From: Culture of Care
<cultureofcare@thepsc.co.uk>
Sent: 22 November 2024 11:41
To: Culture of Care
Subject: Creating a Culture of Care
- what’s the secret to Quality Improvement on the ward?
Greetings from the Staff Care and Development team!
Two months on from the workshop in Birmingham, we’ve been endlessly encouraged by the enthusiasm and thoughtfulness we’ve seen so far. As all 55 ward teams get into their stride, we want to share some topics that keep bubbling up in our conversations with you all.
Let’s talk about:
implementing Quality Improvement (QI)
The Staff Care and Development programme is about helping staff to thrive and grow, and so improving the quality of care and service user experience. QI approaches can provide a toolbox for structuring continuous positive changes, and so deliver lasting, measurable benefits. As food for thought, we have three pearls of wisdom to share from Geoff Brennan (Safewards Clinical Supervisor):
Child rearing not recipes
A big lesson for Geoff was that what works great for one ward may not get off
the ground for another. So, a ‘recipe’ approach, replicating a process from
elsewhere, may not be the best strategy. Wards are unique like children are
unique, and any parent will tell you that childrearing needs continuous trial
and error, an understanding of the unique strengths and weaknesses of each
‘child’, and working with this to get success. Wards are the same.
Finding
the change makers
The important thing for making cultural change is in getting the right people
engaged and supportive. But who are the right people? Geoff’s view is that the
only people that can really change a ward is the ward community (both staff and
service users), so the most important thing for a successful QI project is
genuine buy-in from the ward. Take time to find the right people and look after
them. They are more important to success than you.
Moving
from ‘less’ to ‘more’
One principle you can use is not just finding negative things to reduce (e.g.
incidents, absconding, seclusions, risks), but also positive things to increase
(e.g. visits off the ward, fun activities, chats with trusted staff). A full
tally chart of wanted things always feels good, and helps improve staff and
service user experience at the same time! As the song says, “accentuate the
positive to eliminate the negative”!
As you continue to explore and refine your change idea, we’d like to leave you with a question to consider:
What will your ward
community think is different about your ward's culture once your change has
been made?
A view from the ward: Sherwood Lodge
Sherwood Lodge, a 26-bed male learning disabilities ward, wants to meet the increasing complexity of service users’ needs by making sure staff feel confident to create more therapeutic spaces (‘Moving from ‘less’ to ‘more’’). They want to complement previous general autism-informed training with a new course to reflect the unique mix of needs on the ward (‘Child-rearing not recipes’).
The team plans to decide the content in December, and launch the training in Spring 2025. They’ve held a successful coffee morning to gather views from the whole community about where staff need more support, and are bringing a service user into the project team who is keen to get involved in the design and delivery of the training. They also want to engage staff (‘Finding the change makers’), and will gather views in reflective practice sessions and a survey, hopefully boosting attendance by getting buy-in from the team.
Something for your toolbox:
Equity Huddles and more
Change will look different on every ward. Maybe it’s about building the capabilities of staff, to improve the quality of relational care. Or you could encourage more positive informal interactions with service users to build stronger therapeutic relationships. Or perhaps what’s best for you is fostering psychological safety within a supportive team, so staff feel able to bring the best of themselves, and work through challenges together.
As you explore your priorities as a ward, it’s important to hear from different people in the team, from housekeeping to matrons. If you are a leader on your ward, we encourage you to try out Equity Huddles, prompting rich conversations by asking a question from these cards. Finding just 10 mins over lunch or in a ward round could spark an idea for change you’d never have considered.
We’ve also found some other great resources about Quality Improvement which we’d love to direct you to:
- We’ve published the
headline results of our staff survey on our website. All
wards who have submitted over the threshold of 5 responses will also
receive ward-level insights. Half of the questions corresponded to
Professor Amy Edmondson’s research defining psychological safety;
aggregating these, 63% of respondents indicated that they felt
psychologically safe, but 11% indicated that they didn’t.
- We found that a lot of
the findings from the recent Health Services Safety Investigations Body report
on therapeutic care in adult mental health inpatient settings resonated
with things we’re hearing, although maybe lacking mention of racism and
inequity, given the Independent Review of the Mental Health Act
identified it as one of the most pressing issues for the sector.
- The
School for Change Agents by NHS Horizons offers bitesize online courses for
free (for NHS staff and some others - check for eligibility here).
- Health Innovation West
have created a reference library of QI tools
which you could use - we particularly recommend checking out the habits of
an improver, driver diagrams, and stakeholder analysis tools!
- We love this illustrated guide to QI from North
East London NHS Trust, particularly page 23 which shares some handy tips
on why some projects fail.
Updates from the Culture of
Care team
2-4pm 11th December:
first Community of Practice event (online)
20th & 27th January:
additional Reflective Practice training course (online)
|
Offer |
Updates |
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Project
coaching for teams |
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Individual
coaching |
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Reflective
practice training |
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Community of
practice |
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That’s all for now! We’ll talk more about psychological safety next time, on the 13th December. In the meantime, you can find everything above and more on our website: www.cultureofcare.thepsc.co.uk.
Best wishes,
The Culture of Care: Staff Care and Development team
www.cultureofcare.thepsc.co.uk
A printable version of this email can be found here.
This email relates to the
Staff Care and Development strand of the Culture of Care programme. The other
five strands are being managed separately. For information on the other
strands, please visit the websites of the National Collaborating Centre for Mental Health (NCCMH)
and the Foundation of Nursing Studies (FONS).
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