Supporting clinical innovation: An organization‐wide approach to practice‐based development

Abstract

Key words: engaging clinicians, innovative practice, linking clinical activities, practice development IntroductionWho is best placed to serve the practice development needs of clinicians within NHS institutions? There have been many theories and concepts discussed around the subject of practice development and what this role entails (Clarke, 1999;Garbett and McCormack, 2002;McCormack et al., 2004;McSherry and Warr, 2008). The authors of these articles are usually seated within academic and research institutions. The present article outlines how a practice development team was set up in a busy NHS Foundation Trust. We describe how that team infl uences and supports clinical practice across a wide range of activities. We also refl ect on the introduction of a new terminology -that of practice-based development, a concept situated within health care settings using health care staff developing practice. What does the literature say about practice development?The term 'practice development' has been used extensively across the NHS in the UK since the late 1970s, but has been discussed within the international arena for longer (McSherry and Warr, 2008). Finding a defi nition that pinpoints exactly what the role entails is more diffi cult. It seems to have emerged as a wide umbrella term that means many things to many people. This ambiguity in defi ning what the practice development role is has been discussed by many authors, taking different trends and directions into account. Some have addressed how practice development is heavily linked in with research activities (Clarke and Proctor, 1999; Royal College of Nursing, 2007), whereas others have addressed concept analyses of the subject and role, (Garbett and McCormack, 2001;McCormack et al., 2004;Unsworth, 2000). Further authors have broken down the role into skills and qualities (Garbett and McCormack, 2002). The only consensus would seem that it is a very varied role and diffi cult to pin down! Transforming the contexts and cultures in which nursing care takes place. 3.Employing a systematic approach to bring about changes in practice. 4.The continuous nature of activity within practice development. 5.The nature and extent of assistance required for change to take place.Gilsenan (2004) supports this emphasis of practice development on the fundamentals of evidence-based practice. She further suggests that practice development is any systematic approach to examining the effectiveness of patient care and developing alternatives where needed. In today's health care setting, the extent of patient care activities and developing these services is far reaching and diverse. Gilsenan (2004) also discusses ways to achieve practice development and identifi es that staff need to formulate their own clinical questions to identify issues in practice. They then need to select the right people that they feel would be suitable to challenge the identifi ed issues to develop evidence-based outcomes. She does not, however, identify who these staff should be, but hints at clini...