Determining Excellence Factors in Nursing and Midwifery (DEFINE): Report

Introduction and Methods
The Midlands Regional Excellence Network (MREN) meet bi-monthly as a ‘community of practice’ with representatives from each of the 11 Integrated Care Systems in the region, with the purpose of sharing learning and exploring a collective approach to Excellence. The NHS England Midlands Regional Team, with funding and sponsorship from the CNO for England’s Policy and Strategy Unit from the NHS England national team, commissioned University Hospitals Coventry and Warwickshire NHS Trust via the MREN to undertake a research study into Nursing and Midwifery Excellence. A mixed-methods approach including literature review, survey, interviews, and metrics was selected to explore Excellence in acute and non-acute provider settings using an evidence-based behavioural framework (COM-B) to understand key factors to success.
Findings
1. The following themes were identified as the six pillars underpinning Excellence:
➢ Shared professional decision-making
➢ Local accreditation
➢ Meaningful recognition
➢ Distributed leadership
➢ Continuous quality improvement
➢ Research and innovation
2. Non-acute providers starting on their Excellence journey demonstrated cultural
readiness for change and transferability of the six pillars.
3. Professional leadership and organisational culture emerged as key factors in creating
conditions for behavioural change and continuous improvement.
4. Results demonstrated a positive impact on workforce metrics through improved
workforce stability index rates and reduced leaver rates for nurses and midwives.
Recommendations
Recommendations for future research opportunities include exploring:
➢ Experiences of patients and families, through care quality and improved outcomes
➢ Transferability into additional health and social care settings
➢ Impact of Excellence on workforce including recruitment, retention, and succession
planning
➢ Impact of Excellence on productivity and efficiency