Project Duration
Unknown
Funder
King's Fund
Project Staff
- Jane Seymour (PI) 1
- Antony Arthur 1
- Alex Forsythe 1
- Jonathan Hale 1
- Eleanor Wilson 1
Staff Institutions
- The University of Nottingham
Aims
The aims of this evaluation are:
- to assess the process of change undertaken in the participating projects
- to explore the impact the projects have on the delivery of end of life care
- to explore the impact on those using the physical environment
- to examine what has been learnt about the way attitudes to death and dying are influenced and changed by the physical environment
Methods
The evaluation employs a multi-method design in order to pragmatically evaluate the King's Fund Enhancing the Healing Environment Programme for Environments of Care at the End of Life (ECEL).
Periodic progress reports and summary local evaluations from all 20 project sites are being used to map the development of the projects over time. In-depth case studies are being undertaken at six selected sites: the remodelling and renovation of three mortuary viewing facilities, two centralised bereavement services and palliative care provision in a prison.
Field work takes place during two phases: before and after the renovation. Focus groups (at phase 1) and individual interviews (at phase 2) with the case study teams are providing in-depth data. These are complimented at both phases by observational data at each site, the completion of the Achieving Excellence in Design Evaluation Toolkit and A Staff and Patient Calibration Toolkit and a self-complete questionnaire to gain the views of staff within the trusts that access and experience the mortuary facilities.
Outcomes and Findings
Improvements in AEDET and ASPECT scores were most notable in the areas of (1) character and innovation; (2) comfort and control; and (3) privacy and dignity. All teams highlighted the importance of team composition and cohesion in order to have the right skills for the project and sustain good working relationships. Key to the process were input from estates/capital planning, service providers, access to senior figures within the trust, and a culture of creativity. The ability to integrate these features within the teams appeared to be linked to securing substantial and additional funding and earlier completion.
While none of the teams doubted the importance of the physical environment in the provision of end of life care, the King's Fund programme was perceived as enabling team members to articulate and realise their aspirations. That these projects were concerned with the physical space, at a time when policy attention in end of life care was greater than it had been hitherto, gave a focus that could provide end of life care with a higher profile within trusts than could have been otherwise achieved.