Uniting staff across an organisation to create change
For any quality improvement programme to be successful, there needs to be ‘buy-in’ from all staff involved. Several of the talks at the International Forum 2019 in Glasgow touched on different ways that this enthusiasm can be generated and cultivated at all levels in an organisation.
Leadership for quality improvement
Leaders need a motivated, engaged, and productive workforce – in short, staff that find joy in their work.
A session on this topic featured Stephen Swensen from the Mayo Clinic College of Medicine, Jessica Perlo from the Institute for Healthcare Improvement(IHI), and Amar Shah from East London NHS Foundation Trust. Together, they shared some of their experiences and insight into the types of leaders who nurture joy in their workforce, and the behaviours that others can learn from.
Top 3 points from @DrAmarShah's #Quality2019 talk— The Mental Elf (@Mental_Elf) March 28, 2019
1. Joy is more than the absence of burnout
2. There are specific leader behaviours correlated with greater joy in work
3. Treat people as assets, not burdens
How does this look to YOU?@derekfeeleyIHI @espritdeswensen @jperlo8 pic.twitter.com/aIJsKRTE8v
Part of Amar’s answer was that healthcare leaders should give their staff the permission to stop and change the things that do not add value or bring joy at work. Giving staff agency and responsibility for improving the quality of the healthcare they provide also increases their work satisfaction – an important addition to the business case for quality improvement programmes.
Listen to Amar talking more about his thoughts on creating Joy in Work here:
Jessica Perlo leads on ‘Joy at Work’ at the IHI – you can find out more about the work they are doing here.
Amelia Brooks and Frank Federico from IHI, and Göran Henriks from Qulturum in Sweden also shared some of their thoughts on how leaders can instil the culture, values, and behaviours necessary for quality improvement in their organisation.
Amelia warned leaders of the dangers of simply focussing on ‘workplace culture’, it is not enough to make the changes necessary. A lack of trust at all levels of a workplace is at the heart of many problems. An important step is to open up to feedback from staff – as Amelia puts it, “leaders are people who have all the questions, not all the answers”.
Trust is required to change culture. If we don’t talk about what we don’t talk about we end up treating the symptom not the cause! Change BUT to AND, consider appreciative enquiry. #quality2019 @ameliaIHI @goranhenriks & Frank Federico pic.twitter.com/HOq5RDVlBj— Annette Logan (@nagolettenna) March 29, 2019
Göran Henriks challenges all healthcare leaders to ask themselves some honest but difficult questions about how their staff feel about their style of management.
You can listen to more of Göran’s thoughts on management in this interview by the NHS Confederation:
Agneta Jansmyr and Anna Fabisch described a programme running at Region Jönköping County, Sweden, bringing together 550 managers into ‘Learning Networks’ to share their experiences. The programme not only aims to integrate an approach for quality improvement across the whole system, but also develop personal leadership. Though the groups are made up of people from different organisations and disciplines, each biannual meeting is themed to focus on addressing common challenges.
Innovative approaches for sharing knowledge
We heard from several speakers who are bringing in technology and fresh perspectives, to provide new opportunities for staff across an organisation to come together.
Andrew Cooper and Rachel Trask from the Aneurin Bevan University Health Board in Wales shared how Twitter has helped to increase awareness and engagement amongst staff for their organisation’s Continuous Improvement programme, known as ABCi. A key feature of their approach was ‘Contribute, Create, Curate’ – encouraging staff to share their opinions through social media, creating content which could be shared, and finding content from other sources which adds to the knowledge base.
Tina Lynge from the Danish Society for Patient Safety discussed how a focus on strategic communications can help to scale-up efforts in quality improvement, using the example of a Danish community healthcare project known as ‘In Safe Hands’. The communications strategy wasn’t just focused on celebrating good results to make staff feel proud of their achievements – it also helped share knowledge and make it easier to find the latest tools for their own work.
The slides from session #qfb3 will be available after the conference so you can access Tina Linge Lingbye's model for communicating about your change programme using head, hearts and legs (and cakes!) #Quality2019 pic.twitter.com/FCybFKaLlN— Cat Chatfield (@drcatchatfield) March 28, 2019
Sarah Henderson from The Health Foundation and Medina Johnson from IRISi talked about one method for spreading good ideas more widely across a healthcare system. IRISi is a social enterprise which trains GPs how to spot gender-based violence in their patients. By scaling-up access to IRISi through their ‘social franchising’ model, nearly 700 practices are now aware of the IRIS system, and over 10,000 women have been referred to specialised domestic abuse services. Sarah and Medina shared some of the lessons they learnt from the social franchising model:
Training the next generation of leaders in quality improvement
Other speakers at the International Forum focussed on their organisations’ efforts to embed quality improvement into training for doctors.
Nigel Hart from the Northern Ireland Medical and Dental Training Agency shared experiences of the EQUIP programme, which helping GP trainees to develop skills in Quality Improvement methodology which move beyond the traditional audit.
Aimee Protheroe and John Dean from the Royal College of Physicians in London talked about how they have instilled a culture of quality improvement in trainee doctors, which goes beyond basic audits and moves into meaningful changes. As part of their commitment to quality improvement, the recommendation is now that they will receive one protected day a week for up to five years to concentrate on quality improvement. The Royal College of Physicians in London’s guidance on engaging medical trainees in quality improvement is available on their website.
Peter Lachman, from the International Society for Quality in Healthcare in Ireland, also discussed some of the work his organisation does to inspire young doctors to become quality improvement leaders. He discussed the ‘Quality Improvement Scholars’ programme, run jointly with the Royal College of Physicians of Ireland, and was joined by some of those scholars who shared their experiences of ‘turning the tanker around’
The talks at the International Forum in Glasgow highlighted many ways to bring staff together to improve the quality and safety of healthcare. Respectful leadership and innovative approaches can spread joy throughout a workforce and put patients at the heart of its work.