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

2. Evaluation Team

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

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

5. 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

6. 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

7. 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.

8. 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

9. 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.

10. 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.

11. What Went Well – Staff
Patients
People

12. 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

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

15. Driver Diagram
Original aims

16. Refining…

18. 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

19. 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

20. 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?

21. 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

22. Any questions?
Thank you – and please feel free to contact us at any
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