Heather Morgan on behalf of the Evaluation Team Evaluation Update Heather Morgan on behalf of the Evaluation Team

Evaluation Team

Evaluation Aims whether and how The evaluation will help us to understand: whether and how the programme achieved its aims and objectives.

Evaluation Components Formative evaluation – ongoing Evaluability assessment – complete Summative evaluation – future

Formative evaluation progress Engaging with ICU field of medicine internationally – ongoing Ethics approval – complete Ethnographic work (documentary and observational) – underway First phase of interviews with patients and staff at each site – complete Conversations with QI leads at each site – ongoing Initial synthesis of interim findings for Health Foundation report – due October

Staff/stakeholder – Interviews Site Dates n=8 Monklands, NHS Lanarkshire Physio Gym Wednesday 17 May 2017 09:00-12:00 Cohort 2, week 5 1 x staff (F – doctor, <2 years ICU) – 30002 1 x patient (F) – 30001 Golden Jubilee National Hospital Innovation Hub Monday 29 May 2017 13:00-16:00 Cohort 2, week 4 1 x staff (F – nurse, 9 years) – 30007 1 x patient (M, planned surgery) – 30008 Victoria, NHS Fife Physio Rehab Area Thursday 01 June 2017 13:30-16:30 1 x staff (F – nurse, 23 years ICU) – 30009 1 x carer (F) – 30010 Crosshouse, NHS Ayrshire and Arran Education Centre Monday 19 June 2017 Cohort 4, week 5 1 x staff (M – nurse, X years) – 30013 1 x patient (M) – 30014 Logistics – re interviewing patient/carer – not attending in week 6

What We Have Learned So Far… InS:PIRE has been scaled up (with underpinning ethos and enthusiasm) = feasible to scale up! InS:PIRE is popular among participants. InS:PIRE is variable and still undergoing change within and across sites = tailored, responsive to context, individual and tweaked according to group dynamics. Not clear that all components are essential.

What Went Particularly Well – Patients Letter and time with clinicians – getting questions answered ICU visit – closure Talking with others who have had a stay in ICU – making sense of what happened

In Their Own Words… I did that and it gave me a lot of closure, because like a lot of people who have been ill like myself I was on drugs, I was all over the place, I literally was all over the place and I had a lot of dreams like everybody was… we talk and that and everybody has dreams, “I’ve been in planes”, “I’ve been in boats”, obviously with the morphine and drugs that were in. Going to ICU, the actual ward, and then we could… I could then divide what was real and what was dream more or less. Yes, so when you had the chat with the consultant, they give you a letter, basically explaining what had happened when you go in intensive care ... …the consultants go over with you everything that had happened when you were in intensive care and again, that was something I was really keen for because my family were really good at explaining what had happened to me but it was very much if I asked them things they would tell me. I don’t think they really wanted to tell me a lot of ... not that they were holding anything back, but I think they just didn’t know how much I wanted to know, really but I had quite a lot of questions about various things so I was really keen to do that as well so they were probably the two main things at that point that I thought would be really useful. The one thing I did find that was very useful was they take us… they took us back down, especially the partners or the friends that was there, down to the ICU again, and I felt quite blasé about going in it, and we went in through another door than the door I normally came through, but I’ve seen the two doors and I got very, very emotional about it, and then went up to his bed and I still felt it, I was really thingied. And I felt that was quite good because if you like, it gave me closure that he wasn’t lying in the bed anymore and things like that. So I felt that was very important.

In Their Own Words… (2) And I think listening to the other people on the programme and listening to that group discussion was very much helpful because we’ve all experienced similar things. there was other people, not necessarily going through the same thing, the illness, but through ICU, which is… but all their experiences were relatively the same; they didn’t remember very much about it. And just speaking to the other people that had been there, because your partners, or mother or whatever it is, they’re out of it, and you feel you’re really sort of isolated if you like. And it was good to come and speak to people that have been through the same thing, and their experiences and your experiences, we’re able to discuss them, it was really good. That’s what I found was very useful, being able to communicate with other people that have been through the same because… I mean even when you’re in, the person’s in ICU you see other people, but you’re not actually having conversations with them because you’re not intruding on them and they’re not intruding on you. But likes of coming here it was so handy for to be able to do that, and their progress and things like that, it was really good.

What Went Well – Staff Patients People

Unanticipated Benefits GRI/GGC – Jo McPeake (mat leave) – Tara? Crosshouse/A&A – Peter O’Brien Golden Jubilee/GJ – Isma Quasim Wishaw/Lanarkshire – Philip Lucie Victoria/Fife – Lucy Hogg Monklands/Lanarkshire – Laura Strachan

Even Better If This Photo by Unknown Author is licensed under CC BY-SA

Mapping InS:PIRE… What do you aim to do? DRIVER What do you do? How and why? INTERVIEWS, ETC. What improvements result? QI

Driver Diagram Original aims

Refining…

Staff/stakeholders – Interviews Site Dates n=15 (of total n=35) Crosshouse, NHS Ayrshire and Arran Late 2017 1 x staff 1 x patient/carer 1 x other stakeholder/volunteer Victoria, NHS Fife Glasgow Royal Infirmary, NHS Greater Glasgow and Clyde NHS Golden Jubilee Monklands and Wishaw, NHS Lanarkshire

Staff/stakeholders – Interviews Site Dates n=10 (of total n=35) Crosshouse, NHS Ayrshire and Arran Early 2018 1 x staff 1 x other stakeholder/volunteer Victoria, NHS Fife Glasgow Royal Infirmary, NHS Greater Glasgow and Clyde NHS Golden Jubilee Monklands and Wishaw, NHS Lanarkshire

Summative Evaluation To formally assess the process of scale up of InS:PIRE Quantitatively measure the processes Types of questions: Is there evidence that the hypothesised theory of change holds when the intervention is scaled up? Does context mediate the effects of scale up?

What to Expect Track data for a complete cohort at each site Collect outcomes data and collate centrally Explore whether data changed in anticipated directions Look at variability in measures across the scale-up to assess role of context Early 2018

Any questions? Thank you – and please feel free to contact us at any time: h.morgan@abdn.ac.uk @hm_morgan This Photo by Unknown Author is licensed under C BY-NC-SA