title: Developing person-centred practice in hip fracture care for older people.
abstract: OBJECTIVE
  To facilitate a multidisciplinary collaborative approach to developing person-centred practice in hip fracture care for older people.
  
  
  METHODS
  Collaborative inquiry, a form of action research, was used to collect data for this study. It involved exploration of dilemmas, questions and problems that are part of human experience. Clinical leaders from different disciplines (n=16), who work with older people with hip fractures at different stages of the care pathway, participated in a series of facilitated action meetings. The practice development techniques used in this study included: identifying the strengths and limitations of the current service, values clarification, creating a shared vision, sharing clinical stories, reviewing case records, and reflecting on the experiences of three older people and two caregivers.
  
  
  RESULTS
  Hip fracture care was based on meeting service targets, national guidelines and audits. Care was fragmented across different service delivery units, with professional groups working independently. This resulted in suboptimal communication between members of the multidisciplinary group of clinical leaders and care that was process-driven rather than person-centred. Spending time away from clinical practice enabled the multidisciplinary group to collaborate to understand care from the patients' and caregivers' perspectives, and to reflect critically on the care experience as a whole.
  
  
  CONCLUSIONS
  To develop a person-centred workplace culture, the multidisciplinary team requires facilitated time for reflection. Ongoing facilitative leadership would enable the multidisciplinary team to collaborate effectively to deliver safe, effective person-centred practice in hip fracture care for older people.
authors.affiliation: NHS Lothian, Scotland.
authors.forename: Jane
authors.initials: J
authors.lastname: Christie
authors.affiliation: School of Health and Social Care, Edinburgh Napier University, Scotland.
authors.forename: Maureen
authors.initials: M
authors.lastname: Macmillan
authors.affiliation: NHS Lothian, Scotland.|University of Edinburgh, Scotland.
authors.forename: Colin
authors.initials: C
authors.lastname: Currie
authors.affiliation: School of Health and Social Care, Edinburgh Napier University, Scotland.
authors.forename: Gerardine
authors.initials: G
authors.lastname: Matthews-Smith
mesh_terms: D000368:Aged; D017028:Caregivers / Q000523:psychology*; D003142:Communication; D003299:Cooperative Behavior; D006620:Hip Fractures / Q000451:nursing*; D006801:Humans; D007857:Leadership; D018802:Patient-Centered Care; D036301:Qualitative Research; D012606:Scotland
keywords: collaborative inquiry; hip fracture; multidisciplinary team working; older people; person-centred care; practice development; qualitative research