedmodelofprimarycarenursinginaRehabilitationUnitforolder
persons-HospitaloftheAssumption,Thurles,CoTipperary.
16. Thedevelopmentofstrategiestoenablethedeliveryofeffectivepatient/clientcarefor
olderpersons-HospitaloftheAssumption,Thurles,CoTipperary.
17. Enhancementofthelivingenvironmentforagroupofolderpersonswithinintellectual
disabilityinimprovingtheirqualityoflife-DaughtersofCharity,Lisnagry,CoLimerick.
18. Explorationoftheserviceimplicationsfortheimplementationofagraduateolderpersons
enduringmentalillnesscareservice-HSEWest,ClareMentalHealthServices.
19. Thedevelopmentofclientinformationresourcese.g.websiteandbrochureforacommunity
residentialfacilityforolderpersons-DeanMaxwellResidentialHome,Roscrea,CoTipperary.
20.DevelopmentandimplementationofanactivationprogrammeinaCommunityResidential
facilityforolderpersons-ReginaHouse,CoClare.
21. DevelopmentandimplementationofanactivationprogrammeinaCommunityResidential
facilityforolderpersons-RaheenHospital,CoClare.
Clinical Leadership Pilot Evaluation Report