The Cassandra Project- building a sustainable workload activity model for future community and district nursing workforce capacity planning

Conference paper


Jackson, C., Leary, A., Manley, K., Wright, T. and Martin, A. 2015. The Cassandra Project- building a sustainable workload activity model for future community and district nursing workforce capacity planning.
AuthorsJackson, C., Leary, A., Manley, K., Wright, T. and Martin, A.
TypeConference paper
Description

Purpose
This paper presents work in progress from a two year mixed methods study in the UK to evaluate the impact of a community nursing workload activity tool as a mechanism for modelling optimum caseloads to underpin decisions about safe staffing levels. Current methods of measuring workload and output in the community context are not robust enough to capture the complexity of care differences in rural and urban populations. Many teams have heavy caseloads, poor/inappropriate referrals, and an inability to state when capacity has been reached. .

Research Aim
To develop and evaluate a robust model to predict and plan for optimum community nursing caseload activity within a whole system.

Research Objectives
1. To develop a taxonomy and associated database that provides a consistent language for describing community nursing interventions that can be used to provide reliable and comparable metrics.
2. To determine the utility of the Cassandra tool in capturing community nursing interventions.
3 To use the data collected to build an inter-relational model of community nursing practice that can be used to determine, case-load, activity and develop a predictive model.
4. To evaluate the usability of the model in assisting managers and local decision-makers in workforce planning.
5. To assess the effectiveness of the model in capturing community nursing care left undone or missed
6. To explore how the model interrelates community nursing caseload activity with other care provision in a whole system.

Methods
Informed by critical realism, which attempts to understand real world issues, the design is guided by optimum caseload modelling, and given the multivariate nature of the environment in which workload activity takes place, a multiple case study evaluation across six NHS Pilot sites in England. Full ethical approval is in place.

Results
Results from case study sites demonstrated we have created a robust tool that captures an accurate picture of the multidimensional complexity of community nursing intervention, context of care, users of care and care left undone and are beginning to mine the data to identify patterns and relationships to build and test more accurate predictive optimum caseload activity tools to support workforce planning around patient acuity and skill mix, and provide an economic analysis of the cost of care left undone. Application in international contexts will be considered.

Conclusions
The tool can accurately capture a representative picture of how community and district nurses spend their time by generating both individual and organisational level reports. This reporting is speedy and enables workforce planners to work with robust evidence to make decisions about commissioning education for nurses, identifying skills shortages to target recruitment and retention activities, and to underpin decision making about commissioning services and the workforce required to provide high quality care.

KeywordsWorkforce modelling; district and community nursing; safe caseloads; safe staffing; workload activity
Year2015
Conference16th Healthcare Interdisciplinary Research Conference (HIRC2015)
Related URLhttp://www.trinityhirc.com/page/85/conference-programme/
References

Jackson C, Leary A, Leadbetter T, Manley K, Martin A, Wright T (in press) The Cassandra Project- Pilot of a workload activity tool to reflect complexity of community nursing care for future workforce modelling. British Journal of Community Nursing.

Jackson, C. Manley, K., Wright, T. (2014) A Scoping Project to Develop a Shared Purpose
Framework for the Delivery of First Class Community Nursing Services across Kent and Medway. Final Report ECPD ISBN 9781909067219.

Leary, A. (2011) Proving your worth: Alison Leary has tips on how nurse specialists can demonstrate added value. Nursing Standard. 25, 31, 62-63

Publication process dates
Deposited31 Mar 2016
Accepted05 Nov 2015
Output statusPublished
Accepted author manuscript
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Jackson, C. and Manley, K. 2015. Transforming primary care: vision and reality: a whole systems approach to developing the workforce.
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Jackson, C., Manley, K., Martin, A., Wright, T. and Leadbetter, T. 2015. Making the complexity of community nursing visible: the Cassandra project. British Journal of Community Nursing. 20 (3), pp. 126-133. https://doi.org/10.12968/bjcn.2015.20.3.126
Engagement-related process factors in services for street-connected children and young people in low and middle income countries: a thematic synthesis
Coren, E., Hossain, R., Ramsbotham, K., Martin, A. and Pardo Pardo, J. 2014. Engagement-related process factors in services for street-connected children and young people in low and middle income countries: a thematic synthesis. London International Initiative for Impact Evaluation (3ie).
Interventions for promoting reintegration and reducing harmful behaviour and lifestyles in street-connected children and young people
Coren, E., Hossain, R., Pardo Pardo, J., Veras, M., Chakraborty, K., Harris, H. and Martin, A. 2013. Interventions for promoting reintegration and reducing harmful behaviour and lifestyles in street-connected children and young people. The Cochrane Library. https://doi.org/10.1002/14651858.CD009823.pub2
The Cassandra project: recognising the multidimensional complexity of community nursing for workforce development
Jackson, C., Leary, A., Wright, T., Leadbetter, T., Manley, K. and Martin, A. 2015. The Cassandra project: recognising the multidimensional complexity of community nursing for workforce development. Canterbury Christ Church University England Centre for Practice Development.
A snapshot culture assessment undertaken for Kent and Medway Partnership NHS Trust
Jackson, C. 2014. A snapshot culture assessment undertaken for Kent and Medway Partnership NHS Trust. Canterbury Canterbury Christ Church University.
Action learning: maximizing learning in the workplace
Jackson, C. and Thurgate, C. 2011. Action learning: maximizing learning in the workplace. British Journal of Healthcare Assistants. 5 (9), pp. 454-456.
Developing the role of the Assistant Practitioner
Jackson, C. 2010. Developing the role of the Assistant Practitioner.
Preparing for the new graduate workforce across health provider organisations
Manley, K. and Jackson, C. 2011. Preparing for the new graduate workforce across health provider organisations.
Navigating contested terrain - AP stories from the frontline
Jackson, C. and Thurgate, C. 2011. Navigating contested terrain - AP stories from the frontline. British Journal of Healthcare Assistants. 5 (7), pp. 346-349.
Career planning for the future - where to from here?
Jackson, C. 2011. Career planning for the future - where to from here? in: Jackson, C. and Thurgate, C. (ed.) Workplace Learning in Health and Social Care: A Student's Guide Maidenhead Open University Press. pp. 112-126
How does learning happen in the workplace?
Jackson, C. 2011. How does learning happen in the workplace? in: Jackson, C. and Thurgate, C. (ed.) Workplace Learning in Health and Social Care: A Student's Guide Maidenhead Open University Press. pp. 12-21
First do no harm: reflections on setting up a fitness to practice panel at Canterbury Christ Church University
Jackson, C., Biela, C. and Levine, A. 2008. First do no harm: reflections on setting up a fitness to practice panel at Canterbury Christ Church University.
Becoming a learning community: a transformative journey towards a sustainable model to support student learning in practice
Jackson, C. and West, S. 2008. Becoming a learning community: a transformative journey towards a sustainable model to support student learning in practice.
Personal development plans and workplace learning
Jackson, C. and Thurgate, C. 2011. Personal development plans and workplace learning. British Journal of Healthcare Assistants. 5 (6), pp. 292-296.
Transforming professional development for an era of interagency leadership
Hryniewicz, L. and Jackson, C. 2010. Transforming professional development for an era of interagency leadership.
The importance of partnership working in the design and implementation of band A assistant practitioner roles - a case example
Thurgate, C. and Jackson, C. 2010. The importance of partnership working in the design and implementation of band A assistant practitioner roles - a case example. British Journal of Healthcare Assistants. 4 (12), pp. 603-604.
Learning leaders, new professional identities and the implications for children’s centres and early years
Jackson, C. and Hryniewicz, L. 2011. Learning leaders, new professional identities and the implications for children’s centres and early years.
Understanding the importance of career planning
Thurgate, C. and Jackson, C. 2011. Understanding the importance of career planning. British Journal of Healthcare Assistants. 5 (1), pp. 35-37.
Partnership working and the assistant practitioner
Thurgate, C. and Jackson, C. 2010. Partnership working and the assistant practitioner. British Journal of Healthcare Assistants. 4 (12), pp. 603-604.
Facing the challenge: the development of assistant practitioners
Thurgate, C. and Jackson, C. 2010. Facing the challenge: the development of assistant practitioners. British Journal of Healthcare Assistants. 4 (11), pp. 546-547.
Developing foundation degrees in adult health services
Thurgate, C. and Jackson, C. 2010. Developing foundation degrees in adult health services. British Journal of Healthcare Assistants. 4 (8), pp. 382-383.
Creative thinking for whole systems working
Jackson, C. and Ellis, P. 2010. Creative thinking for whole systems working. in: Standing, M. (ed.) Clinical Judgement and Decision-Making in Nursing and Interprofessional Healthcare Maidenhead Open University Press.
An overview of the national challenges of embedding an assistant practitioner workforce in health and social care
Thurgate, C. and Jackson, C. 2010. An overview of the national challenges of embedding an assistant practitioner workforce in health and social care. British Journal of Healthcare Assistants. 4 (11), pp. 546-547.