Innovation
The programme was developed for NHS staff as a process of learning rather than a course or one-off workshop. Participants were invited to participate in a series of workshops and learning activities. The aims of the programme were that staff undertaking the programme would :
- act as a leader within their team to support the development of a culture where feedback is welcomed and seen as a key learning opportunity
- co-opt two or three colleagues to act as ‘learning buddies’ thus spreading the learning. In this way the participant and colleague(s) act as a peer mentors and support for each other
- practice from a value base which views people (colleagues and patients) as e.g. aspiring, resourceful, capable of change and worthy of respect and of being treated in a dignified way
What prompted innovation?
In response to the Scottish Governments Person Centred Health and Care Programme, NHS Education Scotland (NES) commissioned a development programme for NHS staff (Senior Charge Nurses / Midwives, AHP Team Leaders). Edinburgh Napier University and the Thistle Foundation and NES developed a programme focussed on Facilitating Feedback Conversations. The contribution from Edinburgh Napier University focussed on research from the Leadership in Compassionate Care Programme (LCCP).
Person centred care requires healthcare practitioners who are able to work in different ways and try new approaches. They also need to be able to influence behaviours and attitudes that don’t fit with person centred approaches and support others to make changes.
To do this they need supportive collegial, supervisory and mentorship approaches and relationships which help to alleviate stress, enhance emotional and spiritual wellbeing and promote professional accountability and clinical leadership.
The ability to facilitate feedback conversations is a key element of these supportive relationships. They play a part in increasing confidence, self-awareness and personal development.
These supportive approaches and relationships contribute to the improvement of staff experience and, ultimately, the care experience.
What makes innovation different?
- It has provided an innovative opportunity for the blending of learning approaches, experience and research from key education providers in long term conditions, strength or asset based approaches and compassionate care. The programme has been developed by an occupational therapist, physiotherapist and a nurse and is aimed at multidisciplinary NHS staff with management responsibilities. This blended approach represents a strong collaboration between NHS and third sector provision drawing on shared experiences of Learning Teaching and Assessment from leading providers.
- The programme is focussed on NHS staff and highlights the critical activity of feedback conversations. Feedback is a key theme of the LCCP and NHS Education Scotland through several years of interventions in regard to development of communication skills for NHS staff have decided to focus on this critical area.
- This programme is current and directly responds to national drivers such as integration of health and social care, development of person centred care and innovations directly in support of staff and their practice.
Changes in practice
Participants at the end of the programme were asked the following question;
What could you do to build a culture in your organisation that supports feedback conversations as both routine and as learning opportunities?
The responses below indicate their understanding of what will change practice on completion of the programme further ongoing evaluation is underway.
- Be a reflective practitioner
- Observe your own practice
- Think about what you could have done (even if you didn’t actually do it) that would have been recognised as being strengths based or appreciative
- Notice conversations that focus on problems, deficits or ‘what is wrong around here’…how could these conversations be different
- Try things out
- Try using one question you don’t normally ask e.g. what would other people say you were good at?
- Try it out in every interaction throughout the day
- Try changing some of the usual questions you ask e.g. instead of asking ‘how are things going?’ try asking ‘what would you like to get from our meeting/conversation today
- Try one strategy at a time
- If you are giving feedback to staff try inviting the other person to describe their experiences first
- Try listening with a constructive ear, noticing the little things that went well in a particular scenario, amplify that and be interested in it. Explore it further to get a deeper understanding
- Model new behaviours/practice and influence others
- Be open about what you are trying to do…make it explicit even when it doesn’t quite work as you had hoped
- Ask people if you can try out new/adapted questions
- Ask them about their experiences of that (i.e. ask for feedback that you can learn from)
- Share your learning and observations
- Practice in ‘ordinary’ day to day situations
- Day to day ordinary situations are more frequent (and probably less stressful) so it is here that you have the opportunity to develop/refine approaches that make your feedback conversations more powerful, meaningful and/or genuine…therefore more impact
- It is here that you will grow the confidence and willingness that will enable you to address the more challenging situations.
- Hopefully, by giving more emphasis to ordinary situations/conversation you may prevent the development of challenging ones
Impact
An external researcher has been evaluating this programme through interviews with participants and their line managers, however the evaluation is not yet complete as a final evaluation activity is yet to take place.
Dissemination
- An initial report of the first cohort is now complete and further evaluation is underway.
- Links to learning of long term conditions and networks of skilled practitioners has been shared with module leader at Edinburgh Napier University and this is being incorporated into an undergraduate module about long term conditions.
- Further dissemination of learning is planned.
- NHS Education Scotland present this work to the Person Centred Council as part of the Scottish Governments Person Centred Health and Care Programme.