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The art of wobbling: Part 2
Sally Howard posted an article in Leadership for patient safety
So, you have a network in place, a few allies and that’s working well. Your curiosity means that you are asking great questions. Then you hit a brick wall Push a few boundaries and you may find yourself in the middle of a disagreement, whether that’s you as a leader sharing power with your team or as the one brave soul who says "you don’t have the full picture". Whilst it may seem that people ‘in authority’ must find this easy to handle, otherwise they wouldn’t be in charge, at the end of the day this can be scary stuff wherever you sit within your team and the wider system. You could turn back at this stage, but I hope that you don’t. Top tips for dealing with conflict Here’s a few more tips from me, all drawn from my experience of working with individuals and teams wanting to make the right difference for their patients: Pause and take a long hard listen to what’s being said. Stephen Covey says that most people do not listen with the intent to understand, they listen with the intent to reply (1). Take a moment to reflect on how you listen. Empathic listening is not listening until you understand, it’s listening until the other person feels understood. Combine this with patience. Rome wasn’t built in a day and a big shift in the way things happen may take time. Use this opportunity to grow your network of people who share your passion for making a real difference. Last time I talked about power; from our formal positions, expert power derived from our knowledge and experience, and personal power. There’s also a wonderful power expressed through appreciation (2). Nancy Kline recommends a 5 to 1 ratio of praise to criticism. Researchers studied how appreciation effects blood flow to the brain. Less flows when we are thinking critical thoughts. Appreciation is necessary for optimal brain function. It moves to the heart to stimulate the brain to work better. Infectious, it goes a long way especially when someone may be quietly wondering whether something was the right thing (3). And, unusually, emails and texts can be the unsung heroes of appreciation. Being appreciated for what you did that day, that week makes a real difference. So far so good but what if you really cannot agree with the direction of travel? Well you can disagree respectfully and politely. There is a time and place for agreement and disagreement (4). And finally seek some feedback. One of the real benefits of building a network of support is that it can help you hone your practice and build your confidence. It can be difficult to fully engage, give your best and then know how you landed. Was I clear in that meeting? Could people understand what I was trying to say? Was I too forceful? But you can identify a trusted colleague and ask if they will give you some feedback. I often suggest people set this up ahead of time, you receive richer feedback as a result. The Healthcare Leadership Model is also a brilliant tool (5). It’s not just for people with leader in their title. It’s made up of nine leadership dimensions that you can explore at your own pace and then, if the time is right for you, seek feedback from others using the online tool. In return you receive a comprehensive 360 report along with a session with a trained facilitator to help you get the best out of your report. Thanks for reading this – let me know your experiences. Next time I am going to be talking about our responses to change and why it really is a bit Marmite – some of us are wired for change, others less so. But it’s a little more predictable than you might think… References 1 Stephen R. Covey. The seven habits of highly effective people. Franklin Covey, 1990. 2 Video: French and Raven's Bases of Power. YouTube. 2017. 3 Nancy Kline. Time to Think: Listening to Ignite the Human Mind. Ward Lock, 1999. 4 Peter Khoury. How to Disagree Respectfully, magneticspeaking.com 5 Healthcare Leadership Model. NHS Leadership Academy. -
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News ArticleJust 1 in 4 UK GPs are satisfied with time they are able to spend with patients – appointment times are among the shortest of 11 countries surveyed. A report published today by the Health Foundation paints a picture of high stress and low satisfaction with workload among UK GPs. The report is an analysis of an international survey of GPs from 11 high-income countries, including 1,001 UK GPs, undertaken by the Commonwealth Fund in 2019. Among 11 high-income countries included in the study, only France has lower levels of overall satisfaction with practising medicine, and only Sweden reported higher levels of stress. Over half of UK GPs (60%) say they find their job 'extremely' or 'very' stressful, and almost half (49%) plan to reduce their weekly hours in the next three years. UK GPs also reported significantly shorter appointment lengths than their international colleagues. The average length of a GP appointment in the UK is 11 minutes, compared with a 19 minute average appointment for GP and primary care physicians in the other countries surveyed. Dr Rebecca Fisher, one of the Health Foundation report's authors and a practising GP, says: "These findings illustrate the pressures faced by general practice, and the strain that GPs are under. Right now the health system is in unprecedented territory and mobilising to meet the challenge of Covid-19. This survey shows that over the long term we need concerted action to stabilise general practice. Despite performing strongly in some aspects of care, many GPs consider that appointments are simply too short to fully meet the needs of patients. Too many GPs are highly stressed and overburdened – to the point of wanting to leave the profession altogether." Read full story Source: The Health Foundation, 5 March 2020
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Content ArticleKey points Language influences the perceptions of the accident process. The use of punishment can be harmful to individuals. Punishment does nothing to help achieve future safety. Accident analyses are not independent from the organisation politics.
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Resources for setting up learning from excellence reporting
Claire Cox posted an article in Motivating staff
Resources LfE Quality Improvement Toolkit (based on PRAISe project) Quick start up guide LfE (July 2016) LfE top 10 tips (Jan 2017) How to get started – a few tips from our experience Framework for “reverse SIRI” (now named IRIS) – adapted from Appreciative Inquiry methodology Template (in MS word) for IRIS meetings Example LfE FAQs – for you to adapt for your organisation Mini-AI template – Mini-AI template, as used in PRAISe project 10 uses for LfE & AI LfE how to set up checklist LfE Appreciation card template – front LfE Appreciation card template – back -
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Learning from excellence: Entrance interview questionnaire
Claire Cox posted an article in Motivating staff
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Ten Thousand Feet: workshops and consultancy
Claire Cox posted an article in Suggest a useful website
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National NHS staff survey 2019 results
Patient Safety Learning posted an article in Culture
Key findings 59.7% think their organisation treats staff who are involved in an error, near miss or incident fairly. This is a 1 percentage point improvement since 2018 (58.3%) and continues a positive trend since 2015 (52.2%). 71.1% think their organisation takes action to ensure that reported errors, near misses or incidents do not happen again. 73.8 think their organisation acts on concerns raised by patients / service users (2018: 73.4%). 61.1% gives them feedback about changes made in response to reported errors, near misses and incidents (q17d) This is a 1 percentage point improvement since 2018 (60.0%) and continues an upward trend since 2015 (54.1%). 71.7% would feel secure raising concerns about unsafe clinical practice. This is a 1 percentage point increase since 2018 (70.7%). 59.8% were confident that their organisation would address their concern .This has continued an upward trend since 2017 (57.6%).- Posted
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‘Shameful’ data reveals NHS treatment of minority ethnic staff
Patient Safety Learning posted a news article in News
Five years after launching a plan to improve treatment of black and minority ethnic staff, NHS England data shows their experiences have got worse. Almost a third of black and minority ethnic staff in the health service have been bullied, harassed or abused by their own colleagues in the past year, according to “shameful” new data. Minority ethnic staff in the NHS have reported a worsening experience as employees across four key areas, in a blow to bosses at NHS England, five years after they launched a drive to improve race equality. Critics warned the experiences reported by BME staff raised questions over whether the health service was “institutionally racist” as experts criticised the NHS “tick box” approach and “showy but pointless interventions”. Read full story Source: The Independent, 18 February 2020 -
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NHS Staff Survey 2019
Patient Safety Learning posted a news article in News
Today the results of the National NHS Staff Survey 2019 are out. This is of the largest workforce surveys in the world with 300 NHS organisations taking part, including 229 trusts. It asks NHS staff in England about their experiences of working for their respective NHS organisations. The results found that 59.7% of staff think their organisation treats staff who are involved in an error, near miss or incident fairly. While an improvement on recent years (52.2% in 2015) work is needed to move from a blame culture to one that encourages and supports incident reporting. It also found that 73.8% of staff think their organisation acts on concerns raised by patients/service users. It is vital that patients are engaged for patient safety during their care and there is clear research evidence that active patient engagement helps to reduce unsafe care. Patient Safety Learning has recently launched a new blog series on the hub to develop our understanding of the needs of patients, families and staff when things go wrong and looking at how these needs may be best met. -
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This is how to not fail at failing – blog by Roi Ben-Yehuda
Patient Safety Learning posted an article in Culture
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Content ArticleTalking openly about cancer and our experiences makes a huge difference in increasing understanding, overcoming stigma and reducing fear. This page give you access to numerous stories from around the world from people living with and have experience of living with cancer.
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Content ArticleVanessa Sweeney, Deputy Chief Nurse and Head of Nursing – Surgery and Cancer Board at University College London Hospitals NHS FT decided to share a example of positive feedback from a patient with staff. The impact on the staff was immediate and Vanessa decided to share their reaction with the patient who provided the feedback. The letter she sent, and the patient’s response are reproduced here: Dear XXXXX, Thank you for your kind and thoughtful letter, it has been shared widely with the teams and the named individuals and has had such a positive impact. I’m the head of nursing for the Surgery and Cancer Board and the wards and departments where you received care. I’m also one of the four deputy chief nurses for UCLH and one of my responsibilities is to lead the trust-wide Sisters Forum. It is attended by more than 40 senior nurses and midwives every month who lead wards and departments across our various sites. Last week I took your letter to this forum and shared it with the sisters and charge nurses. I removed your name but kept the details about the staff. I read your letter verbatim and then gave the sisters and charge nurses the opportunity in groups to discuss in more detail. I asked them to think about the words you used, the impact of care, their reflections and how it will influence their practice. Your letter had a very powerful impact on us as a group and really made us think about how we pay attention to compliments but especially the detail of your experience and what really matters. I should also share that this large room of ward sisters were so moved by your kindness, compassion and thoughtfulness for others. We are now making this a regular feature of our Trust Sisters Forum and will be introducing this to the Matrons Forum – sharing a compliment letter and paying attention to the narrative, what matters most to a person. Thank you again for taking the time to write this letter and by doing so, having such a wide lasting impact on the teams, individuals and now senior nurses from across UCLH. We have taken a lot from it and will have a lasting impact on the care we give. The patient replied: Thank you so much for your email and feedback. As a family we were truly moved on hearing what impact the compliment has had. My son said – “really uplifting”. I would just like to add that if you ever need any input from a user of your services please do not hesitate to contact me again
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Content ArticleFindings suggest there is no single best way to collect or use PREM data for QI, but they do suggest some key points to consider when planning such an approach. For instance, formal training is recommended, as a lack of expertise in QI and confidence in interpreting patient experience data effectively may continue to be a barrier to a successful shift towards a more patient-centred healthcare service. In the context of QI, more attention is required on how patient experience data will be used to inform changes to practice and, in turn, measure any impact these changes may have on patient experience.
