the we care culture change - engaging staff to deliver person- centred care for people with learning...
TRANSCRIPT
The We Care Culture Change - Engaging Staff to Deliver Person-
Centred Care for people with learning Disabilities in East Kent
Hospitals
Sally SmithDeputy Chief Nurse & Deputy Director of Quality
Wednesday 18th June 2014
Background
• Inequalities for those with learning disabilities
• Five times more likely to be admitted from A&E
• Four times more likely to be readmitted to our Trust
• The 4C Framework
• Communication
• Choice-Making
• Collaboration
• Coordination
We Care• In 2012, East Kent Hospitals launched its We Care programme – a Trust-wide initiative
to develop a culture that:
‘inspires, develops and supports our teams, so that we consistently deliver the best experience that we can, to ensure we care for every patient and every colleague every
day.’
• Culture affects the way staff feel about work and how staff then behave. This in turn this affects patient experience and impacts patient outcomes. So we want experiences for our staff and patients to be excellent.
• In 2012, many hundreds of staff and patients co-created our We Care values and behaviours – so these standards are based upon what matters most to people who work in and use our services.
What makes a GOOD DAY for staff
What makes a BAD DAY for staff
Reminder of who we listened to
110 patients and 125 staff attended “In Your Shoes”
sessions. We also reviewed a year of patient feedback.
110 patients and 125 staff attended “In Your Shoes”
sessions. We also reviewed a year of patient feedback.
700 staff wrote Graffiti Boards and 100 attended “In Our Shoes” sessions
700 staff wrote Graffiti Boards and 100 attended “In Our Shoes” sessions
Nice people 24Enjoy my job 13Good care 10Innovative 6Good pay 6Good training 6
Not valued 30Need more staff 28Low morale 17Poor care 12Management 10Job insecurity 10
Staff likelihood to recommend as a place to work
Over 1000 staff took part in Values into Action
sessions to set out out ‘we care’ behaviour standards
Over 1000 staff took part in Values into Action
sessions to set out out ‘we care’ behaviour standards
People feel
confident we are making a difference
People feel
cared for as individuals
EKHUFT Shared Purpose Framework
People feel
safe, reassured and involved
Shared Purpose Framework
Shared Purpose framework - developed at EKHUFT as a tool to enable staff to connect their work to a shared vision.
A shared vision for patient and staff experienceWe care – how we deliver a great staff
and patient experience: commitments, values and behaviours
Value: CARING
Value: SAFE
Value: MAKING A DIFFERENCE
Nursing 6 Cs• Care• Compassion
Nursing 6 Cs• Communication• Competency
Nursing 6 Cs• Commitment• Courage
The need for We Care
Our NHS Staff Survey Results
• Below average in staff reporting near misses and incidents
• Deteriorating in scores on work-related stress and how
empowered staff feel to manage their work-related stress
• The National NHS Staff Survey found East Kent
Hospitals to be:• In the worst 20% of Trusts for:• Staff Engagement• Staff Satisfaction• Bullying and Harassment
Staff Engagement
Source: Department of Heath Engaging Your Staff: The NHS Staff Engagement Resource
• High staff engagement correlates with: lower mortality rates; improved financial performance; higher quality of care; higher patient satisfaction; lower staff absenteeism; and higher health and well-being of staff. See Department of Health figure below.
• West and Dawson (2012) found that engaged Trust’s also report:
o Significantly less mistakes
o Better patient experience on national surveys
o Lower infection rates
o Shorter lengths of hospital stays
Patient Experience Improvements• Care and compassion can: improve treatment compliance; help an accurate diagnosis
as patients open up about symptoms; speed up healing and recovery times – which has been found to decrease when patients are less stressed about their care.
• Good communication can: enhance patient well-being and emotional health; hasten recovery and/or symptom resolution; influence functional and physiological measures; decreases reported pain and drug usage; enable independance.
• Treating patients with dignity and respect means they are less likely to be rude and abusive to other members of staff and/or other patients and their families.
Compassion matters – quote written by a Doctor with cancer “If you’d asked me what was the most important quality in a doctor before I was
unwell, I would have said competence. The last three years have taught me how much I now value ‘softer’ aspects of care; by that I mean values that mainly revolve around the patient such as “no decision about me without me” and “see me not just
my disease”. I have yet to meet a doctor on this journey who displays these compassionate attributes who wasn’t also competent.”
A We Care Culture
• To achieve this, we aim to develop We Care Champions in every department across
EKHUFT (our five hospital sites and our community sites).
• We Care Champions will help staff to recognise and engage with the aims and objectives
of We Care, and support staff to use a We Care approach in their daily work.
• This will develop a culture that delivers an excellent patient experience
and the best clinical outcomes.
• The We Care values and behaviours became the Trust’s new
standards in 2014 and are increasingly demonstrated at EKHUFT.
• To embed We Care into our culture, we now need every ward
leader and manager, and every staff member, to be aware of and
understand the We Care values.
The Summer Campaign – Week 1
• CARING. People will feel cared for as individuals. Because we are welcoming and polite; attentive and helpful; we respect people, their dignity and their time, and we have the courage to speak up when others don't.
Behaviour• We say thank you to each
other this week, smile, acknowledge, make eye contact
Improvement Activities• Mealtime Experience• Communication around
discharge and preparing patients
• Daily ward rounds by Matrons
The Summer Campaign – Week 2
• SAFE. People will feel safe, reassured and involved. Because we are consistently safe and reassuringly professional, we listen and communicate clearly, and we work as an effective team.
Behaviour• Clean Hands Campaign in
including telling patients we have cleaned our hands. Helping patients to clean their
hands prior to mealtime.
Improvement Activity• Pain control. ‘Manage My
Pain’• Answering call bells quickly
Summer Campaign – Week 3
• MAKING A DIFFERENCE. People will feel confident we are making a difference. Because we take responsibility for delivering the best outcomes, act as leaders where we can, and we look to improve and develop ourselves and our services.
Behaviour• Make time to listen to someone.
Take a moment to put ourselves in another person’s shoes.
Improvement Activity• Evaluate this and make a change
based on one piece of feedback.• Seek feedback from 1 patient
and/or 1 colleague
The ‘We Care’ staff experienceThrough:
The way we speak
The way we look
The way we behave
…..and the process we have in place that reinforces messages and drives certain behaviours
FOCUS Brand
FOCUS change programme
Brand book
Tone of voice• What we say• How we say it
“xxxx began in 1864 with the opening of the first shop in London's Oxford Street. Our unique promise to our customers that the price of any item we sell will always be as low as the lowest price in the neighbourhood, has been our slogan for over 75 years.
Through the efforts of our partners serving customers with our high quality goods, we have succeeded in building the largest department store retailer in the UK, with 39 shops and a growing online business.Our partners will tell you that this is a very special place to work. We believe our distinctive culture – our spirit – lies at the heart of this feeling.
After all, as a partnership we are a democracy – open, fair and transparent. Our profits are shared, our partners have a voice and there is a true sense of pride in belonging to something so unique and highly regarded.”
The wrong way:
“Targets for the last quarter were achieved and some areas performed beyond expectation.”
The Caring way:
“It’s great news that we all reached our targets for the last quarter. Special congratulations and well done to the [name and name] teams, who have raised the performance bar for the third time this year.”
How will we improve?
Our Actions• Board sign up to the new values and behaviours• Job descriptions will feature the expectations • Via recruitment processes and appraisals• Expectations made clear to all staff groups• Listening events by Exec Directors• ‘Walk the Floor’ sessions – timetables throughout the year• Ward to Board discussions at Board of Directors meetings• Market Place events• We Care Champions
The need for We Care Champions• Recent Market Stall research (collected by current We Care Champions) captured the
experiences of our staff, patients and visitors, highlighting:o Positive comments about our teams and their support.o Negative comments to be improved upon through ongoing support from We Care
champions and future engagement of staff.
95 Patient Responses:73 positive comments
101 Staff Responses:62 positive comments
22 negative comments
39 negative comments
• From now on in, We Care champions will hold monthly market stalls to measure our success in living up to We Care standards across the Trust.
Our current We Care Champions pledged to:
‘make a difference for our patients right now.’
So, what if everyone thought:
‘as one person I cannot change the world
but I can change the world of one person....’
We will make a start and aim to succeed.
