Enjoying Work Cohort 2 Celebration Event
Between June 2018 and February 2019 eighteen teams at ELFT participated in the Enjoying Work learning system. All teams generated and tested ideas around improving their experience at work.
In this collection you can find the video and poster highlights of this work alongside their learning from the experience.
Crisis Resolution/Home Treatment teams in Bedford reflect on their Enjoying Work journey
How do you start an Enjoying Work Quality Improvement project? How do keep team members engaged? How are ideas generated and tested? Learn more in this piece by Emma Myers, Assistant Psychologist and QI Project lead in the Bedford CRHT team.
What issues did the project aim to tackle when you first started with this?
The first difficulty we encountered was the turnover of staff in the team, as two of the original project team moved onto new roles; therefore we had a brief pause near the start of the project before we gained momentum again.
Our main difficulty was getting people to rate their day. We were getting 1 or 2 people rating each day and this was only 11% of the team! We have 14 staff logged onto the app and felt that the 1 or 2 replies were not giving us an accurate reflection of the team’s joy at work. At the Improvement Leaders’ Programme training, I spent time with the Willow Ward Enjoying Work project team and we came up with lots of ideas on how to increase engagement, and from that it was agreed that we at CRHT would try diary reminders and then a WhatsApp group. We were finding that the reminders from the ImproveWell app were popping up at 16:30 and as many of the team work up until 20:30 these reminders would get missed. With the use of the WhatsApp group, reminders were later in the day; we found that the numbers of staff rating their day went up to 5 or 6 on the days from Monday to Friday.
What tools did you use to collect your baseline data and feedback from the team?
We have used the ImproveWell app to gain our baseline data and this was recorded throughout October 2018. We decided to keepusing the app becausenot all the team were in the office to complete a different way to display their good or bad day, so we thought a way to rate their day “on the go” would be more beneficial for the team in the community.
What change ideas did you test and what did you learn from them?
From the first QI project team meeting*, we generated lots of ideas which were put into categories to help us form the driver diagram. We typed up the change ideas and then at the next QI meetings asked the team to vote on their top 3.
Change idea 1 – Roles in the office
Team members wanted to know what they were doing each shift in advance, instead of finding out on the morning of the shift. We tested putting an allocation list on the white board at the front of the office. From this we have learnt about the need for structure and also flexibility in the team during each shift, and it appears to have helped with communication in the team, especially highlighting a shift lead.
Change idea 2 – Office environment
We as a team found that there was a difficulty in communication between team members and we wanted a large table in the office that the team could gather around for meetings. There were also physical barriers to communication in the office with privacy screens that were between each computer. We removed ALL privacy screens in the office (I got excited using the screwdriver) and now we have a more open and welcoming space to work in. We now need to tackle the tidiness of the office with regards to paperwork, to keep the office looking open and ready to work in.
Change idea 3 – Team meetings
The team felt that we were not getting enough time to talk about other issues that were present, and at the last away day, we were not able to allocate enough time for a team meeting. We have implemented monthly team business meetings which give time for management to update on any changes, time to update about QI and time to discuss any difficulties that need to be discussed between the wider team. We have learnt that this is helping to facilitate better communication and open discussion within the team, and we can see this is needed to maintain enjoyment at work.
Kanban – before
Kanban – after
How has the Kanban board been helping communicate with the team?
We are using the Kanban board to visually communicate with the whole team about the progress of the QI project. As we are a community based team, and are in and out of the office all day, we can use the board to keep people up to date. We have also used the board in the meetings to move change ideas between the different columns. We also have a DON’T FORGET column to remind people about rating the app and the newslettersand the number of ratings and % of good ratings on the board for each week, so there is a constant update on the team’s data.
What’s next?
We attended the QI forum meeting in Bedford during January and this has helped us to focus on what we need to do with the project. We are achieving over 90% good day ratings and our original aim was for over 60% by 31st March 2019, so this aim may need to be revisited! We are also going to look at maintaining the gains by auditing some of the processes we have put in place, and we also have plenty more change ideas from the team that we can look at implementing.
*The team is also formed by a CRHT manager, two clinical leads and a senior doctor.
If you want to learn more about this project, visit LifeQI – Project code: 113776
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Community Children’s Nursing Service – Enjoying Work presentation
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Enjoying Work – Medical Management Team presentation
Video produced to be presented at the Enjoying Work Cohort 2 Celebration event in February 2019.
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Enjoying Work – Executive Team presentation
Video produced to be presented at the Enjoying Work Cohort 2 Celebration event in February 2019.
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Enjoying Work celebration – Extended Primary Care Team presentation
Video produced to be presented at the Enjoying Work Cohort 2 Celebration event in February 2019.
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EPCT North West Team Enjoying Work QI Project
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Leadenhall – Enjoying work QI project
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Newham CAMHS – Enjoying work QI Project
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C&H – Rehab Revolution – Enjoying Work QI Project
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Coborn Centre Enjoying Work QI Project
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Quality Assurance Enjoying Work Project
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Bedford CRHT Enjoying Work Project
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BDU Enjoying Work QI Project
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Testing ideas to increase satisfaction: the journey of the Community Children’s Nursing team
Find out what the Enjoying Work team at the Community Children’s Nursing Service (CCNS) has done so far to increase staff satisfaction and engagement. Words by Rebecca Daniels, Community Children’s Matron.
We started the enjoying work project because we wanted to improve our days at work, to improve morale and increase communication across the team. Communication was a key area for improvement identified within last years’ team away day – but we had not had chance to implement any specific actions following this. The project provided the perfect opportunity to work together as a team to make a positive difference.
Examples of the team’s Active Challenge
All of Community Children’s Nursing service was invited to take part in the project. The team is multidisciplinary with nurses, psychologist, administrative professionals, healthcare support workers, dietitians and play specialists. Everyone was encouraged to download the Improve Well App to record the good day measure however this proved to be challenging as community workers were on different shift patterns including office based, home visits, 10-hour night and day shifts on continuing care packages. We have a core project team who facilitated the appreciative inquiry and manage the data, change ideas and feedback to the wider team on a weekly basis during team meetings. The core team comprises of 3 CCNS staff (2 nurses and 1 admin) that are supported by the QI coach fortnightly.
Testing ideas
Our initial change idea was a monthly active challenge which was initially social media based. This worked well in engaging a small amount of staff (approx. 6 staff) with activity during August 2018 where staff took photos and we tweeted to gain virtual medals. We successfully gained gold medals before the end of the month and finished off the challenge in a team game of rounder’s which was really positive for team building and communication. We still struggled to engage all staff with the “good day” measure on the ImproveWell App, which did impact on our baseline data. In September 2018 the team undertook a monthly squat challenge which had less engagement with the team overall. In October, the team focused on Black History month, staff wore cultural clothing on a daily basis and took group team photos which were shared on Twitter.
#60kYourway challenge
This was really engaging with the whole team and resulted in a fantastic celebratory bring and share lunch in which every single member of CCNS participated. In November the team completed a #60kYourway challenge with a visual mountain and air balloons for staff to move their balloon up the mountain as they complete their activity (there are photos if you would like them). This has been the most successful physical challenge as we have managed to engage 12 staff within the month.
Our second change idea was testing CCNS Tuck shop. This generated from the idea that staff wanted a vending machine as the nearest shop to the office is a 20-minute walk. Initially snacks were purchased and cold cans put in the fridge with a price list that reflected cost-price. This was well received and the first PDSA cycle saw us increase the prices and change stock to items staff requested to have within the tuck shop. The Tuck Shop has now become more of a functional shop which sells soup and porridge for those who have not had chance to purchase lunch as well as the usual non-perishable snacks and cold drinks which have proved to be really successful. The price increase has enabled stock to be replenished and profit has been seen after a month of testing. The verbal feedback from staff has identified the tuck shop as wonderful, convenient and sociable, engaging all members of the team. The next stage will be evaluating staff satisfaction and choices through the use of a survey.
Daily management within the team has also been changed with giving band 6 staff more responsibility, changing on take from weekly to daily to manage work load better which has been really positive.
Overcoming challenges
Good Day Measure
Engagement with staff reporting their good day measure has been our biggest challenge. We have removed staff from the App who work different shift patterns (HCSW on continuing care packages) to the office community staff as they were not reporting their measures or engaging within the change ideas. This was partly due to their different work environment as a lot of the project was focused on the office environment and was not impacting on their work directly. We commenced a visual Good Day Measure tool in the office through the use of green and red tokens (we have photos if you would like them). This has helped with staff being able to record their day as it happens and has seen a small increase in staff reporting. Staff have identified they find it satisfying to put in their token, especially if they are having a bad day!
We also identified mid-way through the project that only the core project team were aware of the finer details of the QI project and recognised there was a need to improve communication regards how the project was progressing. This led to the development of our “You Said, We did” board which has helped to share with the wider CCNS team where the project currently is and provides staff the opportunity to share their ideas about next stages.
The overall project is starting to engage more staff with the team as we continue to introduce more change ideas. Staff are identifying new ideas they want to test including monthly creative therapeutic session, mindfulness sessions and developing a celebratory work anniversary board. Staff are feeling more valued because of the time invested into them and having time in our work day to enjoy wellbeing events.
Our next step will be to work on the larger test ideas which are more complex. The main idea is to analyse the current way of caseload allocation and management of visits to reduce travel time and promote more efficient working patterns. We will continue to work with staff about the best way to register their Good Day Measure and how this can work for them.
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Food and humour: Quality Assurance and their journey towards enjoying work
Read about the how the Quality Assurance team have been impacted by their Enjoying Work project and get inspired by the change ideas they have been testing. Words by Charlie Merrick, Project Lead, and Kay Spearman, Project Team Member.
How has having an Enjoying Work project been for you and the team?
Charlie Merrick: As project lead I have had a fantastic opportunity to engage the QA team in what really matters to them at work and to identify their intrinsic motivators to doing a good job. It was clear to see from the get go all the members in the team are highly motivated to do a good job and there was some real valuing in driving ‘enjoying work’. I feel the team have really benefited from this process not only in themselves but the wider network of colleagues within the QA network have seen a change.
Kay Spearman: This project has really helped our team bond. This was especially important with so many new members of the team joining this year. The low cost change ideas like puns and Fruit Fridays have helped build rapport during work and our organised team nights out have allowed us to enjoying spending time as a team outside of work and been a great reward after we have met tough deadlines.
Change idea: Weekly Bake off – QA team v Legal team. This was the Christmas special: Mince Pie battle!
How has the Enjoying Work project impacted the team?
Kay: One thing I wasn’t expecting to gain from this project was a greater understanding of how small things can impact on your enjoyment of your day. This project made us all sit down and highlight all the small actions and interactions we have on a daily basis and how they make us feel. Some popular ones among the team were that we all liked feeling productive and learning something new and valuable.
What is involved in the ‘pun of the week’ change idea?
Change Ideas: Fruit Friday
Charlie: Pun of the week is a no cost, no time test of change which has so many benefits, I am surprised someone one has not written a thesis about it. Every Monday we change to topic of the week and the QA team – and sometimes the wider department – is brought together by facilitating a pun related to the specific topic. This may seem a little silly at first but the power of pun of the week cannot be underestimated.
What top tips or information would you share with other teams?
Charlie: You want to find out what are the blockers to people doing their job and what are the ‘non-tangible/unquantifiable’ elements which make a team what they are. It is these attributes that can help bring a team together or remove any disjointedness and improve communications which otherwise maybe an issue. People have to come here to work and everyone I have worked with in this Trust wants to do a good job. Adding some fun into their job is essential to bringing our work forward.
Would you recommend the Enjoying Work QI project to your friends and co-workers?
Charlie: Yes. It can be the single most important thing any team can do. This has only benefited the QA team.
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Enjoying work in the City & Hackney Rehabilitation and Recovery Service
Running an Enjoying Work project is not always easy. Here’s what the C&H Rehabilitation and Recovery Service have learned and achieved so far. Words by Patricia Simoes, Project Lead.
What is your main aim with this project?
The main aim is to increase the number of good days reported by staff over a period of six months. We have been meaning to put a % to that, but have not yet done this. I think we haven’t gotten around to doing this because the number of people using the ImproveWell app is quite low, so we found it difficult putting a % to this aim when we felt it wouldn’t represent the whole team. But will discuss this in a core team meeting soon
What was the process to decide on which change ideas to test?
I guess the main issues which instigated change ideas were the practicality of putting them in place. For example, a change idea was to put plants in the office, however we had a very small budget for this and therefore not everyone is able to enjoy them. In addition, when putting a change idea such as a wellbeing lunch in place, we found it difficult to get everyone in the same place at the same time, which meant members from the team were unable to join; particularly admin and members from the Clozapine clinic who either had to stay at reception or do not work full time.
Other than this, when we first held a team meeting to come up with some change ideas, the changes which people in the team found of most importance were big systematic changes which we had no power over to do anything about. This meant we had to focus on smaller changes, but made us feel like we were ignoring what would be fundamentally important to the team.
What have you tested so far and what have you learned?
Here are some tests we’ve made:
A bake off – We organised a bake off as part of the Macmillan cancer charity coffee morning. We got a pack from Macmillan with promotional material to advertise the event. We all ate a lot of cake! The atmosphere was nice and everyone chatted and had a laugh. This change idea achieved its aim which was to build friendly rapport between staff. It was suggested by some members for this type of event to become a regular occurrence, e.g. ‘More of it, perhaps every 3-4 months. It was v good fun’.
We are also still testing and collecting data on: Plants in the office; Chill out room; Wellbeing lunch focusing on feeling valued.
What would you say to teams that are thinking about starting their own Enjoying Work project? Any tips?
My number one tip would be to make sure the WHOLE team are up for taking part. You need a good response rate on the ImproveWell app as that data will be the core that drives the project. I feel like the team should view the project as part of their day to day work life and not as a side project which someone else has responsibility for.
What is next for your team?
For now, we are going to work on interpreting the feedback we have received for the current ideas in place in order to make more improvements. We are also looking at new ideas, such as a friends and family test which we could use to get feedback from clients in order to make staff in the team continue to feel more valued.
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Business Development Unit: creating meaningful connections
Read about what motivated the team to start this Enjoying Work project and what they have tested so far in this blog by Lilu Wheeler, Business Development Projects Manager and QI project team leader.
The main aim of this Enjoying Work project is for us to feel happier at work. Feeling happier makes for a nicer environment to work especially as we spend a lot of our time here. This enables us to have better working relationships and be more productive. To measure this outcome we wanted to increase our Good Day Measure by 10% from baseline.
There were many changes within the team last year. Some long-term staff had left followed by a turnover of staff with just two people remaining. A new Associate Director started in the team and set to work helping with recruitment. We needed consistency and resources. In addition, we were moved to new offices which meant our team was split in two.
Alternative job titles: celebrating talents within the team and creating equality.
Essentially, it felt like things were done to us rather than the team having a voice and being able to make decisions collectively. Though we were very productive as a team, meetings were task-focused, ticking off to do lists with little focus on people. We were seeing high volumes of work but we were essentially reactive and not proactive. The recruitment of new team members and the Associate Director gave us a great opportunity to look at our processes and how we wanted to work as a new team.
Setting priorities and testing change
We went for an easy win for our first change idea by trying to create an aesthetically pleasing office. Sadly with the lack of light in the office, the plants we acquired died. We pulled together a matrix comparing what was most important to what most needed improving. We realised that a nice office didn’t make us happy in the long-term. We were trying quick fixes and on their own they don’t make a huge difference. What mattered to us was resourcing, remote/ flexible working and training and progression opportunities.
Flexible working helped not only child friendly practice and work adjustments but also supported the team generally. We are introducing new staff to the BDU over the next few months so the results of this won’t be realised for a few weeks at least. Hopefully better resources will mean we get opportunities to shadow other teams, learn and attend corporate events.
Reflecting on change ideas
We added ideas as we went along and have been setting up networking lunches with other teams. These meet-ups are about getting to know staff individually rather than staff we need information from. It has helped us to approach each other and communicate more effectively which helps when we have deadlines! It also helps to appreciate what each other does.
Sarah, BDU’s mascot, is outspoken, fun and a great listener. Also gives great ‘huggles’ (hugs+cuddles).
We learnt that though people were generally satisfied, one ‘incident’ can change how we feel, much like how patient-facing services react to an incident. For example this could be a colleague handing in their notice that day. It made a difference when we reflected on difficult situations and it helps to have time to step back and reflect. Part of learning is accepting that moments like these happen and being able to reflect and see it objectively. It helps to look back at your values as a team and why you do what you do. Our mascot is still reflective of us despite some changes in the team.
Tips for other teams
Putting the matrix together really helped us to decide where to focus our efforts, otherwise the team could spend energy on areas that will give little return.
What is next for the BDU enjoying work project?
We have more teams we would like to network with, that’s going to be ongoing. Our next steps will be to look at career plans and shadowing opportunities. Any offers from other departments to host our staff would be gratefully received. The Team will be almost fully recruited in January.
Learn more about the project here:
Watch a video poster presentation made by the team at the 2019 ELFT Quality Conference>>
Project Driver Diagram:
Please find some of the team’s supporting documents:
Note from the Project Lead: Please see below for videos I used to help create the matrix I showed. I have also attached the graph and Excel sheet for your information as requested. We pulled together change ideas using post-it notes and created a Driver Diagram in Life Qi.
The matrix was created by asking staff to rank the change ideas (Draft Q Matrix) in order of a) most important and b) Most needing change. I used Survey Monkey to do this.
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