Developing person-centred practice in hip fracture care
Evidence & Practice    

Developing person-centred practice in hip fracture care

Jane Christie Advanced practitioner in clinical education for primary care, NHS Lothian, Scotland
Maureen Macmillan Senior lecturer, School of Health and Social Care, Edinburgh Napier University, Scotland
Colin Currie Formerly consultant, orthogeriatric medicine, NHS Lothian, Scotland; and formerly senior lecturer, geriatric medicine, University of Edinburgh, Scotland
Gerardine Matthews-Smith Senior lecturer and subject group leader, enduring conditions and community care, School of Health and Social Care, Edinburgh Napier University, Scotland
Aim

To facilitate a multidisciplinary collaborative approach to developing person-centred practice in hip fracture care for older people.

Method

Collaborative inquiry, a form of action research, was used to collect data for this study. It involved exploration of dilemmas, questions and problems that are part of human experience. Clinical leaders from different disciplines (n = 16), who work with older people with hip fractures at different stages of the care pathway, participated in a series of facilitated action meetings. The practice development techniques used in this study included: identifying the strengths and limitations of the current service, values clarification, creating a shared vision, sharing clinical stories, reviewing case records, and reflecting on the experiences of three older people and two caregivers.

Findings

Hip fracture care was based on meeting service targets, national guidelines and audits. Care was fragmented across different service delivery units, with professional groups working independently. This resulted in suboptimal communication between members of the multidisciplinary group of clinical leaders and care that was process-driven rather than person-centred. Spending time away from clinical practice enabled the multidisciplinary group to collaborate to understand care from the patients' and caregivers' perspectives, and to reflect critically on the care experience as a whole.

Conclusion

To develop a person-centred workplace culture, the multidisciplinary team requires facilitated time for reflection. Ongoing facilitative leadership would enable the multidisciplinary team to collaborate effectively to deliver safe, effective person-centred practice in hip fracture care for older people.

Nursing Standard. doi: 10.7748/ns.2016.e9926

Correspondence

jchristie5@nhs.net

Peer review

This article has been subject to external double-blind peer review and checked for plagiarism using automated software

Received: 19 January 2015

Accepted: 02 October 2015

Published online: 07 December 2016