Sometimes you hear something at a conference leaves a lasting impression. The London School of Paediatrics has done that for me a few times. This year it was Michael West, professor of work and organisational psychology.
Professor West’s starting point was simple but powerful: How do we provide continually improving, compassionate, high quality care?
Setting targets and specific incentives causes unintended consequences. A better approach is to improve organisational culture: to create an organisation where our objective – continually improving, compassionate, high quality care – is the norm. This relies on leadership. Good leaders continuously ask questions, and pay attention to these issues. Paediatricians are leaders: every interaction, by every doctor, every day, shapes the culture of the organisation.
Michael West described the value of a staff survey which captured the view of 1.3m people. It links staff perceptions with national data such as mortality, patient satisfaction and finance. He described the data he has analysed from a vast ethnographic study of the NHS, consisting of thousands of observations from different NHS settings. They found enormous variability: there were some extraordinary bright spots and some very dark ones.
Team leadership is shown to contribute to the highest quality care. The leadership role moves seamlessly to whichever person in the team is best placed to step forward, be it the ward clerk or the specialist nurse or anyone. To realise this at an individual level, we need each think about what each of us believe is our mission, for our life’s work.
What is our own mission? One person said hers was to be ‘the glue’, another ‘to give permission so that others can be effective’ and another to be the one who ‘sets high standards’. Mine is to help others to reach their full potential, be that a child, parent, or colleague.
If we treat staff with compassion, respect and dignity, staff will treat patients with compassion, respect and dignity. In studies of stress, nurses and doctors are repeatedly in the top three professional groups. We need to start looking after our staff more effectively.
A few more nuggets from Professor West…
The five ways to Wellbeing:
Spending time with people we love and love us – this is the most important of all
The others: exercise, learning and growing, paying attention to here and now, helping other people.
Listen with fascination
Be kind, appreciative and curious.
Be prepared to deal with corrosive behaviours such as bullying
Quality improvement is key. Organisations should encourage innovation. Where the NHS performs well, there is a culture of encouraging innovation, being less fearful, imposing fewer hurdles.
Have teams who take time out on a regular basis to discuss what they are trying to do, agree priorities and what needs to change. Create opportunity for reflection and learning.
We each need to embody the values that are important in our own communities. At least some of these will resonate with every one of us:
Justice, transparency, honesty
Wonder, optimism, gratitude, spirituality
Each one of us who heard Michael West speak with such calm authority at our London School of Paediatrics conference will have felt inspired to put his ideas to the test in our daily work.