Exploring Person-Centredness in the Emergency Department Donna McConnell PhD Student Prof Tanya McCance Dr Vidar Melby Dr Paul Slater (adviser) Donna McConnell PhD Student Prof Tanya McCance Dr Vidar Melby Dr Paul Slater (adviser)

Person-Centred Practice Framework (McCormack & McCance 2010)

Person-centred practice has shown to transform practices for patients... increased choice and involvement in decision making improved quality of nurse/patient engagements staff taking time to get to ‘know’ the person in a more meaningful way staff were more person-centred, in their language and team-work a reduction in ritual and routine

....and staff a shift in values to appreciate caring over the technical aspects of nursing care increased effectiveness of teamwork and workload management improved staff relationships with more effective collaborative working increased personal and professional job satisfaction - less intention to leave posts a more effective use of resources McCormack et al (2010)

Themes from the literature There is a distinct culture within EDs The nature of ED work – saving lives, a medical- technical environment where technology, medical status and patient throughput is valued over caring A culture of worthiness – appropriate pts for ED and the place of those who did not fit in with this Staff experience of working in ED A stressful environment Violence and aggression Managing the patient journey – high responsibility, low power

Themes from the literature Fragmented care Lack of privacy A feeling of not being considered as an individual and a lack of caring Feeling abandoned, exposed, vulnerable, ashamed, ignored, insecure, frightened forgotten or unwelcome Worse for vulnerable groups - older people, those with mental health issues and those at end of life

Aim To explore person-centred practice within the ED environment.

2 stagesStage 1 Staff questionnaire Stage 2 Staff interviews Patient interviews Methodology

Data collection Pilot study undertaken in August 2013 Stage questionnaires distributed to nursing and medical staff in 11 EDs in all 5 trusts in NI during March and April 2014 Reminder letters sent Questionnaires returned 317 (44%) Effective responses 294 (41%)

Missing data n=13

Staff responded neutrally indicating that they neither agreed nor disagreed that they worked in a care environment conducive to person-centred practice Total mean score = 3.5 (1 = Strongly Disagree to 5 = Strongly Agree)

Items comprising Supportive Organisational Systems scale 1 = Strongly Disagree to 5 = Strongly Agree My team take time to celebrate achievements.2.4 My organisation recognises and rewards success.2.4 I am recognised for the contribution that I make to people having a good experience of care. 3.0 I am supported to express concerns about an aspect of care. 3.2 I have the opportunity to discuss my practice and professional development on a regular basis. 2.7

Staff agreed that they engaged in the necessary care processes to deliver person-centred practice Total mean score = 4 (1 = Strongly Disagree to 5 = Strongly Agree)