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Table 1 Steps for developing the Theory of Change model

From: Development of an on-job mentorship programme to improve nursing experience for enhanced patient experience of compassionate care

Aim

Method

Output

To conceptualize the problem from the perspective of external customer

Patient feedback survey and subsequent meetings with the leadership

It was realized that parents’ felt that the staff was disengaged, and their top recommendation was to improve responsiveness and communication to meet emotional and informational needs.

To conceptualize the problem from the perspective of internal customers

Survey and thematic analysis

Top pain points were identified that affected their ability to provide compassionate care: perception of being overburdened, poor connection with work and lack of growth opportunities.

To identify a conceptual framework for evidence-based package

Literature review of mentorship packages available for nurses

Identification of ‘Caring Mentorship Model’ for application in the service.

To assign a group of individuals committed to the design of package

Meetings with service and nursing leadership to identify individuals with strengths to inform the package.

Individuals identified with strengths across: human experience, health outcomes, nursing management, compassion and implementation sciences.

To experience the barriers the staff and supervisors face when delivering patient care and employee care.

Work shadow of frontline staff, discussion on departmental Facebook page, and discussion with the nursing working group

Barriers to patient experience included:

1. Inefficient inter services coordination

Barriers to employee experience included:

1. High staff-supervisor ratio (1:60)

2. Unequal (or no) access to basic facilities

To identify preconditions and design interventions accordingly.

Regular working group meetings

The following overarching pre-conditions were identified:

1. Hire staff with the right skills for pediatric care

2. Define compassionate experience

3. Have competent head nurses as supervisors

4. Create a culture of compassionate experience

The following interventions were agreed on:

1. Include paediatric compassion specific nursing education service (NES) orientation program

2. Communicate about compassionate skills, revise career ladder and provide trainings and on-job coaching

3. Strengthen supervision, conduct workshops create checklists and develop dashboards for data visualization

4. Promote compassionate values and recognize high-performing nurses