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Research project: Creating Learning Environments for Compassionate Care (CLECC): a feasibility study

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The quality of relationships with staff is key to shaping older people’s hospital experiences. While the extent of problems with quality of interactions between older people and nurses on NHS hospital wards is unknown, recent reports indicate that older people frequently fail to experience positive and caring attitudes and behaviours, resulting in a perceived lack of compassion. CLECC (Creating Learning Environments for Compassionate Care) is a practice development programme that aims to promote compassionate care for older people. This study will assess the feasibility of implementing CLECC in acute hospital settings and of evaluating its impact on patient care using an experimental design and associated process and economic evaluations.

CLECC is a ward-based practice development programme focused on developing sustainable ward management and team practices that enhance capacity to provide compassionate care. It is based on workplace learning theory with the ward itself conceptualised as learning environment and team as potential community of practice. CLECC aims to create and support sustainable work-based opportunities for team dialogue, reflective learning, mutual support and role modelling.  

This project is a feasibility study of CLECC implementation and its evaluation. Semi-structured qualitative interviews with staff, patients and carers will be used to assess CLECC’s workability and integration into existing work practices. Contextual data will also be gathered including ward staffing, specialist support, patient information and communication systems. Procedures for a cluster RCT and associated economic evaluation will be piloted to inform a future main trial design, evidence on outcome measures obtained to contribute to the power calculation, risk of contamination between clusters assessed, and participation and attrition rate estimated.  Outcomes to be assessed include quality of staff-patient interactions, patient evaluations of care and staff perceptions of empathy. Carer/visitor perceptions of care quality, staff wellbeing, ward climate and perceived workload will also be measured. Pilot procedures will include wards being randomly allocated to participate in CLECC or act as control. Baseline assessments will be undertaken 2 months before intervention with follow-up at 8 months post-randomisation.  An economic evaluation will be conducted from a health service perspective.

Project team

Dr Jackie Bridges

Prof Peter Griffiths

Dr Ruth Pickering

Dr Lily Yao

Dr Rebecca Kandiyali

Paula Libberton

Dr Chris McLean

Prof Alison Fuller

Prof Avan Aihie Sayer

Dr Greta Westwood

Emma Munro

Rosemary Chable

Project funder

NIHR Health Services and Delivery Research programme

Related research groups

Health Work and Systems

Key Publication

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