Practice Development

Practice development is a facilitated approach to the development of person-centred and evidence-informed practice cultures in health care. It draws upon a variety of methods and approaches that together enable authentic engagement with individuals and teams to blend empirical evidence with the important personal qualities of professional practitioners, such as creative imagination, practice expertise and practice wisdom. The focus is on helping practitioners engage in active forms of learning (e.g. through play, creative problem-solving and/or observations of practice and storytelling) to bring about transformations of individual and team practices in the way health care is delivered. This learning and transformation that occur at individual and team levels are sustained by embedding both processes and outcomes in corporate strategy.

Practice development, whilst strongly connected with action research, has a slightly different emphasis or purpose. Whilst action research and practice development share the common purpose of bringing about changes in practice through collaborative and participative change processes, action research has an additional explicit additional purpose, that of generating new knowledge through the research process. This is not the case with practice development, where generating new knowledge is a secondary intent behind that of learning about the effectiveness of the change processes applied by practitioners in their everyday practice. For some practitioners, acquiring this new learning and internalizing it in a way that enables them to transform their own practice and that of others is [Page 638]enough, whilst for others, they may apply systematic processes of evaluation to these active learning processes and, of course, therefore generate new knowledge that can be applied in a variety of contexts. It is this latter approach that brings practice development into the realm of action research and aligns it as a research process in itself.

Whilst there has always been informal practice development—meaning, individual practitioners changing their own practice and encouraging others to do so also—in the seventies, practice development became more formalized as a change process. Since its origins in the late seventies, practice development has been aware of the pitfalls of top-down change alone, and so it pays attention to these local practices in clinical settings whilst at the same time focusing on the need for a systems-wide focus on person-centredness and the development of person-centred cultures. In particular, practice development pays attention to what are increasingly acknowledged as ‘the human factors’ in health care—factors that acknowledge the importance of the connections between the desire for evidence-informed and person-centred practices and the need for practice cultures that are respectful of all people. Therefore, practice development pays particular attention to staff well-being, leadership, team relationships and morale in order to create a greater sense of belonging among teams, which in turn leads to greater clinical effectiveness and better patient outcomes.