Communities of Practice: Working in New Ways to Advance Oncology Nursing presented by: Esther Green, Cancer Care Ontario on behalf of: Dr. Denise Bryant, McMaster University Lisa Bitonti, The Ottawa Hospital Dr. Debra Bakker, Laurentian University
Communities of Practice: A Brief Introduction Communities of practice are groups of people who share a concern or a passion for something they do, know how to do and learn how to do it better as they interact. Etienne Wenger, 2002 2
Elements of Communities of Practice The Community: The relationships among members and the sense of belonging. The Domain: People from the same discipline or area of expertise with a goal to improve themselves and their profession. The Practice: The body of knowledge, methods, cases, tools, documents enabling members to share their practice. 3
Why Focus on communities of practice? Members Organization Short Term Value Help with challenges Access to expertise Confidence Fun with colleagues Meaningful work Problem solving Knowledge sharing Synergies across units Good use of resources Long Term Vl Value Personal development Professional identity Network New strategies Retention of talents Innovation Wenger, 2002 4
What are some critical success factors? Community Organization Domain energizes the group Involvement of experts Addresses practice Right mix and strategic activities Educate members and others about the approach Recognize the strength and value of being self-defined and self-managed Strategic relevance of domain Visible management sponsorship, but not micromanagement Relationship of formal and informal structures Adequate resources Value the model Recognizing the successes Integrate communities in the way the organization works Wenger, 2004 5
Getting to 7- Cultivating Communities of Practice Stage 1 Identify a common agenda Stage 2 Build trust and commitment Stage 7 Implement your products Stage 3 Establish norms and principles Stage 6 Communication plan: Internal and external Stage 4 Set early wins Stage 5 Recruitment and Retention of Members www.informatics.nhs.uk 2004 6
Oncology Nursing Research Community of Practice Accomplishments 22 members across the province (researchers, educators, organizational leaders, clinicians) Definition of research is broad Quarterly meetings Provincial survey of ambulatory oncology telephone-based nursing services Stacey, D., Bakker, D., Green, E., Zanchetta, M., & Conlon, M., (2007). Ambulatory oncology nursing telephone services: A provincial survey. Canadian Oncology Nursing Journal, 17(4): 186 (e1-5). To explore and describe the characteristics of the telephone-based oncology nursing services provided through ambulatory cancer programs for patients in Ontario To identify factors influencing the use of telephone protocols in practice To identify opportunities to enhance the quality of telephone-based nursing services 7
Oncology Nursing Research Community of Practice Impact Share ideas, knowledge and expertise through collaboration, partnerships, & networking Initiate and implement research activities relevant to oncology nursing Promote evidence-based oncology nursing practice Identify research priorities For the CoP-Research, the ability to meet its goals in sharing knowledge and promoting oncology nursing research lies in the fact that the CoP is made up of nurses who work in different organizations across a large region and represent expertise from all domains of nursing 8
Membership Impact One of the elements, I really appreciate about the group is that t it involves researchers, practitioners, and policy makers. Therefore, we have the support needed to conduct quality research that is grounded in clinical practice and relevant to health policy. The provincial i survey of telephone-based nursing services is an excellent example of conducting research through the network. We were able to get feedback on the survey for content validity, recruit participants, conduct the research and then disseminate the findings across the province. researcher member 9
Oncology APN COP Accomplishments Monthly growth with increase from 25 to 89 members Working document on role clarity Initiating CANO APN SIG 2008 Members survey CCO Advanced Practice Consensus Meeting 2008 1-day Pre-Conference Workshop at ICCN (2006) on APN role development, implementation & evaluation Orientation handbook for new members Oncology APN ementorship Program Development of Position Statements related to Oncology Advanced Practice Nursing (2009) 10
Harvest the Learning and the Knowledge http://www.library.uthscsa.edu/images/phrenology10.jpg 11
Responding to the Development Needs of APNs in Ontario: The Development and Evaluation of a Provincial i e-based Mentorship Program Onta ario Oncolo ogy APN E-m mentorship Interprofessional Prog gram
Evaluation Results Positive impact on APN role development at 2 months: Inter-professional networking & collaboration 80.9% of APN mentees/mentors reported the program had helped to achieve their personal and professional goals 46% of APN mentors/mentees had some to significant improvement in work related to research, EBP, or leadership Significant improvement in APN job satisfaction related to professional, social and community interaction (p=0.03) and time (p=0.04). 13
Contribution to Research Survey of Ontario Oncology APNs 73 of 77 APNs (95% response rate) 50% were novice APNs, 20% had no oncology experience APNs had substantial educational & mentorship needs Few were able to implement all role dimensions APNs were only somewhat satisfied with their jobs Lack of role confidence & number of overtime hours were independent predictors of job satisfaction 33% were seeking new employment ment Bryant-Lukosius et al. (2007). CNJL, 20(2),50-68. 14
APN-COP KT Strategies Targeting g Cancer Care Administrators: CCO Workshop on the introduction of advanced health providers in cancer care Policy document New Ways of Working Position Statement: Oncology Advanced Practice Nursing in Ontario Targeting APNs & other oncology nursing stakeholders Workshops on methods for developing & evaluating APN roles Provincial regulators (College of Nurses of Ontario) & national policy makers (Canadian Nurses Association) 15
Oncology APN COP Next Steps Strengthen pediatric APN participation Role implementation support strategies Oncology APN education Partnering with other stakeholders Influencing cancer care policies i New funding projects & research National leadership role 16
References and resources Wenger, E., McDermott, R., and Snyder, W. 2002. Cultivating Communities of Practice: A Guide to Managing Knowledge. Boston: Harvard Business School Publishing. Wenger, E. 2006. Communities of Practice: A brief introduction. Etienne Wenger Home Page. www.ewender.com. McDermott, R. 2004. How to avoid a mid-life crisis in your CoPs: Uncovering six keys to sustaining communities. KM Review: 7(2): 12-13. St. Onge, H. and Wallace, D. 2003. Leveraging Communities of Practice for Strategic Advantage. Burlington, MA: Butterworth-Heinemann. 17