A case study evaluation of the legacy practitioner role: implications for system and workforce transformation

Abstract

Background: The World Health Organisation’s Global Strategy on Human Resources for Health: Workforce 2030 sets out how vital the healthcare workforce is to the resilience of communities and health systems. Nurses are the largest professional group in that workforce and therefore support for nurses’ practice roles and wellbeing is pivotal to sustaining the global health economy. Nurses with extensive experience can contribute significantly in this respect, and the notion of the legacy practitioner role arose in response to the need to retain the expertise of long-serving nurses. Aim: The aim of the pilot project evaluation was to gather impact evidence of a newly introduced legacy practitioner role, as a workforce planning strategy for retaining the expertise of professionals considering or close to retirement. Design: A mixed-methods case study evaluation was used to capture stakeholder-driven process and outcome data. Emphasis was placed on interacting with project participants and stakeholders with a view to understanding human interconnectedness in the context of sustainable learning and quality-driven improvements at system level. Data analysis used first-order thematic analysis to capture process indicators, followed by a second-order impact framework analysis of workforce and system-level transformation to capture potential sustainable outcome indicators. Conclusion: Evidence identified six core aspects of the legacy role, with one outcome indicator related to reducing attrition in the workplace. Two overarching themes – enhancing practice skills and knowledge exchange – considered the impact of the role, not only with existing healthcare staff but in ‘feeding forward’ practice expertise to the potential future workforce. Implications for practice: Evidence suggests the legacy role can enable knowledge and skill enhancement, and help stressed or anxious staff and learners overcome thoughts and intentions to leave The role provides clinically credible, practice-driven expertise, helping create the conditions for safe and effective person-centred practice Legacy roles can inspire a professional expertise, based on values of compassion and respect that are spread and sustained among new staff External stakeholders who engage with legacy practitioners can also experience positive outcomes