Essentials of Care - Facilitation

The term facilitation is used in various settings, contexts and to describe a multitude of purposes and roles few of which have a shared definition or use matching styles and approaches.

Developed by Pauline Bergin in collaboration with the Essentials of Care Facilitation Development Working Party

In the context of the EOC Program, and other workplace culture work, the required style of facilitation is emancipatory, a style that has been explored and defined by many Practice Developers.

It's aim is to enable individuals and groups to understand what needs to change (enlightenment) and bring about the changes they deem necessary (empowerment), as a result transforming them, their work environment and their practice (emancipation).

Equally important to this desired outcome of facilitation are the processes used to achieve it and around which the standards for skills, knowledge and attributes of emancipatory facilitators focus.

“As a facilitator, I have been fortunate to see first hand the growth and the development of clinical nursing staff, especially as they discover that this process enables them to have some control over their everyday lives and the care that they provide to their patients”.

Do you want to be an EOC Facilitator? ( pdf - 916 KB)

The style of facilitation employed is key to the success of the EOC program. While technical approaches have demonstrated varying degrees of success, the results have sometimes been less than optimal in terms of sustainability and effective change.

Transformational facilitation is used to support the implementation of the EOC program and this differentiates it from other change and improvement projects; aims to enable others to deliver holistic, person-centred care.

It is argued that person centredness and person-centred relationships are integral to the development of effective workplace cultures.

Often defined as 'making easier', facilitation is a complex method and dynamic process that requires specific skills and attributes which are developed and enhanced over time. It is these processes, applied in a safe and therapeutic setting, that will:

enable those involved in practice to gain deeper insights into their practice and themselves, leading to new knowledge through critical reflection;
allow individuals to take ownership and be self directed;
give people autonomy over their actions;
help bring about change and transformation, and
lead to the process outcomes of enlightenment, empowerment and emancipation.

Facilitation is concerned with the context in which practice and changes will occur and has direct relationship with lived experiences. Compared to other change management approaches, transformational facilitation offers something different – it is emancipatory, and therefore can bring about real change that is effective and sustainable.

In recognition of the key role of facilitation, the statewide EOC program implementation is occurring in unison with a program of facilitation skills development appropriate to the needs of EOC participants and leaders. The greatest challenge to the continued successful embedding of the of EOC program is the need for a critical mass of skilled facilitators who can support, enable and drive it.

Resources

Working with EOC: A Resource Guide for Facilitators ( pdf - 3.7MB)
Facilitation Development Program ( pdf - 1.8 MB) Program model and curriculum of the EOC Facilitation Program
Mandala - Content and Context ( pdf - 84 KB)

References

Youngston, R. (2008) Compassion in healthcare: the missing dimension of healthcare reform? The NHS Confederation Futures Debate Paper 2

Wright, S. (2006) The heart of nursing. Nursing Standard 20(47): 20-3.

McCormack, B., Henderson, E., Wilson, V. & Wright J. (2009) Making practice visible: The workplace Culture Critical Analysis Tool (WCCAT). Practice development in Healthcare 8(1): 28-43.

Harvey G., Loftus -Hills A., Rycroft-Malone J., Titchen A., Kitson A., McCormack B. & Seers K.(2002) Getting evidence into practice; the role and function of facilitation. Journal of Advanced Nursing 37(6), 577–588

Larsen, J., Maundrill, R., Malone, J. & Mouland, L. (2005) Practice Development facilitation: An integrated strategic and clinical approach. Practice Development in Healthcare, 4(3): 142-9.

Wilson, V. (2005) Improving the effectiveness of patient care: an emancipatory practice development approach. Neonatal, Paediatric and Child Health Nursing. (8)3: 4-11.

Manley, K., and McCormack, B. (2003) Practice Development: purpose, methodology, facilitation and evaluation. Nursing in Critical Care. (8)1: 22-9.

Dewing, J. (2010) Moments in movement. Nurse Education in Practice (10): 22-6. Elsevier Ltd.

McGill I., and Beaty, L. (1995) Action Learning: a guide for professional, management and educational development. 2nd Ed. Kogan Page, London & Philadelphia.

Crisp, J., and Wilson, V. (2011) How do facilitators of practice development gain the expertise required to support vital transformation of practice and workplace cultures? Nurse Education in Practice (11)3: 173-8.