Here is a post in the form of a recent email sent by Care Group Support Manager, Ian Billington, to his colleagues at Walsall Healthcare NHS Trust. Congratulations to Ian, Esther Waterhouse and the rest of the team on Ward 3 and beyond for the fantastic impact LiA has had for patients, families, staff and the Trust. The team are all LiA stars!
Re: LiA and what it meant to me (a manager's view and experience)
Do you feel irritated by initiatives, feel pummelled by project management cycles, annoyed by action plans and jaded by being offered the chance of going on a 'journey' to nowhere? If so, then Listening into Action (LiA) is for you. I have always thought it important to be involved at the start of new way of working. This view is driven by a personal desire to be an early adopter rather than a slow starter. So it was with great interest that I attended the first LiA Big Conversation.
I attended the LiA Big Conversation with eager anticipation. It did feel different; this was mainly driven by the energy in the room. It was also the fact that colleagues were able to speak on the microphone and felt free to do so. The Care Group identified Ward 3 as an area that would benefit from the LiA approach. This identification and willingness to engage was driven by the staff on the Ward themselves.
The structure of LiA identified that we should create a Ward-based Sponsor Group that would have responsibility for supporting and delivering our mission – ‘Excellent in End of Life Care’.
We then agreed on our LiA team conversation. This in many ways is the critical success factor of the whole LiA approach because it leads to colleagues listening and then acting.
As well as taking part in the Trust LiA Pulse Check survey, the Ward staff (and relevant stakeholders) took part in a specific survey to ask how they felt about End of Life Care on Ward 3. The survey was only three questions but did include the key question…’Would you recommend Ward 3 to a relative or friend who is dying?’
Our LiA Team Conversation was a fantastic success and a pleasure to be a part of. To make the team conversation different we included party hooters, balloons (not inflated) and music. The dynamics were set by the colleagues who came full of ideas and enthusiasm. Colleagues spontaneously blew up the balloons and started playing a Walsall version of 'volleyball'! The group produced great ideas in relation to the two questions – ‘What would great be like?’ and ‘What changes – that we can make happen between us – would make the biggest difference?’. The session scored very well both through qualitative and quantitative analysis of the evaluation forms.
There is a weakness over compliance with the Individualised End of Life Care Plan. Concerns over a rise in complaints leading to poor patient/relative experience. Issues also need to be addressed around engagement and morale of staff.
Please take in liberal measurements - enthusiasm, motivation, a willingness to engage, willingness to smile and having a PMA (Positive Mental Attitude).
The plan was quite simple, to deliver on the clear objectives that were highlighted and agreed at our LiA Team Conversation. The actions and current delivery status have been RAG rated in the table below:
LiA is about colleagues coming together and feeling empowered to create change. This enables the staff to become the 'change makers'. The list above is an impressive illustration of what can be achieved. This was achieved not just by the individuals within the team Sponsor Group but the support of a lot of other departments.
As a manager, I had personal responsibility for one of the actions which was to obtain a mobile phone so that next of kin, or nominated person of an end of life patient, was able to contact the ward day and night for an update on the patient’s condition. This action meant something to me because it would enhance the connectivity of the patients/relatives experience at a challenging time. From this perspective, it certainly is good to talk. This was really rewarding because I felt like I had made a positive difference. Unfortunately I normally see patients dispassionately represented by a number on a spreadsheet or a board but this was different.
The changes above will make immediate, demonstrable and measurable differences to the experiences of all patients and staff involved. The changes have not been major transformational developments but evolutionary steps which have added value to the service - changes which have been achieved in twenty weeks with a negligible level of additional financial resource. The changes have occurred through colleagues allowing themselves to have space to think and space to care. Colleagues made a personal commitment to each other when joining the Ward Sponsor Group and ensured that they delivered on their areas of responsibility. Although I have highlighted the work of the Ward and the Ward Sponsor Group, it really has been a whole Trust approach as the areas that have been improved rely on other departments/services/specialties and individuals. One of the benefits of LiA is the opportunity it gives for individuals to have a dialogue with other areas of the Trust, building relationships and helping the approach to spread across the Trust constructively.
We are currently conducting a survey to establish where colleagues' views and opinions are on the service that they deliver. The sponsor group is also working on their presentation for the LiA Pass it On event event to be held on November 17th. I was speaking to my eldest son, Jack (aged, 7) about the event and I was reminded of the 'Inspire a Generation' slogan from the 2012 Olympics. It is important that 'inspire' is exactly what the first ten LiA clinical teams do at the event - inspire the next generation of teams so that LiA will be embedded within Walsall Healthcare NHS Trust.
I would encourage as many colleagues from around the Trust to come to the event and experience the benefits of LiA. There you will be able to witness changes that have occurred over the last twenty weeks in a variety of areas around the Trust. To reserve your place please email our Trust LiA Lead, Tom Johnson.
Role of specialist (group)
The Sponsor Group for Ward 3 will remain in place and will look to embed the work that has been completed and embrace another 20-week challenge. The group has agreed to build evaluation and review into our work, this will ensure that the Ward will be on a cycle of continuous quality improvement.
Jack challenged me on what inspire means; I responded by telling him within this context it was about listening to individuals, creating the opportunity for people to speak freely and, allowing people to think differently and creatively. LiA enabled this to happen on Ward 3. As a result there are now measurable differences felt among the patients, relatives and staff on Ward 3. We will continue…….
Ward 3 and beyond LiA Team