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Das international erfolgreiche Programm Relationship-Based CareTM wird von vielen Kliniken verwendet, die sich auf den Magnet-Status vorzubereiten. Hier wird die Qualitat der Arbeitsbeziehungen in den Mittelpunkt geruckt. Im Zuge der Einfuhrung des Programmes Relationship Based CareTM wurden zwei innovative Workshops entwickelt, um das Engagement der Fuhrungskrafte und Mitarbeiter von Gesundheitseinrichtungen mit Herz und Verstand einzubinden. Die Workshops wurden entworfen, um neue innovative Lehrmethoden zu integrieren. Im Mittelpunkt stand dabei ein Grundsatz der Erwachsenenbildung, bei welchem der Respekt fur das Wissen und die Erfahrung des Lernenden die Basis bilden sollte. Die Lernenden nahmen an verschiedenen Aufgaben und reflexionsorientierten Ubungen teil, um die Inhalte anzuwenden und zu verinnerlichen. Der Fokus lag hierbei deutlich auf den Kompetenzen der Beziehungsbildung, nicht auf den klinisch-technischen Fahigkeiten der Teilnehmer. Pflegepraktiken fur sich selbst, fur Mitarbeiter, fur Patienten und Familien wurden in Verhaltensweisen umgesetzt. Die Kursteilnehmer lernten Wege, therapeutische und gleichzeitig empathische Beziehungen mit Anderen zu entwickeln. Organisations- und fachbereichsbezogene Messverfahren zeigten die positiven Auswirkungen der Workshops. Festgestellt wurden ein deutlicher Ruckgang der Personalfluktuation ermittelt von den Personalabteilungen sowie eine gestiegene Patientenzufriedenheit, die mittels Fragebogen erhoben wurde. In diesem Artikel werden die Inhalte der beiden sehr erfolgreichen Workshops erstmals einem offentlichen Publikum zuganglich gemacht.

Research happens in all sorts of different places, the university setting and research institutes being key locations. Professional practice settings are also locations where research, particularly applied research, happens. For example, the judicious use of research and continual evaluation of practice are critical to achieving high-quality health care and higher education provision and are integrally linked to the research capacity and capability of the workforce. However, not all workers in such settings are research active and, when pressed to do research, can identify a range of barriers, stating

Aims and objectives To update and re-validate the Valuing Patients as Individuals Scale for use as a patient appraisal of received healthcare. Background Healthcare in the United Kingdom and beyond is required to deliver high quality, person-centred care that is clinically effective and safe. However, patient experience is not uniform, and complaints often focus on the way patients have been treated. Legislation in United Kingdom requires health services to gather and use patients' evaluations of care to improve services. Design This study uses scoping literature reviews, cognitive testing of questionnaire items with patient and healthcare staff focus groups, and exploratory factor analysis. Methods/Setting/Participants Data were collected from 790 participants across 34 wards in two acute hospitals in one National Health Service Health Board in Scotland from September 2011–February 2012. Ethics and Research and Development approval were obtained. Results Fifty six unique items identified through literature review were added to 72 original Valuing Patients as Individuals Scale items. Face validity interviews removed ambiguous or low relevance items leaving 88 items for administration to patients. Two hundred and ninety questionnaires were returned, representing 37% response rate, 71 were incomplete. Thus 219 complete data were used for Exploratory Factor Analysis with varimax orthogonal rotation. This revealed a 31 item, three factor solution, Care and Respect; Understanding and Engagement; Patient Concerns, with good reliability, concurrent and discriminant validity in terms of gender. A shortened 10 item measure based on the top 3 or 4 loading items on each scale was comparable. Relevance to clinical practice The short scale version is now being routinized in real-time evaluation of patient experience contributing to this United Kingdom, National Health Service setting meeting its policy and legislative requirements. What does this paper contribute to the wider global clinical community? •The updated Valuing Patients as Individuals Scale; •Is a reliable and valid measure specifically designed to capture the issues that matter most to people receiving secondary care. •Has been developed based upon current conceptualisations of person-centred care and the clinical practices required to deliver this. •May be used within service improvement work as a trigger to ensure person-centred care delivery.

It began two years ago, then Arriving in Edinburgh the enthusiasm abounds. The first day arrives – oozing anticipation. Great to gather old friends, new friends; Clans and clever creativity, having fun Energy in the room, creating, innovating, Creative ways transforming minds, creating impact. The International Practice Development Collaborative (IPDC) is loose network of practice developers, academics and researchers who are committed to working together to develop healthcare practice. The IPDC believes that the aim of practice development is to work with people to develop person-centred cultures that are dignified, compassionate and safer for all. One of its four pillars of work is a biennial Enhancing Practice conference. Moving round the world, the IPDC members take it in turns to host the conference; in early September 2016 it was the turn of Queen Margaret University (QMU) in Edinburgh. This article has been created collaboratively by a number of the people who attended this three-day conference. The IPDJ team invited participants to offer ‘the line of a poem’ that captured or reflected their experience and/or learning. These were then collected and shared, and together we created a series of poems and a collection of haiku (a three-line Japanese poem with 17 syllables, 5-7-5). Other participants have subsequently offered reflections, which we would also like to share with you here. We offer this article to you, as a celebration of our time together; our learning, connections and creating, in the hope that there might be some learning in here for you and that you may consider joining us at our next conference in Basel, Switzerland in 2018.

Introduction: (comprising context and problem statement) A national two year practice development programme took place in the Republic of Ireland from 2007 to 2010. The programme was commissioned to support staff to implement a framework for person-centred nursing practice-centred practice in residential settings for older persons. Eighteen sites took part in the programme and staff and managers from a variety of disciplines used a person-centred framework and practice development model to develop their practice. Since the programme finished there is evidence that this work sustained and in some places continued to grow. The Health Service Executive in Ireland (HSE) now wishes to extend this programme to all services incrementally using the same methodology so that care and practices can be more fully integrated from a workplace culture perspective. Short description of practice change implemented: Process and outcome evaluation demonstrated improvements in practice and workplace culture for staff and improvements in care experiences for residents. A number of validated tools were used, both process and outcome that engaged residents and staff. Evidence indicated increased choice for residents and more meaningful relationships between them and staff to name but two. There was for example evidence of changes in workplace culture with improvement to quality of communication and support between staff, greater role satisfaction, improved staffing and resources, and greater commitment to the setting. Aim and theory of change: The overall aims of the programme were to: implement a framework for person-centred practice[1] for older people across multiple settings in Ireland, through a collaborative facilitation model and to carry out an evaluation of the processes and outcomes. The programme drew on numerous principles from different yet complementary theories and approaches: emancipatory practice development, co-operative inquiry and a specific person-centred nursing framework. Targeted population and stakeholders: Eighteen residential units for older people were involved in this programme. Along with residents in targeted sites, staff groups represented different areas within the units and grades i.e. Nurse Mangers, Staff Nurses, Health Care Assistants, Housekeeping, Catering and Administration staff. Timeline: An initial two year programme took place 2007 – 2010. The HSE will now replicate this programme by introducing a further three year national programme to develop cultures of person-centredness system wide which commences in February 2017. Highlights: (innovation, Impact and outcomes) This is an innovative methodology and programme that has been replicated in many different settings internationally such as New South Wales, Netherlands, Norway, Malta, UK, and others. Using this methodology and framework staff were facilitated to critically explore their practice and Comments on sustainability: For long term sustainability it is vital that practice development activities contribute to the professional and personal development of staff and managers. The development of staff key facilitation and practice development knowledge and skills enabled staff to work effectively with colleagues to changes their workplace culture. Comments on transferability: This programme has transferability to any care setting demonstrated in the variety of settings it has been introduces in for example in the New South Wales programme Essentials of Care[2] The focus is on developing cultures of person-centredness that supports person-centred practices. Conclusions: (comprising key findings) The HSE had demonstrated considerable impact on care experiences for both service users and staff through the introduction of this programme in older persons’ residential services. Discussions: Developing workplace culture will impact on the immediate experience of both staff and service users[3]. Recognising the enablers and consequences of workplace culture development means that the focus is on basic assumptions that influence actions[4]. Lessons learned: Involvement and engagement of managers in organisations is essential to the success of culture change. Managers are part of the culture and therefore need to be part of making change. References: 1- McCormack and McCance. Developing a conceptual framework for person-centred nursing. Journal of Advanced Nursing, 2006;565(5):472-479 2- Essentials of Care Program - Projects - NSW Health - NSW Government(Accessed 17/01/2017) Available from: www.health.nsw.gov.au/nursing/projects/Pages/eoc.aspx Accessed 17/01/2017 3- Manley, K, Saunders, K., Cardiff, S., Webster, J. Effective workplace culture: the attributes enabling factors and consequences of a new concept. International Practice Development Journal 2011;1:(2). Available from: http://www.fons.org/library/journal/volume1-issue2/article1 (Accessed 17/01/2017) 4- Schein, E. H. Organisational Culture and Leadership, 2nd edition. Jossey-Bass, San Francisco, CA. 1985

Objectives To examine the types of choices available to patients in the English NHS when being referred for acute hospital care in the light of the divergence of patient choice policy in the four countries of the UK. Methods Case studies of eight local health economies in England, Scotland, Northern Ireland and Wales (two in each country); 125 semi-structured interviews with staff in acute services providers, purchasers and general practitioners (GPs). Results GPs and providers in England both had a clear understanding of the choice of provider policy and the right of patients to choose a provider. Other referral choices potentially available to patients in all four countries were date and time of appointment, site and specialist. In practice, the availability of these choices differed between and within countries and was shaped by factors beyond choice policy, such as the number of providers in an area. There were similarities between the four countries in the way choices were offered to patients, namely lack of clarity about the options available, limited discussion of choices between referrers and patients, and tension between offering choice and managing waiting lists. Conclusions There are challenges in implementing pro-choice policy in health care systems where it has not traditionally existed. Differences between England and the other countries of the UK were limited in the way choice was offered to patients. A cultural shift is needed to ensure that patients are fully informed by GPs of the choices available to them.