Lessons from the Family Health Nursing Pilot

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Lessons from the Family Health Nursing Pilot

• Lesley A Whyte

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What the FHN project has in common with the
development of community nursing

• started as an hypothetical role
• based on a model of generalist practice
• likely to cause strong emotional feelings
• provides a development opportunity for nurses

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Differing Cultures

• Phase 1 Remote Rural (31 FHNs)
• Phase 2 Urban site (15) R R (3)
• Different
• Geographies
• Health needs
• Different support systems

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The generalist

• ' A registered nurse who has undertaken
  additional education and has a broad range of
  knowledge and expert skills with the ability to
  co-ordinate, refer on, and manage pathways of
  care for individuals and families

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The Generalist Model

• Skilled practitioner
• Multi-faceted flexible
• Responding to different health issues in the
  family

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FHNs Interpretation

• Applying generalist principles
• Knowing limitations
• Working across the lifespan providing
  inter-generational care
• Being a navigator for care

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Education Partner

• Key role in project
• Member of national implementation group
• Allies for FHN and clinical staff
• Required to develop new skills knowledge
• Curriculum development
• Partnership working with NES

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Skills Development
Team building
Conflict management
Project management
Creative thinking
Nominal group technique (FHN Indicators)
Langleys Improvement model (PDSA)
Learning materials delivery of workshops on
action
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Refining the documentation Reviewing caseloads
Workshops on Improvement Methodology FHN
Indicators
Using Continuous Improvement model (PDSA Cycles)
to change practice
Developing the job description referral systems
Team building and ways of working
Creating FHN National Indicators
Capturing our role on film
Local report Action Plans National Forum
Practice and Perceptions questions with FHNs,
teams managers
FHN Activity Recording Tool
ACTION LEARNING
June 2005
Jan 2004
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What it meant to the patient family

• Addressed gaps in provision which may occur when
  there are specialist divisions in services
• liked one point of contact
• Focused on the health of all family members

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Challenges

• Understanding the generalist concept (breadth
  versus depth of practice)
• Hypothetical role
• Getting the balance right between specialist and
  generalist roles
• Some resistance at all levels

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What Helped

• National input strong NHS Board leadership
• Facilitation and support at all levels
• Having allies who understood the concept
• Working towards common patient and family-focused
  goals
• added valued of education and practice

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Final Thoughts

• What do patients want from the role?
• How do we want the role to look?
• How do we want other people to see us?