Determining Excellence Factors in Nursing and Midwifery: A Mixed Methods Study

Background:
PRESENTED BY
The Midlands Regional Excellence Network brings together senior nurse leaders across 11
integrated care boards to develop collective leadership, positive work environments and a
culture of excellence. Six excellence pillars have emerged namely; shared professional decision
making, local accreditation, meaningful recognition, distributed leadership, continuous quality
improvement and, research and innovation. Conducted in the Midlands, this study is the first in
England to explore nursing and midwifery excellence in acute and non-acute settings.
Mrs. Michelle Hartanto
University Hospitals Coventry and Warwickshire NHS Trust
- (⚑ United Kingdom)
Mrs. Gishi Sashidharan
University Hospitals Coventry and Warwickshire NHS Trust
Aims:
- (⚑ United Kingdom)
To describe approaches and behaviours that drive nursing and midwifery excellence in acute
provider settings and explore the potential transferability of these to non-acute provider
settings.
Mr. Nicolas Aldridge
University Hospitals Coventry and Warwickshire NHS Trust
- (⚑ United Kingdom)
Methods:
Mrs. Lisa Dunn
Mixed methods were a scoping review; Midlands-wide cross sectional staff survey, administered
via QR code using Office 365; case study interviews with acute and non- acute providers via MS
Teams, and an exploration of key metrics to determine impacts of excellence. The six excellence
pillars provided an exploratory framework, directed by the COM-B behavioural change model
throughout1. Forty-four organisations were invited to participate. Coventry University Ethics
P172363
University Hospitals Coventry and Warwickshire NHS Trust
- (⚑ United Kingdom)
Prof. Liz Lees-Deutsch
Coventry University - (⚑ United Kingdom)
Results:
16 global studies reviewed (n=23) focused on delivery of excellence through the Magnet
Recognition Programme2. Twenty-six organisations responded to the survey. Case studies with
acute provider organisations (n=12) identified behaviours driving excellence, with professional
leadership and organisational cultures as key factors. Non-acute organisations (n=3)
demonstrated some early principles of excellence.
1.
2.
3.
4.
AUTHORS
Mrs. Michelle Hartanto (⚑ United Kingdom) 1
Mrs. Gishi Sashidharan (⚑ United Kingdom) 1
Mr. Nicolas Aldridge (⚑ United Kingdom) 1
Mrs. Lisa Dunn (⚑ United Kingdom) 1
Discussion:
5.
Prof. Liz Lees-Deutsch (⚑ United Kingdom) 2
Higher workforce stability and lower leaver rates were found in organisations employing
excellence approaches, compared to those who did not use these approaches. Non-acute
organisations demonstrated a willingness to adopt excellence approaches.
1. University Hospitals Coventry and Warwickshire NHS
Trust, 2. Coventry University
Conclusion:
Well-developed excellence approaches are evident across the Midlands in acute organisations.
Non-acute organisations are at an earlier stage of development. A delivery plan indicating
support for non-acute leaders to develop, implement and sustain excellence approaches is
needed. Further research to expand this work across England is warranted.
REFERENCES
(1) Michie S, van Stralen M, West R. The behaviour change wheel: A new method for
characterising and designing behaviour change interventions. Implementation Science 2011;
6:42.
(2) Boylan et al. Association of Magnet nursing status with hospital performance on nationwide
quality metrics. Journal for Healthcare Quality 2019; 41(4): 189-94.
LEAD PRESENTER BIOGRAPHY
Michelle Hartanto, RN, MSc is a Practice Facilitator for Pathway to Excellence® at University
Hospitals Coventry and Warwickshire NHS Trust. After completing a NIHR/HEE Pre-Doctoral
Research Fellowship (2022), she led research on the ReSPECT process and CPR decision-making
conversations and has been published in peer-reviewed scientific journals. In 2024, as a
Research Fellow on a study commissioned by NHS England – Midlands and funded/sponsored
by the Chief Nursing Officer for England’s Policy and Strategy Unit within the NHS England
national team, Michelle co-led the first study in England to explore Nursing and Midwifery
Excellence in acute and non-acute healthcare settings.
TOPICS
Clinical topic, research field and research issues: Leadership and management
Clinical topic, research field and research issues: Quality standards
Clinical topic, research field and research issues: Workforce and employment (including
heath and wellbeing roles, research careers)
Research approach: Mixed methods research