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  • National Case Study

    Engaging and empowering staff for better patient outcomes

    Breaking paradigms, creating ambition, raising the bar

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  • “LiA is a powerful force for cultural change” says Chief Executive, Alwen Williams

    “We know that to be compassionate to our patients, we need to be compassionate to our staff.

    Following a period of significant change at Barts Health NHS Trust, I joined as Chief Executive in June 2015 and decided to adopt Listening into Action (LiA) as the main vehicle to engage staff on a widespread basis around changes that matter to patients and to themselves. This links directly to our ‘Safe and Compassionate’ improvement plan, and is all about making demonstrable improvements to patient care while, at the same time, unblocking the way for staff so they can get on and do their jobs.

    Barts Health is one of the biggest NHS Trusts in the country with around 16,000 staff, so getting traction around a fundamental shift in ways of working and leading is no small challenge. And yet the results and impact we have seen within even the first 10 months speak for themselves. As a new way of working which centres on engaging with staff, listening to staff, and empowering our frontline clinical teams to work together across all of our sites to bring about improvements in patient care, the difference that LiA is making is clear.

    Being on this journey is helping to galvanise and connect leaders across all of our sites, especially as we work together on linking the engagement effort to the most important aspects of patient care. At the outset, more than 2000 staff were involved in an initial round of catalysing LiA Big Conversations which I personally led, to talk about what gets in their way and to surface great ideas for action. This is driving change at all levels to ‘unblock the way’ for our staff.

    At the same time, we mobilised 40 clinical teams who pioneered adoption of the LiA 7 Steps over an initial 20 weeks to improve patient care in their own areas. This has led to a wealth of stories and outcomes such as a one stop breast clinic, improvements in Cardiology services, cutting waiting times in Trauma and Orthopaedics, and halving the number of unstable patients admitted to our Observation Unit to reduce cardiac arrests. The stories and outcomes from the first 40 teams has quickly ‘fuelled’ the spread to 80 more, and we will be picking up the pace over the next few months.

    In terms of staff, our LiA Pulse Check - completed by almost 3000 staff in September and then again in May - shows an unprecedented

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    improvement in how engaged and valued people feel. Our results are up on all 15 questions.

    And this is just the beginning! I am very confident that we will continue to make significant improvements to the quality of services we deliver to our patients here at Barts Health. But we will only achieve that through the dedication and commitment of all our staff. LiA is a powerful force for cultural change.”

  • “LiA has been a transformative experience at Barts Health”

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    Professor Charles Knight, Consultant Cardiologist and Managing Director, St Bartholomew's Hospital

    “LiA has been a transformative experience at St Bartholomew’s. We’ve seen real results for patients being delivered – halving outpatient waiting times, reducing length of stay and surgical infections, and the development of patient welcome packs amongst many other examples. At the same time, staff experience has objectively improved and morale boosted. We’re excited about the LiA journey ahead!”

    Denise McEneaney, Head of Midwifery, Whipps Cross Hospital

    “LiA feels more like a movement than a strategy. I almost spontaneously clapped recently listening to some staff explain to colleagues how the planned improvement they were about to start was about making positive changes together, no ‘just moaning’ allowed and how they needed to include senior and junior staff and service users together. I didn’t have to say much except that I would support the team.”

    Tim Peachey, Consultant in Anaesthesia and Deputy Chief Executive

    “For me the most obvious benefit arising from the LiA approach is the change in culture in the organisation where staff now enjoy being involved in improvement activities, celebrate their achievements and spread their message with pride. Our workforce is now much more engaged and determined to succeed.”

    Tom Smith, Intensive Care and Anaesthetics Consultant

    “Staff now recognise that before they felt frustrated, they were worried about patients on their ward, they didn’t know how to access help or what extra resources were available to them, and through LiA they’re now seeing that their voice is being heard - that we’ve changed the way we respond – and we’ve listened to their concerns.”

    Lee Parker, Consultant Orthopaedic Foot and Ankle Surgeon

    “Patients are happier, there are fewer complaints and we spend less time on the phone explaining to patients what the inefficiencies are and answering complaints. Patients are seen quicker, my surgical conversion rate is higher, there are fewer patients out in the community waiting for appointments, and the clinic staff are happier as well.“

    Zaliwe Chabala, Service Manager for Trauma and Orthopaedics

    “Clinic turnaround time has improved, our patients are much happier, and our clinicians are much happier as well.”

  • Matt Guinane, Consultant Gastroenterologist

    “One of the things about adopting it as a culture and a methodology for delivering change is that it keeps us all focused on the simplicity of what is required to deliver change. The challenge for us all is to have this embedded as the fundamental way we go about doing things and how we change things in this hospital and in Barts Health as a whole.”

    Michael Pantlin, Director of Human Resources, Barts Health

    “For the first time we have found a key to unlock widespread staff-led change across our large and diverse organisation. The energy, pace and engagement has led to a growing sense of ownership for improvements at all levels towards issues which really matter to staff and patients.”

    Sebastian Dawson-Bowling, Consultant Orthopaedic Surgeon

    “One of the things that Listening into Action allowed us to do is to formalise a structure of better communication channels between the teams across the different sites and to break down those artificial barriers that we have traditionally had between the different teams. People understand that really there is one mission in terms of the type of patient care we’re looking to provide."

    Lucy Morrissey, General Manager

    “As a manager, I know it’s really important to listen to staff’s views. In the hospital setting we have a range of different professionals, all of whom bring a different perspective on the patient pathway. We’ve been able to use LiA as a framework to really understand staff’s views and how we can improve the patient pathway.”

    Darren Barnes, Senior Cardiology Nurse, St Bartholomew’s Hospital

    “Listening into Action really does what it says on the tin. It has allowed us as leaders to listen to frontline staff of all disciplines about what needs unblocking in the organisation and gives staff permission and courage to make changes and improvements. By sustaining and spreading this new way of working, the future at St Bartholomew’s Hospital is looking increasingly better for our staff and our patients.”

    Helen Byrne, Director of Operations, Whipps Cross Hospital

    “There has been excellent clinical involvement so I think loads of positives from our LiA opportunity. We have embraced the concept and the tools and it’s working really well.”

    “For the first time we have found a key to unlock widespread staff-led change”

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  • Some of our stories have already been published nationally in ‘The Best Medicine: 100 Powerful Stories of Staff-Led Change from the 5th Biggest Employer in the World’

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  • Better for organisationBetter for staffBetter for patients

    Delivering demonstrably better outcomes for our patients, staff and our Trust (here are just a few examples from many)

    160 days harm free care on surgical wards with ‘I want great care’ scores up from

    60% to over 90%

    Increased early morning discharges and 50%

    reduction in length of stay for complex patients in

    specialist medicine

    Every Cardiology and Surgical patient seen every

    day by a consultant, reducing length of stay by

    1.5 days

    40% reduction in Surgical Site Infection rates with a

    follow-up Wound Clinic run by Band 4 Healthcare


    7 day Pharmacy service in Oncology means patients get home faster, reducing

    length of stay by 1 day

    Halving number of unstable patients admitted to Observation Unit means

    fewer cardiac arrests

    Cystic fibrosis patients – often teenagers – given ID

    cards so they can come and go freely from the ward

    ‘One stop’ Breast Service up and running with

    significant involvement from patients to get it right

    Cardiology Day Care Team show the biggest national improvement ever in their

    LiA Team Pulse Check


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