RCN Facilitation and Workplace Standards

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RCN Facilitation and Workplace Standards

• Kim Manley
• Head of Practice Development RCN Institute
• Visiting Professor Bournemouth University

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Facilitation

• A technique by which one person makes things
  easier for others
  (Kitson et al 1998).

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Facilitation and practice development

• Facilitation is
• An essential attribute of practice development
  (Garbett and McCormack 2002)
• A pre-requisite to
• evidence-based practice (Ryecroft-Malone 2004)
• Facilitators have a key role to play in helping
  individuals and teams to understand what they
  need to change and how they need to change it in
  order to apply evidence to practice.
  (Rycroft-Malone et al 2002)
• learning in and from practice (Titchen 2000)
• achieving effective workplace cultures (Manley
  2001, 2004)

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RCN Facilitation Standards

• Impetus from RCN Expertise in Practice Project
• 7 evidence-based standards
• Integrates technical and emancipatory
  facilitation perspectives
• Concerned with both formal and informal
  facilitation

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The facilitation standards can help you develop
your facilitation practice by

• Helping you assess how you are learning
• Providing structure and focus to the giving and
  receiving of feedback about facilitation
• Developing a portfolio of evidence for multiple
  purposes
• Ongoing registration and career progression
• Knowledge and skills framework
• Job evaluation
• Appraisal
• Interview
• Preparing for professional accreditation as a RCN
  accredited facilitator

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1. Demonstrate a comprehensive knowledge base to
underpin your facilitation practice.

• Within your facilitation practice Draw on
  experience and knowledge from a variety of
  sources (e.g. evidence base, theory, observation,
  feedback, analysis, reflection, critique) to
  holistically inform your facilitation practice
  which takes account of
• knowledge of self
• knowledge of learning styles
• knowledge of the individual and their context
• knowledge of interpersonal processes
• knowledge of group theory and processes
• knowledge of systems, organisations and power
• knowledge of change theory and processes

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2. Demonstrate professional and personal
integrity with relevant stakeholders

• Within your facilitation practice
• 2.1 Understand your own values and beliefs and
  their potential impact on your practice as a
  facilitator
• 2.2 Demonstrate congruence between your personal
  and professional values and your actions.
• 2.3.
• 2.4

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3. Demonstrate the ability to establish a
mutually agreed contract with relevant
stakeholders1.

• Within your facilitation practice
• 3.1 Establish the starting point for all involved
  in order to identify a mutually agreed purpose,
  goal and ways of working.
• 3.2 Identify the context of the facilitation.
  (i.e. Where the work sits in relation to the
  strategic direction, other development or service
  improvement initiatives for the individual, team
  or organisation)
• 3.3
• 3.4
• 1 The term stakeholder is used to encompass
  those involved directly with the facilitation
  activity and others influencing or affected by
  it.

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4. Demonstrate the ability to facilitate
effectively in a range of circumstances and
contexts

• Within your facilitation practice
• 4.1 Demonstrate the personal qualities and
  capabilities necessary to establish relationships
  that foster mutual trust, respect and
  empowerment.
• 4.2 Foster an enabling culture where individuals
  feel safe to participate, learn and develop.
  4.3 Develop a culture that invites critical
  thinking, mutual reflection, feedback, support
  and dialogue.
• 4.4
• 4.5

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Facilitation Standards 5-7

• 5. Demonstrate understanding of skills in
  facilitating group processes
• 6. Demonstrate the ability to know what matters,
  pick up and act on what is significant.
• 7. Demonstrate the ability to evaluate your
  facilitation practice, identify and actively
  promote the outcomes

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WORKPLACE CULTURE STANDARDS FOR EFFECTIVE
HEALTHCARE

• Built on the indicators of an effective workplace
  culture (Manley 2001,2004)
• Developed by working with collaborators
• NDU/ICU Chelsea Westminster NHS Trust
• Cambridge University Foundation NHS Trust
• Bournemouth University Practice development
  centre
• Piloted at the above centres and also
• Bats The London NHS Trust
• Intermediate Care Bedfordshire NHS Primary Care
  Trust

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How can the standards be used?

• The standards can be used in one/all of the
  following ways
• an assessment tool to identify priorities for
  development work
• part of a development programme for improving
  the quality of care
• an evaluation tool to benchmark/monitor progress
• a framework for gathering and structuring
  evidence that the workplace is person-centred,
  effective and evidence-based
• a framework for putting into practice shared
  governance
• a framework for developing a culture that is
  sustainably person-centered, effective and
  evidence-based
• a way of demonstrating new ways of working
• for sharing good practice

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Workplace

• The workplace can be described as any healthcare
  interface experienced directly by patients,
  carers and staff. This may be at unit, team or
  pathway level, concrete or virtual rather than
  organisational.

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An effective workplace culture

• Provides care that is
• Person-centred
• Evidence-based practice
• Continually modernising

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Emphasis

• Is directly on the patient/user
• how they experience care from practitioners and
  practice teams
• whether care and interventions are evidence-
  based
• whether care and interventions are the focus of
  continuing effectiveness and evaluation

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Standards are structured around

• Person-centredness
• Individual, team and service effectiveness
• Evidence-based health care including knowledge
  use and transfer and evidence development
• An effective workplace culture

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DEVELOPING PERSON-CENTREDNESS

• Focusing every aspect of care around the person
  who is receiving care in relation to how they see
  their health care needs in the context of their
  life plan.
• The person referred to includes not only the
  patient but also users of the service e.g. the
  patients family, friends and carers, as well as
  staff members.
• It involves valuing all individuals, teams,
  organizations, communities and other members and
  their contributions.

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DEVELOPING INDIVIDUAL, TEAM and SERVICE
EFFECTIVENESS

• This standard is about
• developing effectiveness in self and others to
  enable and sustain person-centred, evidence-based
  care.
• Lifelong learning is integral to the standard and
  is linked with formal systems enabling continuous
  critique and reflection (Manley 2001).
• Facilitating others to develop skills for
  sustaining effectiveness requires time, skill and
  effort (Titchen 2000) .

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DEVELOPING EVIDENCE-BASED HEALTH CARE INCLUDING
KNOWLEDGE UTILISATION, TRANSFER AND EVIDENCE
DEVELOPMENT

• This is concerned with
• the actual knowledge and evidence used in a
  practice rather than what is known and may not be
  used.
• includes how knowledge is used and articulated as
  practical know-how as well as continued to be
  refined through structured reflection and
  critique, thus promoting effective care (Titchen
  2000).
• Evaluation and indicators of effectiveness such
  as person-centredness, individual, team and
  service effectiveness linked to how they inform
  ongoing evaluation and development of services

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DEVELOPING EFFECTIVE WORKPLACE CULTURE

• The Kennedy Report (2001) argues a key indicator
  of good practice is a culture that is open to
  change.
• In effective cultures, staff will be empowered
  and practice would develop to enable a constant
  fit between the environment and the culture to be
  maintained through adaptability and learning.
  (Manley 2001)

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Each standard

• Cross referenced to DoH (2004) Standards for
  Better
• Health C Core standard D Developmental
  standard
• Identifies a number of KEY THEMES
• Identifies questions to help provide narrative to
  identify how the standard has been met and cross
  matched to evidence in portfolio.
• Suggests evidence that demonstrates - - change
• - that the standard has been met
• - that could be provided in a portfolio
  alongside the narratives.

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Person-centredness
Cross reference to Heath Commission
standards Patient focusC.18 a) b)Clinical cost
and effectiveness D. 2 b) c) Patient focus D.6D.7
a) b) Accessible and responsive care D.8 a) b) c)
Public Health C.23D.13Governance C.8 c)1. Theme
1 PARTICIPATION 1.1.1 The workplace demonstrates
how genuine involvement of all stakeholders is
achieved to provide a person-centred approach to
care. Questions How are service users encouraged
to participate in their care? How do you enable
representation from patients/carers on workplace
groups and in projects? How do you enable
practitioners to involve patients/users in
decision-making about their care? Evidence
sources Patient stories, minutes and notes from
panels and forums PALS. Joint care planning.
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What are the benefits of using workplace
standards?

• The standards will help you and your team
• develop the type of workplace culture that
• provides quality services to patients and clients
  that is sustainable
• are good places to work which will help with
  recruiting, developing and retaining staff
• develop evidence useful in demonstrating
  achievement of core and developmental healthcare
  commission standards

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More information

• Resources for developing facilitation skills. An
  RCN guide for practice development RCN Institute
  Practice Development Function June 2006
• RCN Workplace resources for practice development
• www.rcn.org/practicedevelopment/