Table 1

A summary of the results containing examples of evidence according to Kirkpatrick areas

Study IDReactionAttitudesKnowledge/skillsBehaviourOrganisational practiceBenefits to patients
Randomised controlled trial
Ruhe et al 34XShared purpose and identityXDeveloping action steps and timelinesNo change in the preventative service delivery score. New staff morale activities & patient care systems.X
Controlled Observational Studies
Chen et al 17Highly satisfied with the programmeXImproved scores for self-learning. Group-learning improvement not significantXXX
Hussein et al and Sharma et al8 9XImproved self esteem and understanding of each others roles, management more approachable.Improved knowledge about infection control and the importance of cleanliness.Improved teamwork, better work allocation, definition of responsibilities. Changes in infection control practice for example, handwashingRegular staff meetings introduced or improved to make discussion of infection prevention more effective.Lower infection incidence in the intervention compared with the control group
Joshi and Subramanyan and Joshi et al18 19Positive reaction to contentWorking together betterXXBetter relationships with the communit. Cleaner surroundingsImproved patient satisfaction in exit interviews
Kavanagh et al
and Kavanagh 20 21
Enjoyable and refreshing but challenging to attendXMean knowledge scores increased over timeNo evidence of behaviour change of staffXNo difference in children’s pain intensity scores
Moorer et al49XXXAltered practice to round hourly on patients and hold multidisciplinary bedside ward roundsSenior leaders visiting the clinical areas, snack cart being available when patients waiting for beds.Improved patient experience measured by recommending to a friend.
Page et al50XXXStaff have a series of conversations with patients to discuss their needs, and develop or begin a care plan.Care plan now exists and families have ownership of it and carry it around. Clear expectations on staff to complete this.Carers feel more involved in care planning and decision making on intervention wards.
Shendell-Falik et al35X’Understanding of each other’s challengesXXImproved adherence to guidelines. Introduction of new protocols. Increased satisfaction and teamworkImproved patient satisfaction from 79.1% to 87.2%
Stefaniak22Positive reaction and general enjoymentDesire to spread Appreciative InquiryXXDecreased vacancy and turnover rates. New recruitment CD and exit interviews. Staff morale activitiesX
Wagh et al52XXXXXReduction in cases diagnosed and a reduction in the false positive case
Qualitative studies
Carter et al and Carter14 15Positive sharing of practice and storiesXUnderstanding of what makes things work wellXSingle point of referral system now being pilotedX
Dewar et al 43–45XXA better sense of understanding the needs of patientsAltered interactions with patients & carersFocus on meeting the patients non-medical needs using positive caring statementsX
Trajkovski et al16Positive experienceXUnderstanding the needs of parentsXXX
Yoon et al36XDesire to gain knowledge and provide consistent careXChanges implemented by 4/9 people for example, increased oral care frequencyOral care incorporated into the agenda for regular staff meetingsX
Non-Randomised Observational Studies
Aggett et al 23Useful and relevantXXBetter discussion of and culture around clinical riskRegular meetings to highlight practices reducing risk. 30% feel clinical decision making improvedX
Alfred and Shohet and Hobbs37 38XImproved teamwork, better interpersonal relationships, common goalsXImproved communication and appreciation; emails and meeting agenda itemsReduced staff turnover (by 3%) reduced sickness (by 2%X
Baker and Wright24Positive experienceBrought people closer togetherIdentification of key aspects for successful managed care networksChanging individual practice for example by greeting patients.Regular multi-disciplinary meetings. Joint clinic started with email access to the specialist centre and appointed representatives in one region.X
Brookes39XDesire to embrace changeStaff developing knowledge as a team resourceXSix monthly basic life support introducedX
Buck40XSense of community scores insignificant improvements. Likelihood to leave increased.XXXX
Campbell et al25Favourable experience but no timeFeeling of empowerment and enthusiasmXXXX
Carter et al 26Lively discussionsXXXNew patient pathway, changed care delivery model, monthly staff meetingsX
Challis46XXFactors effecting nurse longevityXReduction in vacancy rateX
Clarke et al 47XXHow to achieve good handoffsXDevelopment and implementation of a transfer checklistX
Clossey et al27Positive staff reportsXXXDesign of more user friendly paperworkX
Guliar and Start48XXUnderstanding of what patients need from staffXCollaboration with local diabetologist, patient education support group and patient held notes developedX
Halm and Crusoe51XXXXMore frontline workers took part in shared leadership councils and there were better relationships between departmentsX
Havens et al28Excitement and a feeling of positive insightsTransforming their approach to infection prevention and departmental visionXMeetings, start with the positive; improved interdepartmental communication; altered human resources interactionsAppreciative start to each meeting in some hospitals. Use of Appreciative Inquiry to frame employee surveys and patient satisfaction feedback sessionsX
Jaccai and Dorman29Effective approachXXXImplementation of knowledge management resource and a leadership education series. No one performing hospital in area surgical and pneumonia careImproved patient satisfaction by 37% and the birth centre being ranked in the 99th percentile nationally
Lazic et al30 31High satisfaction with courseMotivation and professional self confidenceXXXx
Mash et al41XStaff more satisfied and motivatedImprovements attempted but skill improvement confined to certain groups.Well functioning teamImproved patient education, patient support groups, regular team meetings, summary sheet for patients, implementation of national foot screening guidelines & retinal screeningX
Messerschmidt32Spirit raising, but doesn’t always workIncreased social equality and self confidenceXNurses taking initiative; cleaners working hardergXX
Reed et al33Enjoyable but not sure if its effectiveShared organisational perspectiveUnderstanding of the system and how it workedXXX
Seebohm et al42XLess isolation, understand need to build relationshipsUnderstanding of the needs and desires of patientsXXX