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Critically outline a brief history, and an overview of the National Health Service (NHS) and its current challenges, along with recent key developments and policy drivers (there are many) to deal with these challenges

Assessment Brief:

You have been asked to provide an evidence-based rationale for a Patient Service Innovation (PSI), outlining reasons why you believe this field-specific strategy will address a clearly specified area for improvement. Please refer to the SMART principles. This will include a chosen strategy for change, and refer to key theories and frameworks regarding leadership and change management principles. A thorough review and understanding of the related evidence base regarding the PSI needs to be demonstrated, including field related and other research along with other healthcare information and literature; patient satisfaction reports; NICE or other clinical guidelines; findings and recommendations from inquiries and reports; findings and recommendations from ‘never events’ and patient safety incidents) and so forth. You need to outline how the proposed changes for service improvement will be implemented, monitored and subsequently evaluated (e.g. via clinical audit). The strategy must consider the role of individual nurses in advancing nursing care and service delivery, along with organisational clinical governance frameworks, and associated change management strategies.

 

Word Count: 6000 words +/-10%

Module Learning Outcomes

 

Learning Outcome 1

Critically explore relevant strategies and approaches that can be employed in managing care delivery and discuss their relevance in providing safe and effective services in line with national health and social care developments and reforms.

 

Learning Outcome 2

Demonstrate a critical insight into current health care challenges in health care practice that require further exploration.

 

Learning Outcome 3

Confidently employ and lead innovative approaches to effective problem solving and decision-making in response to current health care challenges within a complex and dynamic health and social care system.

 

Learning Outcome 4

Critically and confidently appraise change management strategies in support of organisational change and service improvement.

 

Learning Outcome 5

Confidently apply methods of measuring and evaluating outcomes, within clinical governance and quality assurance frameworks, leading to improvement and innovation in nursing practice.

Patient Service Innovation - Structure

Part 1:

  1. 1.    Introduction (300-500 words)

Outline what the Patient Service Innovation (PSI) is all about. This needs to include a summary of key points outlined across the work: beginning with context of today’s NHS, the importance of service improvement and clinical excellence – and the role of innovation in the present health and social care environment. Introduce and briefly discuss your chosen innovation, justifying the reasons for your choice. Briefly outline the format that the dissertation will follow re what the entire plan will entail.

 

  1. 2.    Theory (Approx 1,000 words)

 

Critically outline a brief history, and an overview of the National Health Service (NHS) and its current challenges, along with recent key developments and policy drivers (there are many) to deal with these challenges.  Do try and ensure that you include a critique of documents such as the NHS Consititution, the NHS Five Year Forward View, NHS Outcomes Framework (current version), and its various domains/indicators.  These and other strategies have been introduced to try and ensure the NHS can move into the future, delivering equitable and excellent patient care whilst dealing with less resources and greater demands on services.  This is very relevant to the issue of service improvement and innovation. It is important that you do not simply ‘describe’ these drivers/strategies, but critically evaluate them using a variety of contemporary literature.

 

You will also need to critically discuss the key principles of Clinical Governance and its role in service improvement, quality improvement and clinical excellence. Linked to this, critically explore the role of the Registered Nurse in advancing nursing care and innovative service delivery, along with organisational clinical governance frameworks, and associated leadership and change management strategies that are being used to address current challenges (e.g. NHS Leadership Model, and the Leading Change, Adding Value – (which is alligned to the NHS Five Year Forward View).  What skills and knowledge will the nurse of the future – you – need, to be able to challenge, lead, implement and evaluate service improvement, such as your chosen PSI?

 (Learning Outcome 1 & 2)

  1. 3.    Background (Approx 1,000 words)

 

This section needs to provide a thorough background that will give rise to the rationale, aims and objectives of your chosen PSI. A thorough review and understanding of the related evidence base will need to be demonstrated, including field related and other research; other relevant healthcare information and literature (current incidence, statistics, costs); patient satisfaction reports; NICE or other clinical guidelines; findings and recommendations from inquiries and reports (e.g. Care Quality Commission); ‘Never Events’, patient safety incidents, may also be relevant to some PSIs.

 

If the patient service innovation aligns with the topic chosen for the Research in Practice assessment, some of the literature reviewed may be incorporated here. This does not mean the work can be simply ‘cut and pasted’ (you could be at risk of self-plagiarism, despite this being your own work), but rather we encourage you to use it critically and wisely, to give context to the chosen innovation.

(Learning Outcome 2)

 

  1. Rationale/Aims and objectives of Proposed Innovation (Approx 300-500 words)

 

Here you need to outline clearly:

 

What is your chosen innovation?

 

How will this field specific innovation address the area of concern (clincal gap) outlined in the Background section?

 

How might patients benefit from this innovation?  (This will need to link to the NHS Outcomes Framework and the chosen domain/indicator from which the idea for the innovation has arisen).

 

Be mindful of referring to the principles of SMART (Specific, Measurable, Achieable, Realistic, Timely) in this section, to help you clearly outline your chosen innovation. For example, you should at this point be able to articulate how how the innovation has ‘hypothetically’ been successful - i.e.  what outcomes are you going to measure? This might be a positive change in knowledge, attitudes, satisfaction, or a reduction in the incidence of a clinical outcome e.g. infection.

 

In this section you can outline more generally, how service innovations/improvments might be identified in practice through models such as process mapping, root cause analysis or fish tail analysis.

 

(Learning Outcomes 1 & 2)

 

PART 2: The Project Plan: (Approximately 3,000 words)

(Key areas of any change mangement process which are essential for the PSI to be successful).

Whilst in reality, you are not required to implement this plan; you will need to clearly document how you would hypothetically plan, implement, and evaluate the chosen Patient Service Innovation, which will follow with a reflection on the process. This requires a great deal of detail regarding the who, where, when and how.  This would incorporate such things as:

 

 Change Management Strategy: (Approx 1,000 words)

 

Outline the key components of change theory, which should include:

 

  • A general critique of several of the change models available, and the model chosen to implement your PSI - (justify why you have chosen it over the others).

 

  • Using the chosen model as a guide, capture the following:
    • What are the major components of the project?
    • Where will it take place?
    • Who will it involve? What role might they play?
    • How will the project be rolled out?
    • What will need to be considered in order for the innovation to be successful (e.g. organisational culture, resources?
    • Possible challenges/barriers to dealing with change & the successful implementing the project; what strategies could be used to address these?

 (Learning Outcomes 3 & 4)

 

Leadership theory re: successfully  implementing a change: (Approx 500 words)

 

This can be incorporated in the above section or dealt with separately. Either way, it needs to include:

 

  • Team working/building;
  • Developing a positive work culture that facilitates and embraces change/innovation/service improvement;
  • Methods of motivation in regards to change management.

(Learning Outcomes 3 & 4)

 

Time Management: (Approx 200 words)

 

  • How long do you predict it will take to plan, implement and evaluate the chosen patient service innovation; (incorporate a GANTT chart as an appendix, that will outline key milestones of the innovation, from beginning to end).
  • What is the importance of having a time management plan to aid the project being successful? (Examples of a Gantt chart have been uploaded on to the module Blackboard site).

(Learning Outcome 4)

 

 

 

 

 

 

 

 

 

Evaluation: (Approx 500 words)

 

  • What is its importance to quality assurance and clinical excellence?
  • What method do you propose to use to evaluate the patient service innovation (e.g. pre and post clinical audits; satisfaction surveys; Likert scale measurements of knowledge/attitudes and so on)?  This will need to be specific and related to your original rationale and aims re the PSI.
  • How will you know that it has been successful or not?
  • How can the outcome be sustained?

(Learning Outcome 5)

 

The Role of the Nurse in Service improvement and innovation: Reflections (Approx 500 – 700 words)

 

What have you learned from the process, and how do you think it has informed or enhanced your ability to challenge, lead, implement and evaluate innovation as a future Registered Nurse? Why is it important in order to provide excellent patient care in a dynamic, ever changing health care environment?  (Please avoid the use of I, me, my and so on). 

(Learning Outcome 2)

 

Conclusion (Summary of the Key points raised across the proposal. (Approx 300 words)

 


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