Introduction A successful funding application to the St James’s Place Foundation through Hospice UK has seen the commencement of a project focusing on enabling rather than disabling people; blending compassion and care with a rehabilitative and enabling approach.
Aims of the Project The project aims to shift the culture from one of ‘over caring’ within hospice services, to one that is working for and with people to determine what living well looks like for them individually. The project aims to utilise a collaborative, interdisciplinary, and whole team approach.
Approach Used The project has taken a multi-faceted approach:
· Appoint a project lead
· Set up a multi-professional task and finish group
· Champion and role model a different way of thinking.
· Delivery of training sessions from ward to Board
· Develop core enablement and rehabilitation competencies for assistant staff
· Incorporate rehabilitation and enablement approach into staff and volunteer induction.
· Implementation of a programme of circuit exercise in the gym
· Development of ‘What Matters to Me’ documentation
· Implementation of a self-management ‘Positive Steps to Well-being’ programme
· Development of a visual manual handling plan for patients on the Inpatient Unit
· Pilot mirroring package of care on the Inpatient Unit prior to discharge home
· Development of a new volunteer community enablement assistant role.
Organisational structure and process
· Staff job descriptions/volunteer role profiles to reflect rehabilitation and enablement
· Incorporate reflection and evidence of rehabilitative palliative care practice in the appraisal process
· New healthcare assistants shadow the Allied Health Professions team to learn rehabilitative skills in practice.
Outcomes On completion of the project, the hospice aims to increase our total rehabilitative palliative care score to over 80/111 from 29/111 in August 2015 and 51/111 in August 2016 (Tiberini & Richardson, 2015).
Conclusion Effective implementation of an enabling approach has required a stepped approach, an understanding of organisational readiness, and key cultural barriers.
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