TY - JOUR

T1 - Clinical nurse specialists in palliative care (2): explaining diversity in the organisation and costs of Macmillan nursing services.

AU - Clark, David

AU - Douglas, H. R.

AU - Seymour, J.

AU - Bath, P.

N1 - 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

PY - 2002/7

Y1 - 2002/7

N2 - 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.

AB - 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.

KW - clinical nurse specialists • costs • Macmillan Nurses • palliative care organization

U2 - 10.1191/0269216302pm585oa

DO - 10.1191/0269216302pm585oa

M3 - Journal article

VL - 16

SP - 375

EP - 385

JO - Palliative Medicine

JF - Palliative Medicine

SN - 1477-030X

IS - 5

ER -