High-quality complex care involves the successful coordination of a multidisciplinary team of expert clinicians and therapists, to integrate a wide range of treatments and therapeutic interventions. To ensure that each individual’s diverse health and rehabilitation needs are met, irrespective of their complexity or severity, a standardised set of core competencies is needed, outlining the required knowledge and skills for team members.
As part of our EveryExpert approach to neurocare and rehabilitation, Elysium Healthcare has recently conducted a thorough review of its complex care core competencies, to ensure that every person we support receives the same high standard of care.
In this article we talk with Joanne Kent, Service Lead at Badby Park, who played a significant role in the review process. As a former intensive care nurse, Joanne is passionate about ensuring all members of a care team have access to best practice and the latest developments in healthcare. Here we discuss why achieving core competencies are so important and how they bring immense benefit both to the individual patient and the team delivering complex care.
Thank you for joining us today Joanne, could you tell us a little bit more about the review that has just been completed?
“Over the past few months, myself and other team members, Angela Owen and Denise Nannetti, have completed an extensive review of all core competencies required for delivering high-quality complex care. These range from wound care, tracheostomy care and management to feeding tube competencies for RN’s and HCA’s, bowel management NEWS2, and naso-gastric insertion and management.
Our objective was to standardise the competencies, include appropriate references to evidence-based research, the latest best practice guidelines, and make them accessible to all team members. It’s part of an ongoing drive so that all team members, at all levels of care, are following the current guidelines, using the same frameworks and standardising outcome measurements.
For me, it’s also about up-skilling our team and empowering them with the latest clinical knowledge.”
Why is this so important in complex care?
“The individuals that we care for have very complex needs. A person may present with a single condition but understanding the cause of the condition is not always straight forwards. There’s often an interplay of significant healthcare needs (physical, mental or behavioural) so our team need specialist skills and knowledge to provide each individual with the personalised care that they require.
There’s also a systemic issue here – hospitals are at the forefront of clinical best practice but sometimes there are barriers to this knowledge reaching other care settings. I saw this first-hand in my previous role. When I initially moved into community nursing, after having been a nurse on an acute ward in a hospital, it was very apparent there were barriers to information sharing. This meant that nurses weren’t always up-to-date with current practice and it affected patient outcomes.
As a provider of long-term complex care it’s our responsibility to remove those barriers and ensure that our team members have access to the latest research, equipment and new methodology. This review of competencies plays an important part in that process and also contributes to Elysium’s ethos of continuous learning and innovation.
I hope that as team members incorporate these core competencies into their practice, it becomes a continuous circle of learning, improved practice and improved outcomes for patients.”
Could you say more about how individual outcomes will be improved? What is the benefit to the people Elysium supports?
“Through standardising all of our core competencies, we are making everything evidence-based and we are ensuring that everyone who works within our services is following proven practices that support healthcare needs and quality of life. When a whole team follows this system the inevitable result is better outcomes for individuals.
One significant improvement is a reduction in hospital admissions. Having to spend, even a short period of time in hospital can be quite disruptive for some of the individuals we support. Their routine is interrupted and they may not adjust as well to the new team that is providing care. Continuity of that team, whilst the individual is in hospital, will also be an issue – due to schedules, lack of funding etc, hospitals cannot provide the same consistent level of support that we can. So the more we reduce admissions to hospital, and the more we can provide the different elements of complex care within our services, the better it is for the individual.”
Would these improvements also benefit the family in some way?
“Yes, I think anything that benefits the individual will in turn benefit the family. In particular I think they find it reassuring. Typically family members of the individuals we support have been through a lot, in terms of interacting with different healthcare systems. Their loved ones have complex needs, and throughout their time in hospital or even in a community setting, they will have encountered different healthcare teams and systems. It can be a little overwhelming for the family.
Core competencies not only standardise practice, but they also have an overarching function to bring together different disciplines or therapeutic treatments, into a more coherent system. It helps the diverse elements of care work better together. Families can then feel more relaxed and they can focus all their energy on their loved ones rather than worry about the different aspects of care.”
And how do colleagues respond to these core competencies?
“Colleagues respond very well – with the right training and support they feel more confident about their knowledge and their skills. Having confidence in your own capabilities is hugely important in complex care. It means a healthcare professional is more assured in themselves and willing to try new methods, with a more positive mindset. Crucially, they’re willing to be part of a culture of continuous improvement and that’s what we are looking for. That’s what best practice and following a standard of high-quality is – ensuring that you’re always trying to achieve the best outcome for each individual.”
Thinking about the organisation more widely, how does a standardised set of core competencies improve care at a service level and then at an organisational level?
“This again relates to our efforts to continuously improve the delivery of care and support in our services. The nature of complex care is that it requires a team of experts to work together sharing best practice, pooling knowledge and resources. For a service to get the most out of that approach we have to standardise everything that we are implementing. And then at an organisational level, we can further pool our resources and we benefit from a community of best practice, across the services.
Once you have a culture of compliance to core competencies, it actually really enhances personalised care. They can be applied and adapted within an individual setting or context. Ultimately, if the organisation and the service follow standardised best practice the patient will always benefit.
For example, the implementation of core competencies in all our neuro services contributes to the outcome measures so we can monitor progress and identify any need for improvements in the care we provide. Sharing best practice throughout the services also promotes best outcomes for patients and residents as well as giving staff members more confidence in the care that they deliver.
It also gives you the confidence as a manager to be assured that the individuals in your care are receiving up-to-date evidence-based practice.”
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