Thomas V. & Lambert S.(2008) Journal of Nursing
Management. 16(2):181-187
An
ethnographic study of intermediate care services in Wales:
the hidden work
Aim: To
explore the perceptions of staff working in and referring to
community-based intermediate care teams in Wales. Background
Central
and devolved governments have high expectations of intermediate
care to promote independence and quality of life for older people
and to solve the system pressures within the acute hospital sector.
Developing an evidence base of the effectiveness of a model of care
that is characterized by diversity and difference in practice is
problematic. Method
Fourth generation ethnographic evaluation involving focus
groups, non-participant observations and semi-structured interviews
with people working within and referring to intermediate care
teams. Preliminary findings
Strong
evidence of interprofessional working demonstrated by shared
responsibility, coordinated rather than parallel services,
understanding of other organizations and recognition and resolution
of conflict areas. This generated work which traditional measures
would not identify. Implications for nursing management
Evaluation is inherent in the work of healthcare
professionals and managers. Managers need to aware of the systems
and structures within which they are required to manage. This is
important for intermediate care services as the heterogeneity
contributes to the challenges encountered by managers when seeking
to describe services and measure their effectiveness. Applying an
appropriate evaluation framework will facilitate both.
Affiliations: Val Thomas: Doctoral
Student and Tutor, School of Health Science, Swansea
University, Swansea &
Sue Lambert: Centre
Head, School of Health Science, Swansea
University, Swansea, UK
