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Clinical nurse specialists in palliative care (2): explaining diversity in the organisation and costs of Macmillan nursing services.

Clark, David and Douglas, H. R. and Seymour, J. and Bath, P. (2002) Clinical nurse specialists in palliative care (2): explaining diversity in the organisation and costs of Macmillan nursing services. Palliative Medicine, 16 (5). pp. 375-385.

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Abstract

In the UK, the work of Macmillan clinical nurse specialists in palliative care is now well established. There has been little research, however, into the organizational context in which these nurses operate and the implications for the services they deliver. We report on a major evaluation of the service delivery, costs, and outcomes of Macmillan nursing services in hospital and community settings. The study was based on eight weeks of fieldwork in each of 12 selected services. Data are presented from semi-structured interviews, clinical records, and cost analysis. We demonstrate wide variation across several dimensions: location and context of the services; activity levels; management patterns; work organization and content; links with other colleagues; and resource use. We suggest that such variation is likely to indicate the existence of both excellent practice and suboptimal practice. In particular, our study highlights problems in how teamwork is conceptualized and delivered. We draw on recent organizational theories to make sense of the heterogeneous nature of Macmillan nursing services.

Item Type: Article
Journal or Publication Title: Palliative Medicine
Additional Information: This is one of a series of publications resulting from a major study commissioned by Macmillan Cancer Support. RAE_import_type : Journal article RAE_uoa_type : Social Work and Social Policy & Administration
Uncontrolled Keywords: clinical nurse specialists • costs • Macmillan Nurses • palliative care organization
Subjects: R Medicine > R Medicine (General)
Departments: Faculty of Health and Medicine > Health Research
ID Code: 3301
Deposited By: ep_importer
Deposited On: 20 Mar 2008 16:36
Refereed?: Yes
Published?: Published
Last Modified: 26 Jul 2012 17:20
Identification Number:
URI: http://eprints.lancs.ac.uk/id/eprint/3301

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