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161207 iHV leadership conf - Ros Bryar


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Presentation by Professor Ros Bryar, Professor Emeritus in Community and Primary Care Nursing, at the iHV Leadership conference on 7 December 2016.
Creating a postive practice environment

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161207 iHV leadership conf - Ros Bryar

  1. 1. Creating a Positive Practice Environment Ros Bryar, Trustee, iHV
  2. 2. Content •Positive Practice Environment Campaign •Elements of PPEs •Benefits of PPEs •Assessment of the practice environment •PPEs in a different environment •Levers for PPEs
  3. 3. Positive Practice Environments Campaign •‘PPEs are settings that support excellence and decent work. In particular, they strive to ensure the health, safety and personal wellbeing of staff, support quality patient care and improve motivation, productivity and performance of individuals and organisations.’ (ICN, 2008) •The alternatives are environments that constrain practice (Twigg and McCullough, 2014)
  4. 4. Positive Practice Environments Campaign •Launched in 2008 •Multidisciplinary focus •Recognition of the international health workforce crisis •Aiming to improve practice environments to enhance care and retention of health staff •Initial focus on three countries: Morocco, Uganda and Zambia •Funding ceased in 2011 (Schmidt, 2012) •PPE elements now incorporated into WHO strategy: Workforce 2030
  5. 5. Some Elements of PPEs •Occupational health and wellness policies •Fair and manageable workloads •Effective management, leadership, peer support, staff participation in decision making •Professional identity, autonomy and control over practice •Support, supervision and mentorship •Access to adequate equipment, supplies and support staff (ICN, 2008)
  6. 6. Some Benefits of PPEs •Higher quality care •Staff satisfaction •Enhanced teamworking •Greater awareness of health and safety •Greater participation in organisational decision making •Strong leaders promote shared values •Staff retention
  7. 7. Assessment of the Practice Environment Lake’s (2002) assessment tool assesses: •Nurse participation in hospital affairs •Nursing foundations for quality care •Nurse manager ability, leadership and support of nurses •Staffing and resource adequacy •Collaborative nurse-physician relationships Bryar, Kendall and Mogotlane (2012) PHC Nursing Roadmap
  8. 8. Primary Health Care Nursing Roadmap Incentives Education Health and safety Leadership and managerial support Skill mix Regulation Competencies Human Resources for Primary Care Quality Improvement People Centredness Partnering and inter- professional working Information and communication technology Public health perspective
  9. 9. Work Environment
  10. 10. Equipment
  11. 11. Work Environment
  12. 12. External environment
  13. 13. Making PPEs a Reality Undertake an assessment of the current environment Apply learning from today’s conference on: •Leadership •Responding to and shaping change •Collecting evidence •Influencing •Partnership working •Incentives
  14. 14. Making PPEs a Reality Make use of International Strategies: •Sustainable Development Goals: gs •WHO Workforce 2030 •APPG on Global Health: Triple Impact Report: heeg/triple-impact-appg/en/
  15. 15. SDGs: application to PPEs
  16. 16. WHO Workforce 2030 22. ‘Promote decent working conditions in all settings. Ministries of health, civil service commissions and employers should adopt gender-sensitive employment conditions, remuneration and non-financial incentives. They should cooperate to ensure occupational health and safety, fair terms for health workers, merit-based career development opportunities and a positive practice environment to enable their effective deployment, retention and adequate motivation to deliver quality care and build a positive relationship with patients.’ (WHO, 2016 p.17-8) (highlight added)
  17. 17. All-Party Parliamentary Group on Global Health Triple Impact of Nurses: Better health; Greater gender equality; Stronger economies •Recommendations include: 1. Raise the profile of nursing and make it central to health policy 3. Develop nurse leaders and nurse leadership 4. Enable nurses to work to their full potential 5. Collect and disseminate evidence of the impact of nurses on access, quality and costs
  18. 18. Creating a Positive Practice Environment •Assess the current environment for practice •Identify areas for improvement •Develop strategies to address issues making use of international and national policies •Implement and evaluate the impact of the improvements on staff and on practice
  19. 19. PPEs: Realising the Value of Nurses/HVs ‘We need to market nursing [health visiting] as if it were a new drug or treatment. Heather Henry, UK nurse entrepreneur’ (APPG, 2016 p.13)
  20. 20. References • Bryar, R, Kendall S and Mogotlane S (2012) Reforming Primary Health Care: A Nursing Perspective • ICN (2008) positive practice environments for health care professionals. Fact Sheet. ICN, Geneva • Lake ET (2002) Development of the practice environment scale of the Nursing Workforce index. Research in Nursing & Health 25 (3) 176-88 • Schmidt, A (2012) Positive practice campaigns evaluation report. Global Health Workforce Alliance, WHO, Geneva • Twigg D and McCullough K (2014) Nurse retention: a review of strategies to create and enhance positive practice environments in clinical settings. International Journal of Nursing Studies 51 (1) 85-92 • WHO (2016) Global strategy on human resources for health: Workforce 2030. WHO, Geneva Togo: • Film ‘Exchange of Ideas’ from Togo visit on YouTube: fNTP323M • Blog on the City, University of London web site: needs-assessment/#.V3QxM7grKhd