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Showing results for tags 'Organisational culture'.
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Content ArticleNurse bullying has been an issue for decades and continued during the Covid-19 pandemic. Now, in the post-pandemic era, allegations of toxic behaviour are continuing to climb. Becker's spoke with Jennifer Woods, vice president and chief nursing officer at Baptist Health Hardin in Elizabethtown, Pennsylvania, and Jamie Payne, chief human resources officer at Saint Francis Health System in Tulsa, Oklahoma, to understand the increase in nurse bullying and how their health systems are working to address it.
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Content ArticleLearn from Patient Safety Events (LFPSE) is a centralised system that healthcare staff can use to record patient safety events and access data and analytics about patient safety events nationwide using the NHS database. It replaces the National Reporting and Learning System (NRLS) that was used to upload incidents to the NHS. LFPSE introduces improved capabilities for the analysis of patient safety events occurring across healthcare, and enables better use of the latest technology, such as machine learning, to create outputs that offer a greater depth of insight and learning that are more relevant to the current NHS environment. LFPSE fields can now integrated into Datix incident form, and the information is uploaded to the national database upon the completion of an incident report. After the reviewing manager’s and Patient Safety Team review, any changes are automatically re-uploaded and the information updated in the national database. CSH Surrey share their presentation slides on LFPSE and Datix.
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News Article
Don’t panic when staff leave, NHSE advises managers
Patient Safety Learning posted a news article in News
New NHS England guidance has advised line managers to ‘remain calm’, ‘not panic’, and ‘show kindness’ when handling staff resignations. The Expectations of Line Managers in Relation to People Management framework, published on the NHS England website, contains guidelines on several areas for line managers, including equality, diversity and inclusion, recruiting and flexible working. In the “managing exits” section, managers are told they are expected to: “Support your colleague by showing kindness to them, respect their decision, and wish them well for the future”; “Lead by example and remain calm, ie do not panic when key colleague leaves”; “Use opportunity to reflect and innovate, ie should services be redesigned?”; and “Be mindful that the colleague may have mixed emotions about leaving. Include them in planning any leaving event”. Managers are also told they should “undertake an exit interview, or ask another manager if appropriate, to understand the employee’s experience of working in your organisation” and “consider skills gaps and risks of someone leaving”. Read full story Source: HSJ, 9 November 2023 -
Content ArticleNHS England has launched this framework on the expectations of NHS line managers in relation to people management. The report contains a recommendation to create a clear view on the expectations of line managers in the service in relation to people management and the implications for provision of people services.
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News Article
Most foreign doctors in NHS face ‘racist microaggressions’, survey shows
Patient Safety Learning posted a news article in News
Three in five foreign doctors in the NHS face “racist microaggressions” at work, such as patients refusing to be treated by them or having their abilities doubted because of their skin colour. The widespread “thinly veiled, everyday instances of racism at work” experienced by medics trained overseas has been uncovered by a survey of more than 2,000 UK doctors and dentists. Almost three in five (58%) said they had encountered such behaviour, from colleagues as well as patients, although most did not report it because they thought that no action would be taken. Doctors affected can feel upset, humiliated, marginalised and not taken seriously as a result. The findings have raised fears that international medical graduates may choose not to work in the NHS, which is increasingly reliant on their skills given the service’s shortage of doctors. Dr Naeem Nazem, the head of medical at the medical defence organisation MDDUS, which acts for doctors accused of wrongdoing, said: “These findings show us that a worryingly large number of overseas-trained doctors working in the NHS face racist microaggressions in the course of their work, from both patients and colleagues, and that many do so regularly.” Read full story Source: The Guardian, 8 November 2023 -
Content ArticleMedical defence organisation MDDUS's latest annual member attitude survey has found that many have experienced or witnessed persistent racist microaggressions at work. Almost two-thirds of International Medical Graduate members report they’ve been subject to racist microaggressions and have little faith in being heard and the issue being taken seriously. MDDU's 'We hear you' campaign aims to be a catalyst for positive change and help rebuild confidence in the way such abuses can be reported.
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Content ArticleHigh reliability organisations are organisations that work in situations that have the potential for large-scale risk and harm, but which manage to balance effectiveness, efficiency and safety. They also minimise errors through teamwork, awareness of potential risk and constant improvement. This evidence scan collates empirical evidence about the characteristics of high reliability organisations and how these organisations develop within and outside healthcare.
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Content Article
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It was recently reported that NHS Finance Directors were ‘incensed’ that the Health Services Safety Investigations Body (HSSIB) should think that they could be working more closely with patient safety chiefs. Whereas medical staff and clinicians represent the sharp end of healthcare delivery, the administrative functions, including finance, are the blunt end. Removed in space and time from the action, it can be hard to see how their behaviour can directly influence workplace outcomes. To understand the issue, Norman MacLeod reflects on how systems behave and the decision-making hierarchy within healthcare organisations. -
Content ArticleThis study from Allan et al. investigates whether nurses working for a national medical telephone helpline show evidence of “decision fatigue,” as measured by a shift from effortful to easier and more conservative decisions as the time since their last rest break increases. The study found that for every consecutive call taken since last rest break, the odds of nurses making a conservative management decision (i.e., arranging for callers to see another health professional the same day) increased by 5.5% from immediately after 1 break to immediately before the next. Decision-making was not significantly related to general or cumulative workload (calls or time elapsed since start of shift). The authors concluded that every consecutive decision that nurses make since their last break produces a predictable shift toward more conservative, and less resource-efficient, decisions. Theoretical models of cognitive fatigue can elucidate how and why this shift occurs, helping to identify potentially modifiable determinants of patient care.
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Content ArticleHealthcare Organisational Culture (OC) is a major contributing factor in serious failings in healthcare delivery. Despite an increased awareness of the impact that OC is having on patient care, there is no universally accepted way to measure culture in practice. This study from Simpson et al. was undertaken to provide a snapshot as to how the NHS is currently measuring culture. Although the study is based in England, the findings have potential to influence the measurement of healthcare OC internationally.
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Content Article
Roger Kline's writings
Patient Safety Learning posted an article in Suggest a useful website
Roger Kline is a research fellow at Middlesex University Business School prior to which he held senior positions in eight UK trade unions. Roger has an extensive knowledge and experience of workplace culture, primarily in the public sector. On his web page you can find a selection of his published papers, books and blogs. -
Content Article"With every patient safety inquiry the lessons are the same. We owe the families affected by these repeated failures meaningful organisational change." Says Juliet Dobson, in this Editorial for the BMJ.
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Content ArticleChanges of all kinds can have a profound effect on us, both in terms of our wellbeing and performance. David Murphy has worked therapeutically with people, including front-line professionals, for over 20 years, helping them to change, and adapt to change. David talks to Steven Shorrock about dealing with traumatic events and more mundane changes.
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Content ArticleThe Thirlwall Inquiry has been set up to examine events at the Countess of Chester Hospital and their implications following the trial, and subsequent convictions, of former neonatal nurse Lucy Letby of murder and attempted murder of babies at the hospital. This document sets out the terms of reference for this inquiry, following an engagement process led by the inquiry’s independent chair, Lady Justice Thirlwall, with the affected families and other stakeholders.
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Content ArticleDrawing on his research and practice, Steven Shorrock explores the various barriers that we face when trying to make sense of Just Culture, inviting readers to refl ect on the intricate nature of justice and safety in our complex world
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News Article
Birmingham NHS trust sacks staff after sexual harassment claims
Patient Safety Learning posted a news article in News
A hospital trust has dismissed three members of staff following complaints of sexual harassment. The sackings by University Hospitals Birmingham (UHB) NHS Trust were revealed at the launch of its sexual safety charter on Monday. Sexual safety was one of the areas highlighted in a review of the trust's culture. UHB said sexism, misogyny and sexual harassment would not be tolerated in the workplace. The trust has been subject to three enquiries following a BBC investigation into its culture. The second of these investigations, by Prof Mike Bewick, identified a new line of inquiry into allegations of misogynistic behaviour and sexual harassment. Prof Bewick said the trust had begun formal investigations and there was a widening of the scope of the enquiry to accommodate the sensitive nature of these concerns. Read full story Source: BBC News, 19 October 2023 -
Content ArticleHealthcare is starting to embrace a shift towards Just Culture. In England, the new Patient Safety Incident Response Framework (PSIRF) prioritises respect, compassion, and systemic improvements. The potential benefits of this, and other initiatives, are significant, as Suzette Woodward reports
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News ArticleThousands of complaints made against nurses and midwives were rejected by the watchdog without investigation last year as it battles a huge backlog amid concerns rogue staff are being left unchecked. The Nursing and Midwifery Council has rejected hundreds more cases a year since 2018, including 339 where nurses faced a criminal charge, 18 for alleged sexual offences and 599 over allegations of violence in 2022-23, according to data shared exclusively with The Independent. The new figures come after The Independent revealed shocking allegations that nurses and midwives accused of serious sexual, physical and racial abuse are being allowed to keep working because whistleblowers are being ignored and that the NMC was failing to tackle internal reports of alleged racism. And now, a new internal document, obtained by The Independent, reveals more staff have come forward to raise concerns since our expose. Former Victims’ Commissioner Dame Vera Baird KC said the backlog of complaints was “worryingly high” and called for urgent action to tackle it. Read full story Source: The Independent, 19 October 2023
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Content ArticleIn this opinion piece, BMJ journalist Clare Dyer examines how the healthcare system is grappling with the question of how Lucy Letby was allowed to get away with killing babies in plain sight for so long. She looks at culture and governance issues that meant that concerns raised by consultants were not appropriately acted on.
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News Article
NMC ‘toxic culture’: regulator appoints barrister to investigate
Patient Safety Learning posted a news article in News
An employment and equality lawyer will lead investigations into claims of racism, sexism and toxic culture at the Nursing and Midwifery Council (NMC). The nursing regulator has appointed Ijeoma Omambala KC to review claims that fitness to practise cases have been mishandled, especially those involving racism, discrimination, sexual misconduct and child protection. She will lead a concurrent investigation into how complaints about allegations were handled. "I’m sorry anyone has concerns about our culture, and the regulatory decisions we take. We’re committed to a rigorous, transparent and independent response". Read full story (paywalled) Source: Nursing Standard, 17 October 2023 -
News Article
Be careful of celebrating staff as ‘heroes’, NHSE advises trusts
Patient Safety Learning posted a news article in News
Trusts haven been warned to be careful of “contentious” approaches to staff recognition, such as those that mimic the “clap for carers” initiative organised during the pandemic. NHS England has published a Staff Recognition Framework which stresses marking staff achievements is important. However, it also warns staff could also be demoralised by recognition they felt was derisory. The framework says: ”During the pandemic, studies suggested the weekly 8pm ‘clap for carers’ movement and use of the word ‘heroes’ were contentious approaches to staff recognition. The NHS is always in the media spotlight. Don’t let this put you off but do consider the broader political and economic context.” Recent strikes saw clinicians make the point that organised clapping was no substitute for increase-linked pay increases. The document for senior leaders recommends “developing a recognition strategy” which takes a triple track “formal, informal and everyday” approach to celebrating staff achievement. It said “evidence shows that pay alone will not influence staff wellbeing, engagement, and retention in the long-term – praise and social approval have also proved to be critical factors”. Read full story (paywalled) Source: HSJ, 12 October 2023 -
Content ArticleRecognition is about thanking people for their contribution at work. It is embedded in the organisational values of the NHS. By improving recognition we can deliver the NHS Long Term Workforce Plan’s ambition to attract and retain the workforce we need to deliver improved patient care. One of the seven elements of the NHS People Promise is, ‘we are recognised and rewarded’. It defines recognition as: “A simple thank you for our day-to-day work, formal recognition for our dedication…” It is important that we recognise our staff because evidence shows that pay alone will not influence staff wellbeing, engagement, and retention in the long-term – praise and social approval have also proved to be critical factors. The NHS and wider health and care sector has faced unprecedented workforce shortages and pressures in recent years. Yet, the most recent NHS staff survey illustrates that approximately half of staff do not feel recognised at work. NHS England has drawn on research and evidence and has worked with NHS organisations to develop this framework. It provides simple, easy-to-follow guidance and ideas for organisations to inform their own strategies and approaches.
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Content ArticleThe case of Lucy Letby has dominated recent headlines and caused widespread shock. Much of the early discussion in the media after the verdict has focused on whether NHS managers mishandled concerns and suspicions raised by doctors about the sudden deaths of babies and potential criminal actions—and has labelled the doctors raising those concerns as the problem. But a polarised narrative of doctors versus managers won’t help resolve many underlying systemic issues in the NHS, writes David Oliver in this BMJ opinion piece. Many managers are themselves current or former clinical practitioners, so the divide isn’t sharp. Many of the serious problems currently affecting culture and morale in the NHS workforce happen with doctors, nurses, and other clinical staff in influential leadership and management roles. Simplistic and politicised talk of “pen pushers,” “bureaucrats,” and “too many managers” ignores the fact that many of the people in charge have clinical qualifications.
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Content ArticleIn this interview, Derek Feeley, IHI President Emeritus and Senior Fellow shares the work of the Health Improvement Alliance Europe (HIAE) workgroup related to curiosity. He outlines five simple rules linked to complexity theory, which states that if you are trying to make sense of a complex situation, you should create simple, order-generating rules. The five simple rules are: Ask rather than tell. Listen to understand rather than to respond. Hear every voice rather than only those easiest to hear. Prioritise problem framing rather than problem solving. Treat vulnerability as a strength rather than a weakness.
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Content ArticleIn this opinion piece for the BMJ, Rammya Mathew talks about the limits of a no blame culture in identifying where harm is being caused by a clinician. "The Letby case is an extreme example of the shortcomings of a “no blame” culture. When things go wrong we’re encouraged to always support staff and ensure that no one feels implicated. It’s as though only systems and processes can be criticised, and discussing the possibility of individual accountability is considered “off grounds.”
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