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Found 46 results
  1. Content Article
    “There's no such thing as the unknown—only things temporarily hidden, temporarily not understood.” James T. Kirk, Captain, Starship Enterprise. Star Trek, Season 1: The Corbomite Maneuver. Leading a large enterprise isn’t easy. Vision, compassion, humility, curiosity and adaptability are required attributes for those in charge to keep moving forward during times of relative calm or uncertainty. The stress and tragedy that accompanies catastrophic events can reduce the resolve and effectiveness of even the most accomplished leaders. Unprecedented large-scale situations, such as the Hurricane Katrina landfall or the September 11th terrorist attacks, reveal gaps in understanding that may not have been apparent before the disaster. These blind spots can dismantle the reserve of a leader and their team to culminate in poor decisions, inaction and organisational dysfunction. The COVID-19 pandemic is such an event. Rules are being mindfully adjusted to respond to the litany of process, clinical, financial and political disruptions healthcare workers must grapple with as they face the uncertain conditions of their patients, communities and themselves. It is incumbent on leaders to create stability by addressing these unknowns. Leaders within hospitals, social care organisations and within the public health spectra need to make immediate process adjustments to optimise effort, realise opportunities for improvement and learn to be resilient. They need to arrive at understanding while simultaneously managing challenges that emerge from the strained system to keep their enterprise on track. They need to do this by paying attention to safety culture, transformation and innovation, and will need tools and resources to do so. Leadership must build a culture to keep patients and workers safe. Leader’s communications and actions are core to the implementation of safe working conditions to provide the best care possible during a crisis. Yet, a Gallup poll of US healthcare workers found a lack of understanding of their organisation’s COVID-19 plan and lack of belief that safety policies in place will support their safe return to work. To address this gap, experts recommend leaders three steps to a better safety culture: use formal and informal mechanisms to explicitly communicate what the organisation is doing to keep staff informed and safe during the pandemic enlist their managers to implement policies, create opportunities to align the work of management and hold managers accountable to implement and sustain current practice and procedure talk to their people. Keeping an open dialogue through the use of established mechanisms such as ‘rounding’ can solicit insights and raise concerns to enhance the safety of teams and patients. Leadership must see opportunities to transform systems: COVID-19 has presented leaders with immense responsibility to act, adjust quickly as required and use those process changes to improve the overall system of care post-pandemic in preparation for the next unprecedented challenge. Geisinger Health System leaders in their article, 'How one health system is transforming in response to Covid-19' share the experience of designing their emerging COVID response to reliably innovate rather than only react. Leaders examined core system business concerns such as pharmacy and information technology by bringing together multidisciplinary groups that dismantled silos. Teams worked together using scenario planning to fully consider how restoring care processes, entering new work phases, preparing for the second wave and restoring financial viability would affect patients and employees. Leadership must use evidence and collective knowledge to adapt: The Journal of Public Health and Management Practice shares recommendations for leaders to meet COVID-19 stressors successfully. The article suggests leaders communicate well, be decisive, lead without hierarchy, remain proactive and take care of themselves to protect others. For example, to lead across a system seek expertise from a variety of organisational and environmental elements. Working with government officials, staff and peers can form collaborations, solidify shared purpose and distribute responsibility to serve a community well in crisis. Public health is a core partner in understanding how to guide, motivate and inspire change to enhance a collective response to COVID-19 and upcoming health threats. Clinicians in patient-facing leadership roles also exhibit these behaviours as their roles shift to manage crisis. The perspective of a New York cardiologist leading a COVID-19 infections disease service illustrates how the transfer of tacit knowledge around deliberate leadership observed daily while coordinating the service shaped his views on leadership and his ability to lead. Being emotionally available was a core characteristic that helped to express grief, exhibit vulnerability and openly share concerns, giving the experience the humanness it needed. This was important not only in his ability to mature as a leader but to demonstrate the empathy needed to get his team through the challenges at hand. James T Kirk knew how to lead. He sought consensus, learned from mistakes, yet acted as necessary to keep his crew safe, engaged and aligned with the organisational mission. He sought partners across the federation as needed. Kirk could be firm, decisive, yet empathetic. Have health leaders done similarly to protect staff, patients and the community, while gaining experience during COVID-19 to apply over time to enrich the care system at large and boldly go to a better, safer future?
  2. Content Article
    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.
  3. News Article
    The mother of a student, who took his own life, said today she felt 'sick to her stomach' after an NHS communications manager labelled a media report on her son's suicide a 'malarkey'. Pippa Travis-Williams, whose son Henry was found dead days after leaving a mental health unit run by the Norfolk and Suffolk Foundation Trust (NSFT) in 2016, said an email sent by NSFT communications manager Mark Prentice to his boss was 'disgusting'. It comes weeks after Mr Prentice gloated in another email to his boss that the NSFT had 'got away (again)' with media coverage of the death of a dementia patient. In an email to his boss, explaining why NSFT chief executive, Jonathan Warren, was going on BBC Look East, Mr Prentice said the NSFT might look 'uncaring' if Mr Warren did not appear and then described the coverage of Mr Curtis-Williams' suicide as a 'malarkey'. Read full story Source: Ipswich Star, 10 March 2020
  4. Content Article
    This video gives a summary of the PRAISe project - a QI project about antibiotic stewardship, based on Learning from Excellence philosophy. Funded by the Health Foundation.
  5. News Article
    In early January, authorities in the Chinese city of Wuhan were trying to keep news of a new coronavirus under wraps. When one doctor tried to warn fellow medics about the outbreak, police paid him a visit and told him to stop. A month later he has been hailed as a hero, after he posted his story from a hospital bed. It's a stunning insight into the botched response by local authorities in Wuhan in the early weeks of the coronavirus outbreak. Dr Li was working at the centre of the outbreak in December when he noticed seven cases of a virus that he thought looked like SARS - the virus that led to a global epidemic in 2003. On 30 December he sent a message to fellow doctors in a chat group warning them about the outbreak and advising they wear protective clothing to avoid infection. What Dr Li didn't know then was that the disease that had been discovered was an entirely new coronavirus. Four days later he was summoned to the Public Security Bureau where he was told to sign a letter. In the letter he was accused of "making false comments" that had "severely disturbed the social order". "We solemnly warn you: If you keep being stubborn, with such impertinence, and continue this illegal activity, you will be brought to justice - is that understood?" He was one of eight people who police said were being investigated for "spreading rumours". At the end of January, Dr Li published a copy of the letter on Weibo and explained what had happened. In the meantime, local authorities had apologised to him but that apology came too late. For the first few weeks of January officials in Wuhan were insisting that only those who came into contact with infected animals could catch the virus. No guidance was issued to protect doctors. "A safer public health environment… requires tens of millions of Li Wenliang," said one reader of Dr Li's post. Read full story Source: BBC News, 4 February 2020
  6. Content Article
    This blog highlights solutions to the problem of poor culture of speaking up and bullying within healthcare. Dr Blair Bigham and Dr Amitha Kalaichandran propose three solutions to enable a culture without fear. Measure culture within the organisation. Hire talented leaders. Embrace diversity and inclusion and reject hierarchy.
  7. Content Article
    Summit objectives: to foster connections and support networking across the Alliance to surface key issues that are top of mind to Alliance leaders to support capacity around personal, organisational, and industry leadership to promote discussion and activities that foster and advance courageous, creative, collaborative leadership across the network to inform and advance the direction of engagement, collaboration, and collective action opportunities across the Alliance network.
  8. Content Article
    The report argues that better engaged staff have higher morale, make fewer errors and deliver better patient experience. It demonstrates that patients receive more appropriate care and better outcomes when they are actively engaged in their care and highlights how leaders must be increasingly effective at integrating healthcare activities across healthcare systems. It sets out recommendations and outlines the argument for engagement, looking at what engagement means and why it matters. It looks at engaging across the system as well as with specific groups: Staff Patients Doctors Nurses and allied health professionals Boards
  9. Content Article
    Patient safety made headlines at the recent Patient Safety Learning Conference when Professor Ted Baker (Chief Inspector of Hospital for the CQC) declared that there has been “little progress' for NHS patient safety over past 20 years”. Such an assessment feels overly harsh, but in the context of the Mid Staffordshire incident and the more recent events in Liverpool, it is clear that sometimes hospitals do fail to protect the patients they are caring for. When Aidan Fowler, NHS National Director of Patient Safety, called for “Directors of Patient Safety” to be appointed in every NHS organisation it was a positive move towards reducing the variation in patient safety across the country. And if the enthusiasm at the recent Patient Safety Learning Conference is anything to go by, then we may soon be able to reach that goal. One of the interesting discussions at the conference was what do these future directors of patient safety look like? What are the skills and attributes that they will possess? Professor Ted Baker pinpointed three key areas, but what would these look like in practice? The first identified attribute was that a leader of patient safety should be “humble”. A true leader must be able to reflect on when they are wrong. Based on some misplaced Machiavellian leaderships beliefs, we've often trained leaders to feel like they have to be infallible. However the art of a true leader is actually someone who can reflect and take accountability for their mistakes. In healthcare there is no room for cover-ups, the stakes are too high. We need a leader who can put their hands up when things are not safe, and be an advocate for the patients that they are working to protect. Often when things have gone wrong, it's because organisations have failed to be transparent about the problems that they are facing. The leaders of patient safety must be able to be a torchbearer of safety and be humble enough to admit when the right standards are not being met. The second element of a good leader for patient safety is “strong values”. To be a real leader and an advocate for patients they must truly believe in the values of NHS organisations. They must be genuine and believe that the values are there to be upheld. Too often leaders pay mere lip service to values and fail to exhibit the right behaviours. We see examples of bad behaviour in the workplace but too often they are left unchallenged. A patient safety leader must act with integrity and be prepared to challenge individuals when their behaviours fail to live up to the organisation’s values. The final attribute of a good patient safety leader is one that works “collaboratively”. Healthcare works at its best when it utilises the skill sets of all its staff. Only through a multi-disciplinary approach can we hope to keep our patients safe. The best knowledge is gleaned from a wide range of staff, and patients are kept at their safest when teams work together. Therefore, a patient safety leader of the future would need to be collaborative and able to engage a wide range of expert clinicians. Only then can we learn to share our mistakes and improve the care we deliver so that every patient gets the standard of treatment they deserve. Not all people will be able to stay humble, value focused and collaborative whilst delivering patient safety to an organisation. We must be able to have the right conversations with patients to ensure that they are able to make informed decisions to keep themselves safe in our care. Only through patient engagement can we get the full picture and make care safer in the NHS. Patient safety is a discipline in its own right and we must not assume all healthcare staff possess the knowledge and skill sets to be leaders in the field. Patient safety is complex, it is multifaceted, and it cannot be done by one person alone. We must work to train more staff in patient safety so that all healthcare professionals can see its value and the impact that poor patient safety has. We must all work to be patient safety leaders of the future and work openly and collaboratively to learn from our mistakes.
  10. Content Article
    In this blog, David Naylor, a senior leadership consultant at The King’s Fund, reflects on ‘imposter syndrome’, considering its impact on third sector leaders and beyond.
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