Enhancing Patient Care Through Reflective Practice in Healthcare


The reflection in healthcare allows professionals to enhance clinical reasoning regarding experiences to ensure creating a positive care impact on the patient. This is because in reflection the professionals determine their strength and weakness which allows them to determine the actions to be required for growth and continuing best care to patients. In this assignment, the reflection account of creating improvement plan to cope with service failure in Liverpool Community Health NHS Trust is to be discussed by using reflective model. Moreover, a personal development plan is to be framed to cope with identified skill gaps in developing the reflection.


Reflective account of developing improvement plans for Liverpool Community Health NHS Trust

The reflective models such as Rolfe’s reflective model, Kolb’s reflective model and Gibb’s reflective cycle are commonly used for reflective practice in healthcare. The limitation of Rolfe’s reflective model is that it does not allow assessment of all situations from different aspects creating limited scope to inform the strength and weakness of situations analysed (Dressler et al. 2018). Thus, it is not to be used in reflecting the improvement plan for the LCH trust. The limitation of using Kolb’s reflective model is that it does not consider the essentiality of unconscious learning and defence mechanism which may influence skills thus creating hindrance in presenting valid reflective analysis with efficiency (Morris, 2019). Thus, this model is also not be used in developing the reflection for improvement of NHS trust. I selected Gibb’s reflective cycle to be used for presenting reflective account of improvement plan for service failure in Liverpool Community Health (LCH) NHS Trust. This is because benefit of Gibb’s reflective model is that it allows the learners to easily analyse their experiences and examine the experiences over time to develop a balanced and accurate judgement of personal skills during the situation (Koshy et al. 2017). Thus, I would use the model in developing reflective account for improvement plan framing in case of LCH trust as it would help to develop accurate and balanced judgement of the strength and weakness during the situation. The Gibb’s Reflective Model includes six key stages which are description, feelings, evaluation, analysis, conclusion and action plan (Okamoto et al. 2017).


In description phase, the detailed situation faced by the individual is discussed to determine the concerns for what has happened in the activity (Kanofsky and CCPA, 2019). In framing the improvement planning for service failure in Liverpool Community Health (LCH) NHS Trust, I initially develop detailed observation regarding the incidence and critically tried to think about the key impact of the explained causes of service failure such as untrained staffs, hindered communication, inappropriate whistle blowing and others mentioned by the NHS assessment for the organisation. I later identified that lack of continuous training of the staffs was the key issue that led to service failure in the organisation and tried to develop the improvement plan based on resolving the specific issue. I analysed the reports of service failure in LCH trust without leaping directly into the situation to develop conclusion for improvement planning. This is to avoid influence of conflicting beliefs and thoughts such as the reports may be wrong, the service users may have made up the situation to harass staffs and others in collecting information that may lead to manipulate the real facts (NHS, 2018). In developing improvement plans, I developed paired discussion with the service providers, healthcare staffs and managers at the LCH trust. This is to identify in which areas improvements are required in the trust so that the service failure can be resolved. During development of the improvement plan for the trust, I was confused about strategies to be implemented in the plan because I lacked ability to from group discussion to gather ideas from others in supporting effective upgradation of services.

In framing the improvement plan, I developed the objectives to be fulfilled for the success of the plan which are professional training and supporting evidence-based practice. The objectives are developed based on the observed activities and feedback from service providers and reports regarding trust. In framing the objectives, I thought of developing SMART goals. This is because it would help me to provide clarity and direction in which they would be able to ensure success of the plan (Stonehouse, 2017). I developed the improvement plan by reading the reports and analysis of service failure for the trust and tried to visualise or directly communicate with service providers and managers in the trust in making the plan. I tried identifying the resources for improvement in the plan such as books and articles, past experience reports and others based on own concept and avoided communicating with experts because I had feared they are going to reject my thoughts. Moreover, I have issues with active listening and therefore avoided to avail advice from others in framing the improvement plan. On the basis of the objectives to be fulfilled, I determined the stakeholders to be required so that effective accomplishment of the improvement plan is made. In framing the improvement plan, I solely worked without accessing assistance from any others. I planned the improvement without involving others because I am incapable to resolve raised conflicts between people while working in groups.


In feeling phase, the detailed thoughts of the individual during the experience are determined and analysis is made regarding the way it influenced the experience (Key et al. 2019). The experience regarding improvement planning for LCH trust made me feel that I followed reflector learning style mentioned by the Honey and Mumford. In reflector learning style, people are seen to develop learning through observation and thinking of the incident happened, in turn, avoiding to actively involved in analysing the incident (Salahuddin and Nurumal, 2018). I followed the same learning style in developing the improvement as I avoided to directly survey the LCH trust activities and mainly based my analysis by observing the existing reports and collecting different perspectives of service providers in the trust. During the situation, I felt that I have effective logical and critical thinking ability along with brainstorming skill. This is evident as in framing the plan I logically and critically analysed different aspects of service failure to appropriately determine the key factors that are to be improved to overcome the service failure. Moreover, I brainstormed each of the recommendations in making the improvement which was found to be effective in overcoming the service failure at LCH trust.

In the planning, I have hindrance being flexible at work and expressed inability to resolve conflict. This is because I avoided taking steps in overcoming my weakness of working as a team and being an active listener along with avoided team working that could be beneficial out of inability to manage conflict at work. In planning improvement, the teamwork creates diverse potential ideas from experts and colleagues to be shared which allows framing a well-structured improvement plan (Rosen et al. 2018). Moreover, team working helps in sharing roles and responsibilities in making improvement to lower work burden along with allow sharing of solutions to overcome problems for improvement, in turn, ensuring its smooth accomplishment (Arnett et al. 2017). Thus, at present, I feel that team working was essential and could be established by me in framing the improvement plan. I also feel that I could have developed direct participation in analysing the factors for improvement apart from observing and visualising the reports. This is because it could provide me a better analysis of the situation in an enhanced improvement plan. I felt that I was not assertive in the situation and was fear to take enough risk to frame the improvement plan that could have ensured better service enhancement in LCH trust.


In the evaluation phase, examination of the experience is made to determine which aspects effectively worked and which did not in managing the situation (Koshy et al. 2017). As commented by Arumugam et al. (2017), reflector has the strength of being methodical in making decision and planning regarding any situation. This indicates that being reflector in the improvement planning of LCH trust was beneficial as it led me to develop thorough and effective analysis of steps to be taken for overcoming service failure in the trust. As criticised by Anderson (2016), disadvantage of being a reflector is that they become extensively cautions in taking risk and often lag in taking decision out of direct participation. I faced the similar weakness in making the improvement plan as I was not being an active participator in analysing service failure in the trust. This led me to take increased time in making decision in which aspects improvement are to be made to enhance quality services to patients.

I developed visual observation of the entire incident to frame objectives in the improvement plan. This led to hinder the development of an effective improvement plan because visual observation led to avail surface information (Potthoff et al. 2017). Thus, in framing the plan I was unable to determine which hindered training factors led to bully of the staffs during whistleblowing in the organisation. This led me unable to develop appropriate actions in overcoming the situation. As argued by Willis et al. (2018), reflectors have effective brainstorming ability and effectively listening ability. However, I identified that I do have effective brainstorming ability due to which I was able to effectively frame the improvement plan and the objectives but I did not have patience listening attitude. This is evident as during collection of evidence from feedback and interview of healthcare staffs at the LCH trust to frame the improvement plan I was reluctant and impatient to hear to their entire conversation and developed certain unnecessary conclusions.

I faced issues with adaptability in the improvement plan that made me unable to execute teamwork that could have been potential aspects in framing a better plan. As commented by Potthoff et al. (2017), hindrance to adapt to condition and individuals during improvement planning leads people to face barrier in accepting changed ideas, expectations, responsibilities and others. I was seen to be avoiding adopting changes in my thinking based on ideas to be shared by others ensuring I lack adaptability skill. However, I had effective strategic thinking ability due to which I was able to develop effective SMART objectives in the improvement plan. As criticised by Harris et al. (2016), inability to perform scheduling of tasks to be performed during planning leads to hindered organisation of activities. This, in turn, makes the individual involved in the plan face hindrance to fulfil the deadlines within time as well as contribute towards wastage of resources and need increased finances to manage the extended working. However, in the present improvement, I effectively executed time scheduling and goal setting that led to fulfil the plan to be completed in time.


In analysis phase, the causes behind the success and failure in the activity are determined (Okamoto et al. 2017). The analysis of the experience of improvement plan development in resolving service failure in LCH trust informs that weakness in team working, communication and planning was experienced. However, strength in organisation and strategic management was seen. The hindrance in team working to frame the improvement plan was faced due to gap of effective persuasion and influence skill, conflict resolution, communication and decision-making skill. As commented by Chauhan et al. (2017), persuasion and influencing skill is required to develop a shared decision within the team. This is because without shared decision effective collaboration between team members to work cannot be established. However, I lacked persuasion skill which is evident as I feared inability to make team member understand and appreciate my decisions in the plan, in turn, neglecting teamwork to be executed in planning. As argued by Almost et al. (2016), conflict resolution skill is important in team working as it helps team members to resolve conflict and work in collaborative manner. However, I face hindrance with active listening and framing complex communication due to which I face hindrance with conflict resolution making me unable to execute effective team working in the improvement plan.

The presence of adaptability and flexibility skills in planning is required so that the individual developing the plan can make changes as per requirement and altered needs of stakeholders (Monkhouse et al. 2018). However, I lacked adaptability and flexibility skills as I did not make any required changes in the plan that was suggested from the feedback of healthcare staffs in the trust on their own initiative. As criticised by Linton et al. (2016), problem-solving skill is essential in planning to overcome barriers in framing the strategies for change. This is because lack of overcoming the barriers would lead to failure in establishing improvement plans. However, I had effective problem-solving skills along with critical and logical thinking skills that led me to overcome barriers in farming the improvement plan for LCH trust, in turn, allowing me to ensure the established plan would resolve service failure towards patients in the trust. As argued by Morley and Cashell (2017), lack of collaboration skill during planning leads individual makes the plan unable to avail potential ideas and advice from experts that would enhance the viability of the plan. This is because without collaboration potential ideas cannot be shared with trust. In the present condition, it was seen that I lacked effective collaboration skill which is evident I was unable to act together with experts and avail their advice, in turn, making me depend solely in framing the improvement plan.

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The discussion led me to learn that I have effective brainstorming, critical thinking, logical analysis and strategic thinking as planning skills in making an improvement plan for LCH trust. I also identified I have effective project management, record keeping scheduling and time management skill to ensure the planning is executed within time. However, I lack effective collaboration, interpersonal communication, persuasion, flexibility, adaptability and other skills. I do have effective interviewing and verbal communication skill but I lack active listening skills due to which hindrance in communication in making the improvement plan is experienced to some extent. The weakness could be resolved by creating a personal development plan where actions and resources to improve the skills can be determined. The positive impact in the improvement planning for LCH trust could have been created with the presence of enhanced communication and team working. Moreover, I think better training and development could have helped me prepared in a better way to develop an enhanced improvement plan for overcoming service failure at the LCH trust.

Action Plan

The action plan helps to determine the aspect in which weakness could be resolved by performing activities in different way (Hengel et al. 2018). In future, I am going to access training regarding the way team working can be established in making better improvement plan. I am going to improve my confidence in making negotiation and persuasion by trying to work in collaboration with colleagues rather than working alone. I am going to access communication training to overcome the additional lack of skills that are hindering me in establishing potential communication. I am going to access training and gather evidence regarding the way better strategic planning can be made to overcome critical situation. Moreover, I would try to develop a personal development plan to improve my skill gaps identified during the experience.

Developing Personal Development Plan for addressing skin gap

Developing Personal Development Plan for addressing skin gap Developing Personal Development Plan for addressing skin gap Developing Personal Development Plan for addressing skin gap

Table 1: Personal Development Plan


The above discussion informs that Gibb's reflective cycle is effective in reflecting the experience of framing the improvement plan for overcoming service failure in Liverpool Community Health (LCH) NHS Trust. This is because it allows systematic thinking to determine the strength and weakness in the experiences as well as allows the experiences to be evaluated over time to identify improvement of personal skills. The reflection informs that I have failed to work as a team in framing the improvement plan due to lack of negotiation, adaptability, collaboration and conflict resolution skills. However, I have effective critical thinking ability due to which I was personally able to frame the plan in appropriate manner. I also have effective time management skills along with logical analysis ability and used reflector learning style as well as observation skill to determine the factors to be focussed for improvement in the plan. The personal development plan has helped to overcome the identified skill gaps in the reflection.


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