In this edition, Laura Gatenby, Claire Marsh and Sarah Byrne step back and think about how the Improvement Academy can help you to improve culture in health and social care, by recognising the increasing challenge: ‘where do we start?’
At the Improvement Academy, we have been talking to colleagues to understand the real-world challenge of improving culture, especially within the current climate of squeezed resources in health and social care. A dilemma that is taking its toll on individuals on a daily basis is: ‘how do I strike a balance between looking after colleagues, patients and myself without compromising any of these?’ We offer a variety of tools and approaches to support and value each party (see our venn diagram) and crucially, the relationships between them.
We support colleagues trying to improve quality and safety across a number of programmes e.g. Martha’s Rule, Patient Safety Incident Response Framework, Care Homes, Maternity & Neonatal. We also support colleagues in specialist roles to improve culture e.g. Freedom to Speak Up guardians, Patient Safety Partners, senior board members through our collaboration with NHS Resolution. A common theme across all of this is the appearance of a collective and equal amount of confusion of different voices in the “room”. These are: the voices of the patients, our colleagues, our own individual voice – who do we listen to when all speak as loud as each other, with compelling reasons to be heard and attended to?
Different voices have valid reasons to be heard and supported, but we note that the competitive rub of them speaking their truth in unison is creating a lot of division, be it generational, hierarchical, organisational, and/or between professional groups. Some individuals have the admirable task of trying to bridge these divisions and bring unity, either through a role such as cultural change champions, or because they are personally motivated to do so. We particularly want to support these colleagues.
Taking a step back from everything helps to gain clarity, and consider the bigger picture. At the Improvement Academy we have assimilated and listened to the different voices, taking onboard wider research. We are continually expanding our tools and approaches, and providing safe spaces to help by starting to bring the different voices together. Whatever position you are in as a frontline staff member, a manager, a patient or senior executive, we want to help you to respond and not feel paralysed by the complexity and the lack of clear answers. Such feelings of helplessness and overwhelm are bad for morale.
Victor Frankil famously said “Between stimulus and response there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom.”
Below are some of the Improvement Academy offers and resources which speak into this cultural dilemma and may help you to find a way forward:
- Just Culture Network
A supportive learning and engagement network for anyone involved in improving culture. Link to: https://improvementacademy.org/networks/a-just-culture-network/
- Second victim
For health and care employees who have experienced a significant personal or professional impact as a result of a patient safety incidents. Link to: https://secondvictim.co.uk/
- Workplace Detox Training: Essentials for personal fulfilment and influence in the everyday at work. Contact academy@yhia.nhs.uk for more info.
- Measuring teamwork and safety culture: support for data collection, analysis and improvement using a validated tool from the University of Texas. Link to: https://improvementacademy.org/expertise/teamwork-and-safety-culture/
- Perinatal Culture and Leadership Programme:
Culture improvement support for maternity and neonatal departments in the region through online learning events, resource sharing and coaching. Contact academy@yhia.nhs.uk for more information.
- Our insight summaries:
Patient experience: https://improvementacademy.org/wp-content/uploads/2022/02/What_Really_Matters_To_Patients_And_Their_Carers_Report_June_2020.pdf
Staff experience: https://improvementacademy.org/wp-content/uploads/2022/06/Beyond-demoralised-IA-report-Jan-2022.pdf
Understanding personal influence on culture in the workplace:
https://improvementacademy.org/wp-content/uploads/2024/09/Facing-Up-V2.pdf If you have any questions about the networks and resources listed above, or any other projects/programmes we support, please contact us at Academy@yhia.nhs.uk
