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The aims of PD work can be to enhance clinical services, such as to increase quality and safety in healthcare within a unit, to develop shared values and service priorities, and to improve communication within a healthcare team (Bradd et al. 2017). The cases presented in this chapter do not focus on the professionals in a service. However, both cases share other aims and use methodology that are similar to those developed in the PD tradition. The most obvious similarity is that aims relate to enabling human flourishing and enhancing learning and transformative change (Bradd et al. 2017) (see Chapter 8). An important element at play in both cases is also that the facilitators aim to engage authentically with the group members to ‘blend personal qualities and creative imagination’ (Bradd et al. 2017, p. 2) (see Chapters 10 and 11). PD seeks to rebalance traditional power hierarchies in the health services. In the cases, the rebalancing is about valuing and building on experience‐based knowledge (as well as on professionals’ knowledge). The facilitators sought to address imbalances in the groups due to experiences in people’s lives – like stigmatisation, and lack of opportunity to contribute in society.

In both cases, the importance of facilitation skill as a kind of ‘glue’ which accommodated the complexity and promoted positive change and growth was heavily apparent. Whilst consumer empowerment was a key target for both groups, it was never a possibility that the group interventions could be run without the presence of a skilled professional or professionals. It’s important here to recognise that by ‘skilled’ is meant skilled as both a clinician and a facilitator. Professional involvement affords safety and also reliable engagement with knowledge sets at play.

In both case studies, the professionals sought to enter into true partnership with patients and service users by striving to ‘level out’ the value of their knowledge with the knowledge that persons have from their lived experience. Such an approach entails focusing on acknowledging all knowledge (both professional and lived). In this kind of partnership, the professional may realise that the experiences people have from living with a stoma or mental health problems represent knowledge that the professionals need to incorporate and work with if they want to provide optimal services. Professionals may also become more aware of the resources each of their patients have and allow more space for the patient in the caring relationship.

This shift means blending what clinicians have learned in school with what they learn from people living with health problems – valuing that input, being moved by it and changing their views based on it. There is great potential to develop new knowledge in such a true collaboration. Together they will have an array of solutions, advice and examples of how issues can be understood and handled. The groups represent a forum of persons that are open and interested in the same issues. Ideas are valued and developed further, and participants may become more hopeful as they have the opportunity to speak about challenges and expect that others may have experienced the same things (rather than getting stuck with something).

Being in a partnership and learning from each other produces opportunities to take on new roles. The patients are no longer passive recipients of care and support – they are also someone who is of help to others and someone who is learning and developing based on their own motivation and interest. As a patient participant in the stoma group, listening to a narrative about how someone handles travelling with a stoma may not make it possible for that participant to travel, but it may give them hope of expanding from where they are at now. Professionals may have travel‐related advice, but the knowledge the group have together about this issue (both academically and experientially) is probably extensive. For some participants in both groups studied, their involvement represented a move away from an established pattern – and the change gave hope and may have altered the way the person thought about themselves. The experience of being someone who knows something that is useful to others is empowering, and providing support to others gives meaning to life.

In both case studies, the agenda in the group was set in the partnership – what is relevant is answered not only from the professional’s perspective but from what is relevant for the participants’ lives. New knowledge arising from research and new knowledge‐based processes in health services is relevant – but so are narratives from people’s everyday lives. The groups define what is relevant – for example what is relevant for persons living with stoma to know, and how hope can play a role in a person’s recovery in mental health issues. The professional may have a definition for hope and may have knowledge about the role hope can play in a person’s life. Defining hope in the group may extend this and make it possible for participants to relate hope to their own everyday life. Definitions are often closed, whilst narratives are open, and the person can choose to relate to it, leave it or expand the meaning.

The longevity of the stoma care group evidences the success of the partnered approach, and the proliferation of the mental health/drug health group across western Norway equally evidences such success. Even though the Norwegian example was to some extent ‘boundaried’ (as a course, not as an ongoing group), it has been an increasingly common experience that these groups continue to meet after the course has finished. Such a phenomenon is a very powerful indicator of programme success.

Besides the outcome, growth and flourishing related benefits discussed above, partnership models contribute to service quality and service efficiency. In case 1, the existence of an STN‐facilitated group provided a way for ostomates to access an informal service without requiring a formalised clinic appointment. One system‐related effect of this has been the freeing up of scarce appointment time for clinical matters. Further, the group can also function as a means of screening with consumers as to whether a clinic appointment may be of some benefit. Whilst it’s unlikely that such efficiency savings could (or should) result in a lower service presence overall, they certainly contribute to the conduct of an optimised engagement schedule between consumer and professional, and likely impact positively on hospitalisation and other health service utilisation rates. This is equally the case for the recovery course. With positively evaluated courses continuing to meet post completion, it’s reasonable to expect that illness‐related service utilisation may be reduced among group members over time.