Enjoying Work Learning Set 6 – Celebration Event

Thank you to everyone who attended the Enjoying Work Celebration event on on 1st February 2019. Well done for the amazing work teams have done over the last 8 months. Your teams’ stories were so inspiring. Keep up the good work!!

Illustration of Enjoying Work Celebration by Jonny Glover

In this area you can find the presentation from the event, along with a photo gallery, plus video and poster presentations from all teams involved. Please find all of these resources shared throughout the learning system available here >>

Photo Gallery

Click on the images to open the full photo gallery

Celebration Event Presentation

Poster and Video Stories

Executive Team

Medical Management Team

Extended Primary Care Team

Business Development Unit

Bedford Community Rehabilitation Team

Quality Assurance Team

Coborn Centre for Adolescent Mental Health

City and Hackney Rehabilitation Team

Newham CAMHS (Child & Adolescent Mental Health Service)

Leadenhall Ward

Extended Primary Care Team – North West

Access all Enjoying work team posters and videos in this collection >> 

Related Resources

Enjoying Work Learning Set 5

Thank you to everyone who attended Learning Set 5 of Enjoying Work on 23^rd November 2018. It was a fine opportunity to think about the stories behind your work.

Illustration of Enjoying Work Learning Set 5 by Jonny Glover

In the menus below you will find content and the product of the activities from the day, together with some tasks for your team to do. Some of the key highlights you’ll find there are:

• What attendees said contributes to a good day
• The top 10 ideas the room came up with for improving the collection of Good Day Measure
• How to start to tell the story of your enjoying work project
• A photo gallery of the day!

Click on the titles below to explore the content

Photo gallery and what people told us contributes to good day

Enjoying Work Learning Set 4

Derek Feeley, IHI

On Tuesday 16 October we came together for Learning Set 4 of the ELFT Enjoying Work programme. We were delighted to welcome Derek Feeley, Chief Executive and President, Institute of Healthcare Improvement (IHI) to the session.  Derek shared the IHI’s Framework for Joy at Work, and some learning about High Impact Leadership. You can find both of these presentations available below

In the sections below you can also access further information from the learning set and also what teams should be focusing on in the lead up to our next learning set in November.

Click on the titles below to reveal more:

Illustration of Enjoying Work Learning Set 4 by Jonny Glover

The IHI Framework for Joy in Work

Have a look at the slides that Derek Feeley used when sharing the IHI Framework for Joy in Work. Look out for slide 10 which shows the critical components for ensuring a joyful, engaged workforce.

Watch Derek’s presentation here

Changes tested by teams

From the exercise we did to identify change ideas that teams have tested, this is what came out:

IHI Framework for Improving Joy at Work. Each coloured dot on this image represents a test of change made by a team.

 

Enjoying Work Learning Set 1

Illustration of Enjoying Work Learning Set 1 by Jonny Glover

We hope you were encouraged by our learning session on 28th June to aid you along your journey towards helping your team enjoy their work.

Here are the things you need to do over the next 5 weeks:

Please click on the titles below to reveal more…

Run an Appreciative Inquiry

We have attached a PowerPoint presentation with everything you need to do this including some pointers in the notes section. This is also provided as a PDF handout so you can print out and refer to during the exercise. Your QI Coach can help you facilitate this.

Click the image to open the AI presentation

 

Collect Good Day Measure

Click on the image to access ImproveWell instructions

Collect the Good Day Measure for at least 4 weeks before the next learning set. Continue to collect thereafter.

Here are five things you need to do to be ready to collect the Good Day Measure:

1. Inform the QI team who your project lead, Data Champion and Team/Service leader is. They will be able be given permissions and instructions to set the time of daily notifications, set bespoke surveys and download team data and responses.
2. Discuss with your team and assure them this will help them identify things that work well and areas for improvement and that their responses to the Good Day Measure are anonymous.
3. Get everyone to download the ImproveWell app on their personal or work phone or tablet (Android or iOS) from their app store or through https://www.improvewell.com/. Download and sign-up instructions attached. A unique team code for your team will be sent in a follow-up email today.
4. For the first few weeks, have a process for encouraging people to complete the Good Day Measure.
5. Create brief regular 10 minute slots (weekly if possible) to look at the data and group the ‘Mostly Yes’ and ‘Mostly No’ responses into themes by printing the responses and using Affinity Diagram exercise to group them.

Complete Pulse Survey

This will be sent by the QI Team through the ImproveWell app as a survey on 16^th July. People will get a notification on their phones when it the survey goes live. The survey will be open until 31^st July. Your Data Champion and Team/Service Lead will be able to access the results and share with the team. Once identified to the QI Team, they will be sent further information and support to use enhanced features of the ImproveWell platform.

Here are three things you need to do to be ready to collect the Good Day Measure:

1. Discuss with your team and assure them this will help them identify things that work well and areas for improvement and that their responses to the Pulse Survey are anonymous.
2. Come up with a process for encouraging people to complete the Pulse Survey.
3. Arrange a time for the Project Team to look at the responses together and how to share with the rest of the team.

Register your project on Life QI

To help identify you project, please start the title of the project with “Enjoying Work –“ Your QI coach can help you with this. 

Come up with an Aim

Use all the above to come up with or refine the aim of your project. Record on Life QI. Use your QI coach to help with this too.

Develop a Driver Diagram

Use all the above to develop a Driver Diagram for your project. Use your QI coach to help and record on Life QI.

Use the Readiness Radar

As a project team, use the Readiness Radar to do a self-assessment of the conditions for giving you the best chance of success. Where you score low, come up with some ideas of how to improve.  Access the Readiness Radar tool here>> Please ask your QI Coach or QI Sponsor to help with this.

Next Learning Set

Please arrange for 1-3 people from your team to attend the next learning set.

Date & Time: 07/08/2018 12pm-2pm

Location: Hightown Community Sports & Arts Centre, Concorde Street, Luton LU2 0JD

Lunch: Will be provided.

Travel Expenses: Travel expenses will be reimbursed using the standard Expenses Claim from using the QI Team Budget.

If your service already uses the online trips platform for train tickets, drop us an email and we will give you the budget code to use.

We look forward to seeing you in August in Luton, hearing you share your stories from the constructive discussions you are going to have with your teams and working together to get to testing some of their ideas. We will put together the ‘must-dos’ we developed today and share them at the next learning set.

Finally, when times get hard and you need a pick-me-up that reminds you why this is important, have a look at the symbols you created of what it will be like ‘when’ everyone can have a good day at work everyday – See your creative representations of ‘Why this matters’ in this short video

Enjoying Work Learning Set 3 – Illustration

Visual summary of topics covered in the Enjoying Work Learning set 3. Illustration by Jonny Glover (More than Minutes).

Enjoying Work: Learn from C&H and Business Development Unit teams

Find out why the City and Hackney Rehabilitation team and the Business Development team have made the decision to focus on improving enjoyment at work and what their experiences have been so far.

Business Development Unit

Hear from Lilu Wheeler, Business Development Projects Officer and Enjoying Work Project Lead:

Other change ideas being tested

Also as part of the QI project, the team are doing something they call ‘Networking with BDU’. One of the change ideas was how to make work meaningful and improve psychological well-being. “In order to have good working relationships with others and build recognition, we need to be more ‘out there’”, Lulu says. “Each month we will pop dept names in a hat, starting with Corporate services and invite teams to join us for a social. No requests for work, no talking business, just get to know each other. We have already invited Finance and we are doing a Doodle poll to select best dates for lunch”.

City and Hackney Rehabilitation and Recovery Service

What inspired you to join the Enjoying Work Learning Set? What does this work mean to you and what will it help the team improve?

The team came together at our Away Day in April 2018 and we talked about the opportunity of possibly getting involved in the project. Staff readily identified many positive aspects of working in the Rehab team, however we are always seeking to improve. We acknowledge that the work we do with service-users can be both rewarding and yet frequently challenging. The team has taken on many new roles and is required to tolerate changes and to constantly adapt. We know this can be also quite difficult at times and wanted to ensure we were giving enough thought to the well-being of staff and the health of the team.

Who is taking part of the project and how are you involving the broader team as part of the changes?

In the core quality improvement project group we have a number of different staff members, including Social Workers, Occupational therapists(OT), Doctors, support worker, senior practitioner. A support worker and OT are leading on the project. We have so far had two team lunches, where we have worked as a group to develop our driver diagram and also identify change ideas of things we could do differently

What change ideas have you tested?

We had a team session recently where many ideas were generated. Many of these were around staff wellbeing, such as from having a yoga class here at Primrose Square, or having plants in the office to create a healthier environment and a picnic table for the garden so that staff can have an outdoor space for lunch breaks. Other ideas were around organisational issues, such as changing times of meetings, who should be attending and looking at how we use our OT resources in the community. Others were more around generating a positive social environment, possibly introducing a team bake-off, or having more social gatherings after work.

Have you found anything challenging and how are you working together to overcome them?

To see if the changes we are making are making things better, we are using Improvewell (a phone app) to ask whether or not people have had a good day. Response rates on ImproveWell are reasonable but could be better. Finding time to get together as a core group is also at times challenging, due to different schedules. Keeping the momentum going, and motivation is also a challenge, however the team lunches do seem to be helpful in having time for all to put our heads together and work on improvement. Understanding how to input data has been a bit of a challenge too, however the QI team have been very supportive.

In the long term, how do you see this evolve? Where do you want to be as a team?

We would like to use the project as a means to think creatively about some of the difficulties we face and how to find ways around them. We are all so busy day-to-day, we hope the project will give us the headspace and the structure to reflect on how we are individually and as a team, and how we can prioritise our health and well-being, so that we can continue to work effectively with service users.

The Enjoying Work team is formed by Rosalind King and Patricia Simoes (project leads), Hester Morgan, Irene Kulubya and Elaine Athanas. 

Enjoying Work Learning Set 2

Thank you to everyone who was able to attend Learning Set 2 for the Enjoying Work Learning System this week. There was a lot of “enthusiasm, collaboration and synchronicity” and an “organic mix” of “ch-ch-ch-change and fun”…♩♪♫♬

Illustration of Enjoying Work Learning Set 2 by Jonny Glover

To make it easier for you to refer back to the content, resources and actions from the learning set, we have put everything on this webpage.

Feel free to share this information with the rest of your team.

Please click on the titles below to reveal more…

Enjoying Work – Luton IAPTS

Please learn more about this completed ELFT QI project from the adjacent poster.

ELFT staff, service users and carers can access full details of this project on Life QI .The project code is 103865 please log onto your Life QI account before clicking the logo below.

Immunization Against Burnout

Clinician burnout is far from being eliminated at health care organizations, but leaders, frontline
physicians, and nurses are joining forces to get to the roots of the crisis. That’s the takeaway from
the NEJM Catalyst Insights Council survey, “Immunization Against Burnout.”

Appreciative Enquiry

Please click on the image to view the Appreciative Inquiry PDF.

Change Ideas From IHI

The IHI are our strategic partners in this Quality Improvement journey. Please click on the image to read their Change Ideas document.

Enjoying Work – A Trust QI Priority

Several teams have been testing and helping refine a learning system which brings together methods, resources and peers to help teams work on improving the experience of staff and enable people to enjoy their work. We are now extending this learning system to bring in more teams from across the Trust.

Here are the details:

To view the infographic as a PDF file please click here.

Enjoying Work – A Trust QI Priority

Healthcare Staff Wellbeing, Burnout, and Patient Safety: A Systematic Review

This review illustrates the need for healthcare organisations to consider improving employees’ mental health as well as creating safer work environments when planning interventions
to improve patient safety.

Please click on the image to open the paper.

Related Resources

Stephen Swensen Papers

Esprit de corps – Taking care of each other for our patients

Restoring joy in work and preventing burnout: an IHI framework for joy

We’re Quality Improving!

Enjoying Work

‘Enjoying Work’ Workstream Update

In previous newsletters, we shared some of the Trust-wide priority areas that are being tackled collaboratively by several teams using QI (Quality Improvement) as the design framework. One such work-stream is “Enjoying Work”. Feedback from staff through different avenues, including the annual staff survey, has highlighted the need to improve the experience of staff working across the East London NHS Foundation Trust (ELFT). A handful of teams started to work at addressing the issue of staff satisfaction and morale by running improvement projects. There is a wave of interest internationally in bringing back joy in work¹.

Why it’s Important:

In addition to running appreciative enquiries with some teams, a survey was sent to all staff in early 2017 to gauge what matters to them. What came out of that exercise was astonishing. There was a lot of emphasis on needing to rebuild meaning, teamwork, trust and embrace new ways of working. The responses received from eighty-five survey responders and three services were used to create the wordcloud that is now the symbol of this work.

Who is involved:

Five teams from a variety of the Trust’s services have volunteered to be prototype teams for the Enjoying Work workstream. These teams were either already working on this problem or volunteered to get involved. The five teams also represent some of the different type of work environments in ELFT, they are:

• Highly mobile staff: West Locality EPCT (Enhanced Primary Care Team)
• Geographically dispersed: Luton IAPT (Improving Access to Psychological Therapies)
• Geographically centralised: Isle of Dogs CMHT (Community Mental Health Team)
• Corporate: Quality Improvement Team
• Inpatient: Millhabour Ward

Each service has established a project team which consists of staff from that service. They also have a local sponsor from the directorate management team, a Quality Improvement Advisor to coach them and a named Business Partner from the Human Resources/Organisation Development team. Mason Fitzgerald, Director of Corporate Affairs, is the executive sponsor for the workstream from the Trust Board.

This work will also be linked to other work taking place across the organisation on leadership development and compassionate leadership. We are also keeping in contact with other organisations that are doing this type of work to collaborate and learn from each other. We have also adopted the change ideas and change concepts identified by the IHI (Institute for Healthcare Improvement) in their recently published framework for improving joy in work in healthcare organisations². Some of these will be tested by the prototype teams together with their locally generated change ideas.

What they are doing:

In the preliminary stages of the work, the prototype teams have been testing how best to approach this work in terms of measurement, appreciative enquiry, defining the problem and testing change ideas.

Some of the prototype teams are still collecting baseline data which will help us set a global aim for this work. We expect that the learning that comes from the teams doing this work will be scaled up to the rest of the organisation as we build confidence in the approaches and changes being tested.

Colleagues from Human Resources and Organisation Development will also be working closely with these prototype teams to test out the new Business Partner model of supporting teams and leaders in tackling specific challenges when leading and delivering services. You can also read in this newsletter about the events that took place in September with more than 200 staff, with Professor Steve Swensen who has led much of the research and work internationally on understanding staff burnout, team engagement, joy in work and quality improvement.

What can you do?:

After the publication of the annual staff survey, many teams make an action plan to address some of the issues which come to light. This also tends to happen throughout the year following team away days and other occasions. At ELFT, improvement has always been part of our DNA and we know that most problems can, and are, being solved without necessarily starting a formal QI project. We would love to hear about what you have tried in your team and what you have learnt while trying to improve staff enjoyment of work. In addition, if you would like to test out some of the tools that the prototype teams have developed for carrying out an appreciative enquiry, or the simple measurement tools, please get in touch. Drop us an email at elft.qi@nhs.net with the subject line “Enjoying Work”.

¹Feeley D, Swensen SJ. Restoring joy in work for the healthcare workforce. Healthcare Executive. 2016 Sept;31(5):70-71.

²Perlo J, Balik B, Swensen S, Kabcenell A, Landsman J, Feeley D. IHI Framework for Improving Joy in Work. IHI White Paper. Cambridge, Massachusetts: Institute for Healthcare Improvement; 2017.

Steve Swensen – Report on Leadership development events

By Marco Aurelio and Auzewell Chitewe 

The 2016 NHS Staff Survey showed us that we have made significant progress as an organisation in terms of staff engagement. We are committed to making further progress in the areas we have improved in, such as recognition and value of staff by managers and the organisation. Additionally, we want to address the areas that our staff identified as needing further improvement.

One of the actions taken was to invite Professor Steve Swensen to run workshops with leaders from all levels of the organisation to help us building on our culture of caring for our patients and each other. Steve Swensen has led much of the research and work internationally on understanding staff burnout, team engagement, joy in work and quality improvement. He previously led on leadership and organization development at the Mayo Clinic, a large healthcare system in America with many similarities to ELFT. He is currently Medical Director for Professionalism and Peer support at Intermountain Healthcare.

Steve ran several masterclass sessions with the executive team and leaders from around the Trust on 14^th and 15^th September 2017. Over the course of two days Steve helped us think through how we can support leaders to create an environment that prevents staff burnout, empowers everyone to be part of the solution by embedding a model he called “esprit de corps” – taking care of each other for the benefit of our patients.

Over 200 members of staff from a range of professional backgrounds attended a variety of workshops and events to learn about building “esprit de corps”. The model encourages leaders to address four basic elements –  trust, resilience, passion and camaraderie^{1, 2}.

So, as leaders, how can you go about doing that? A big focus over the two days was understanding 6 actions of the organizational framework for improving “esprit de corps”³ and enjoyment at work:

• Leadership – Exhibit behaviours that are open, encourage staff to try out new ideas and show them appreciation
• Design – Design organisation systems that eliminate or mitigate structural and functional drivers of burnout
• Commensality – Encourage staff to come together and socialise. Be it a simple coffee morning or having team lunches
• Pebbles in shoes – Ask staff what matters to them, or what is getting on their nerves and try and fix it together
• Don’t let staff be second victims – Having a bad patient outcome or sentinel event can cause serious psychological impact on staff. Don’t let them become a victim of that by having a culture of blame. Focus on changing systems
• Develop resilience in staff – Encourage staff to take care of their own health and wellbeing.

Of course, that sort of change doesn’t happen overnight and Steve’s key take away point is to start an open and honest dialogue with staff by asking what matters to them, what gets in the way and work together to design solutions to problems.

¹Baard, Deci, Ryan. Intrinsic Need Satisfaction. J Applied Social Psych, 2004. 34(10): 2045

²Swensen, S., A. Kabcenell, and T. Shanafelt, Physician-Organization Collaboration Reduces Physician Burnout and Promotes Engagement: The Mayo Clinic Experience. Journal of healthcare management / American College of Healthcare Executives, 2016. 61(2): p. 105-127.

³Swensen, Shanafelt. Organizational Framework to Reduce Professional Burnout. Joint Commission Journal on Quality and Patient Safety June 2017 43(6) 308

Steve Swensen visiting the Trust

This week we are delighted to welcome Professor Steve Swensen to ELFT.  Steve is Medical Director for Professionalism and Peer Support at Intermountain Healthcare, and was previously Medical Director for Leadership at the Mayo Clinic. He has written and researched extensively on clinical engagement, enjoying work and staff burnout and you can find some of his published work available on the microsite here>>

During the two day visit he will meet with close to 200 ELFT staff, service users and carers who are working together on these issues. We will share some of the outcomes from these learning groups and workshops with you over the coming weeks.

Watch Steve present alongside Derek Feeley, CEO & President IHI, and Jessica Perlo IHI, at the 2017 International Forum on Quality & Safety in Healthcare.

IHI Framework for Improving Joy In Work

With burnout and staff turnover in health care continuing to rise at alarming rates, this white paper describes four steps leaders can take to improve joy in work; a framework with nine critical components for ensuring a joyful, engaged workforce; key change ideas; and measurement and assessment tools.

An Organizational Framework to Reduce Professional Burnout and Bring Back Joy in Practice

The epidemic of physician burnout undermines quality of care, patient satisfaction, and access to care, making it a major threat to the US health care delivery system. Burnout is primarily a system issue—not a problem of individual resilience. Accordingly, meaningful progress will not be made until the drivers of burnout are addressed at the level of the organization and care delivery system.

Click on the image to read this paper.

Restoring Joy in Work for the Healthcare Workforce

While burnout in the health professions is alarmingly high, restoring joy in work is more than just reducing burnout. So, what can leaders do to counteract this epidemic? This article describes four key steps that leaders can take to restore, foster, and nurture joy in the health care workforce.

Feeley D, Swensen SJ. Restoring joy in work for the healthcare workforce. Healthcare Executive. 2016 Sept;31(5):70-71.

Restoring joy in work and preventing burnout: an IHI framework for joy

Restoring joy in work and preventing burnout: an IHI framework for joy

• Stephen Swensen, Medical Director, Leadership and Organization Development Mayo Clinic; USA
• Derek Feeley, President and CEO, Institute for Healthcare Improvement; USA
• Jessica Perlo, Network Director, IHI Open School; USA

International Forum on Quality & Safety in Healthcare – London 2017