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Clinical nurse specialists in palliative care. Part 2. explaining diversity in the organization and costs of Macmillan nursing services

Clark, D., Seymour, J.E., Douglas, H.R., Bath, P.A., Beech, N., Corner, J., Halliday, D., Hughes, P., Haviland, J., Normand, C.E., Marples, R., Skilbeck, J. and Webb, T. (2002) Clinical nurse specialists in palliative care. Part 2. explaining diversity in the organization and costs of Macmillan nursing services. Palliative Medicine, 16 (5). pp. 375-385. ISSN 0269-2163

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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
Keywords: clinical nurse specialists; costs; Macmillan Nurses; palliative care organization
Institution: The University of Sheffield
Academic Units: The University of Sheffield > Faculty of Social Sciences (Sheffield) > Information School (Sheffield)
Depositing User: Information Studies
Date Deposited: 17 Aug 2009 09:07
Last Modified: 17 Aug 2009 09:07
Published Version: http://dx.doi.org/10.1191/0269216302pm585oa
Status: Published
Publisher: SAGE Publications
Identification Number: 10.1191/0269216302pm585oa
URI: http://eprints.whiterose.ac.uk/id/eprint/9145

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