Blending Critical Realist And Emancipatory Approaches In Practice Development For Person-Centered Health Care

The Importance of Practice Development in Healthcare

Discuss About The Blending Critical Realist And Emancipatory.

In the context of health care that has been changing from time to time, formulating the best strategies for getting a sustained change in practice has been termed as one of the prime challenges for organizations. In the healthcare sector, formulating services and practices has applied multiple approaches. In the United Kingdom, and now increasingly in Australia, practice development is one of these crucial strategies (Devenny and Duffy, 2014 p.37). In essence, this strategy is mainly focused on creating quality patient-centered care. By definition, practice development is the act of continuously improving the effectiveness of patient-centered care. In other words, it entails enabling healthcare teams to improve their skills and knowledge and hence transform the context and culture of care (Bradd, Travaglia, and Hayen, 2017 p.67). In this regard, this reflective paper will focus on my learning outcomes and how I will apply practice development to enable support and facilitation. This paper also critically reflects on the application of the elements concerning practice development in the development of an effective person-centered practice and culture including the ways in which I will apply the strategies of practice development to create solutions to complicated problems.

One of the areas that has been crucial during my learning process is the application of practice development in the workplace. There is no doubt that even though the prime aims and values of healthcare remain steadfast, the greater landscape of the field has undergone modernization. According to my learning experience, some of the areas that have undergone significant modernization include how health care professionals examine the needs of individuals in their care, the technologies which are applied, how the execution of general roles is carried out, how new registrants are prepared, and how learning and development takes place (Hardy, Wilson and Brown, 2011 p.45). Practice development will, therefore, enable me to develop new approaches that can accommodate, and at the same time, respect the complexity evident in professional practice, in the needs of people, and in healthcare systems. In essence, I will apply practice development in multiple scenarios at the workplace to improve clinical operations and services, such as to enhance safety as well as quality in healthcare, to enable my healthcare team communicates more effectively, and to create service priorities and shared values (Hunnisett, 2011 p.53). For the purposes of determining how I will apply practice development more comprehensively, there is need to consider the nine key principles that I learned during this course. These principles outline the philosophical, theoretical, and practical concepts underpinning practice development.

1. Principle 1- this is the first principle that I will apply in the clinical setting. I will use it in fostering person-centred, evidence-based health care delivery that translates in an effective workplace culture and human flourishing.
2. Principle 2- the second principle that I will apply endeavors to explore the microsystem whereby delivery of care is facilitated by a change agent with the help of macro and mezzo levels.
3. Principle 3- this principle will be highly applicable at my workplace as it encompasses active learning and work-based learning strategies.
4. Principle 4- encompasses the application of both evidence from and evidence in practice and hence it will be very useful to me.
5. Principle 5- this principle merges the blending of cognition with creativity to facilitate human flourishing and facilitate new thinking. Facilitation of new thinking will ensure that I will be innovate at the workplace.
6. Principle 6-entails an approach that is complicated and can be adopted with all stakeholders or across boundaries.
7. Principle 7- this principle is facilitated by multiple processes and methods contextualized to the workplace scenario.
8. Principle 8- applies various processes including skilled facilitation executed near the place where care is provided.
9. Principle 9- integrates collaborative, participatory, and inclusive strategies to evaluation.

Application of Practice Development in the Workplace

In brief, practice development will engage me and other persons in all the healthcare levels to develop a culture that creates a difference and listens to the needs of the individuals (Parlour and McCormack, 2012 p.354). Practice development aims at engaging the entire team to facilitate person-centered healthcare by applying collaborative, participatory, and inclusive approaches.   

The use of practice development to solve complex problems can be viewed through the theoretical underpinnings of practice development. During my learning of practice development, Fay’s (1987) book of critical social science was one of my primary sources of theoretical underpinnings of emancipatory practice development. In turn, the critical social theory concept in the nursing field is believed to have been founded by Habermas 1972, who submitted three spheres of knowledge emanating from multiple needs including emancipatory, practical, and technical (Covill and Hope, 2012 p.380). The theory of human interest and human knowledge by Habermas is illuminated in Fay’s seminal work, who maintained that the role of critical social science would be realized by integrating empowerment and enlightenment thus leading to emancipation. Therefore, this would see me solve some of the complex problems in the clinical setting. In addition Manley, Titchen and Hardy (2009) proposed that practice development moves hand in hand with the focus of critical theory given that it helps the healthcare professionals view the world in a critical way (Manley, Titchen and Hardy, 2009 p.76). Seeing the world in a critical way means I will be able to look at the complex problems more critically. Moreover, since I will understand myself better, the world, and the situation in hand, will be able to solve the complex problems and produce the desired results. It is believed that critical social theory is essential to practice development as its activities enhance critical action-based thinking and learning which collectively solves complex problems in healthcare (Rapley, J., 2013 p.326). In addition to that, the approaches, tools, and methods applied in practice development are reflected in the critical social science theory. These include challenges with support, reflective practice, critical inquiry, values clarification, and action learning. All these have their distinct role in generating solutions to complex problems.

Practice development can be denoted as a continuous procedure of enhancement aimed at increasing the effectiveness of person-centered care. During my learning process, I noted that this can ne attained through empowering the teams in healthcare to improve their skill and knowledge.  On the other hand, an effective person-centered culture can be defined as a method of executing things that enables the individuals using social and health services as equal stakeholders in monitoring, developing, and planning care to ensure that needs are met. In other words, to create an effective person-centered culture, I will need to integrate families and people into the process of decision making. I will achieve this by viewing them as experts playing their part in helping the healthcare professionals get the desired results. Having looked at the definitions of the two key terms in this section, it is also important to now discuss the strong elements of practice development which include evidence and facilitation and the role they play in the development of a person-centered culture. Evidence means that clinical experience, patient experience, and research are well understood, planned, and executed (Chambers, Connor, and Davren, 2006 p.354). It is also important to note that a consensus exists in this whole scenario. Also worth noting is that the context in which implementation of evidence takes place is signified by a proper understanding of roles, decision-making process that is decentralized, excellent leadership, and inclusion of various sources of information on performance. This context, therefore, ensures that an effective person-centered culture is realized. On the same note, facilitation entails mechanisms that are necessary to the situation in hand or the case that is under investigation. As a practice developer I will apply a set of facilitative strategies such as motivating healthcare professionals to adopt a broader and more creative way of thinking and supporting them to put their innovations and ideas into action (Chin and Hamer, 2006 p.126). Facilitation is often viewed as a mechanism that incorporates multiple projects rather than a single one. Facilitation is associated with the creation of people in groups to enable fostering of motivation, self-reliance, and greater initiative (Boomer and McCormack, 2010 p.634). The overall investment can thus be regarded as two folds as it not only aims at clinching the objectives of a certain project but also entails equipping individuals with skills, knowledge, and experience needed for development of a person-centered culture. Facilitation needs a set of skills, abilities, and qualities.

Theoretical Underpinnings of Practice Development and Emancipatory Approaches

A comprehensive look at the theoretical and chronological transformation of practice development has indicated how scholars in the healthcare field have contributed to each other’s work in creating and refining multiple concepts that have presented a basis for developing practice. Evolving theories and consistent themes run across practice development in all the developmental stages thus empowering groups to come up with practice change that enhances the services given to patients (Beckett, Field, Molloy, Yu, Holmes, and Pile, 2013 p.595). In this regard, my lessons on practice development maintain that creating a culture change can be summarized as stimulating, sustaining, and supporting the active engagement of practitioners with evidence-based practice and research, allowing and advocating for professionals to exercise autonomy and control in their environment of professional practice, ensuring that resources are availed equally and also opportunities and support are granted to the professionals, and cultivating and creating a collaborative and cohesive teams.

Notably, person-centered care takes high priority for various reasons. First, it will ensure that my patients are incorporated in and a key to their care is currently regarded as a significant component of creating high-quality healthcare (Well, First, Dignity, and Training, 2011 p739). There is much that needs to be done to ensure that social and health services are more person-centered and the past decades have seen this become a high priority. This is mostly because it is hoped and believed that incorporating individuals at the center of their care will ensure that the quality of service is improved, the individuals will get whatever they need at the appropriate time, people will actively look after themselves, and pressure on social and health services will minimize. In the UK, for instance, where the demand for healthcare services increases day by day in the face of limited resources, research has revealed that person-centered care can be of the great essence in minimizing the burden on health services as well as enhancing the health of people (Schofield, 2009 p.884). In this regard, policies formulated by the government are stressing on strengthening patients’ voices and discarding the paternalistic models characterized by practitioners “doing things to people”. Besides that, the UK is characterized by individuals living for a considerably longer time and hence the probability that they may suffer from some age-related illnesses. Again, person-centered care comes in handy in solving this prevailing problem.

As a healthcare professional, practice development has taught me that I need to actively learn. As the general understanding of practice development turns complex day by day, there is need to determine ways in which I can facilitate my learning in practice more effectively. There are various strategies that I can apply to maximize and enable learning in the practice development referred to as active learning. Active learning considers ways in which, considering that creating a culture of learning is a prerequisite for practice development in a healthcare setting, practice developers can promote learning for practitioners and other relevant stakeholders (Andvig and Biong, 2014 p.324). In essence, active learning calls for increased attention on the part of institutions committed to practice development, at a strategic and corporate scenario for methods applied in the workplace to achieve learning strategies. The facilitators of practice development should relook at how learning is offered and organized so that the strategies of learning are coherent with the aims, processes, and visions of practice development and the planning should also have the needed skills. In brief, each and every encounter in practice development presents me with an excellent chance for learning. I view active learning as a dynamic strategy for comprehensive learning that is founded on the integration of multiple methods of learning (McCormack, Dewing, and Mccance, 2011 p.451). It is founded on healthcare environment as well as personal experience. In practice development, the key principles of active learning include using senses in multiple ways and applying social intelligence, critical personal dialogues regarding the future, the present, and the past, holding a critical dialogue with other parties, intentional act of executing issues in a different manner, and enabling similar learning encounters with other professionals (Andersen, 2012 p.90).

Strong Elements of Practice Development and the Development of Person-Centered Culture

The ability to merge research initiatives, practice, and education are excellently documented and literature on healthcare submits multiple models of collaboration that have emanated between service institutions and educational organizations to realize this aim (Akhtar, Casha, Ronder,  Sakel, Wight and Manley, 2016 p 456). Notwithstanding, a collaborative partnership agreement not only helps in achieving these objectives but also acts as a mechanism that bridges the theory-clinical practice gap. Collaborative partnerships play an active role in enhancing communication between myself as a health practitioner and educational services as well as promoting the development of healthcare knowledge and research. The collaborative partnership process initiative entailed the creation of what is commonly referred to as a Practice-Research Model (PRM) of collaboration. Essentially, this model promotes a close and worthwhile working relationship between the academics and the practitioners and has also enabled the development of rigid connections in healthcare (Aitken and Von Treuer, 2014 p.85). In summary, the implementation of the model has facilitated further research for the purposes of clinical practice. As a consequence, innovations and changes in practice have been realized, and most importantly best practice results have been disseminated.

At my workplace, I will need to conduct an evaluation of practice development. An evaluation of practice development should follow a criterion as set by (Barnes, Cox, Doyle, and Reed, 2010 p. 17) which submits that:

1. There should be a consideration when applying models such as TLC to give a design for practice development work in groups.
2. The initial step of practice development should entail a review of working within the team.
3. Mapping culture in the workplace needs to integrate multiple methods and should also take into consideration methods of staff engagement.
4. Facilitation development is vital to practice development’s success.
5. Support from the leaders is of the essence to the general fruition of practice development.

Conclusion

To summarize, practice development is a methodology that is seemingly structured to improve the healthcare sector while also focusing on emancipatory transformation at the level involving care provision, translating to evidence-based and person-centered care. The term practice development was first heard in the United Kingdom but has now become a common term in other nations including Australia. Practice development is one of the crucial strategies that will help me as a health practitioner to create quality patient-centered care. Practice development has been widely applied to generate solutions to complex problems considering that practice development moves hand in hand with the focus of critical theory which will enable me to view the world in a critical way. Seeing the world in a critical way means that I will solve complex problems as I will understand myself better, the world, and the situation in hand so as to make the desired change. This paper has also looked at practice development as a vehicle for creating a person-centered culture. In this regard, practice development can be viewed as a double-edged sword that not only purposes at clinching the objectives of a certain project but also entails equipping individuals with skills, knowledge, and experience needed for development of a person-centered culture. Another aspect that has been outlined in this paper is the commitment to active learning which is necessitated by the fact that the general understanding of practice development turns complex day by day and hence there is need to determine ways in which learning facilitation in practice can be achieved more effectively. Other significant areas that have been discussed include partnership and collaboration, how to create a culture change, and the importance of person-centered care.

The Evolution of Practice Development in Healthcare

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