Understanding the Problem (Working Well Handy Guide)
In this step, the team seeks to drill-down into the opportunity there is to improve their experience and wellbeing, valuing and hearing from as many voices as possible in the team. Here you will find information on Appreciative Inquiry, leadership, measurement and the hierarchy of needs.
Appreciative Inquiry
Appreciative Inquiry is a tool that can help your team to identify their strengths and apply them to tackle complex problems. Click here for the step-by step guide.
Click here to watch a puppet show about how Newham Child and Adolescent Mental Health Services (CAMHS) ran an appreciative Inquiry as part of their Enjoying Work project.
Anyone can be an Enjoying Work leader
Watch this 3-min video by Professor Don Berwick (President Emeritus at the Institute for Healthcare Improvement) about how to lead teams during Covid-19. Here is a summary of the key points of this talk. We encourage you to reflect on these in your role as a leader at the current time, and in particular how you are role modelling and promoting wellbeing at work.
Measurement
One core principle that can help any improvement effort to be meaningful and relevant is measurement. Before starting any work, measurement can help a team understand why this effort is meaningful and what specifically to focus on. As changes are tested, measurement will also help identify whether the changes that are being made are leading to improvement. Measuring and sharing the data can help keep people engaged in the effort and help tell the story of the improvement. It’s important to keep your measurement simple and relatable. Try to embed the data collection into an already existing process. Better still, use measures you already have.
Three top tips for measuring for improvement (Dr. Amar Shah, Chief Quality Officer at ELFT)
Collection methods:
- You can ask these questions during team huddles
- You can use free online survey tools like Survey Monkey, Microsoft Forms, Menti
Feedback Loop:
- Share the data back with the team as soon as possible
- Use the data and discussions from that data to plan test of change
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What matters to you and where do we want to be?
Find out how to use Maslow’s Hierarchy of Needs to draw out what matters to people in your team and help focus what you want to achieve together.
Maslow’s Hierarchy of Needs
Maslow’s hierarchy of needs is a motivational theory in psychology, it is often shown visually as a five-tier hierarchical pyramid. Needs lower down the hierarchy must be satisfied before individuals can attend to the needs higher up. It can be a really helpful tool to think about your own and your team’s hierarchy of needs and how you will adapt to fulfil these when working in different conditions.
Feedback
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Your local QI Coaches and Improvement Advisor are here to walk you through this guide and help you apply the methods. Click here to find these people in your directorate.
IHI Framework for Improving Joy In Work
With burnout and staff turnover in health care continuing to rise at alarming rates, this white paper describes four steps leaders can take to improve joy in work; a framework with nine critical components for ensuring a joyful, engaged workforce; key change ideas; and measurement and assessment tools.
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Leadership Behaviours (Yukl, 2013)
A copy of the Leadership Behaviours (Yukl, 2013) tool that Donna shared in Enjoying Work Cohort 3 – Learning Set 3 can be found here.
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Healthcare Leadership Model
The NHS Leadership Academy have developed the Healthcare Leadership Model to help you become a better leader in your day-to-day role. You don’t have to be in a clinical or service setting to use it. And it doesn’t matter whether you work in a team of five or are responsible for 5,000, you can benefit by discovering and exploring your own leadership behaviours.
Who is it for?
The Healthcare Leadership Model is useful for everyone because it describes the things you can see leaders doing at work and demonstrates how you can develop as a leader – even if you’re not in a formal leadership role.
How does it work?
The model is made up of nine leadership dimensions, which you can explore in your own time, at your own pace. You’ll find brief descriptions of each dimension – why it is important and ‘what it is not’ – so that you can fully understand it in relation to your role.
Once you’ve explored the dimensions, you may want to undertake the free self assessment tool, which helps you to assess your leadership behaviours and more fully understand your leadership development. A 360 degree feedback tool is also available to help give you insight into other people’s perceptions of your leadership abilities and behaviour.
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Leading through COVID-19
The King’s Fund have pulled together learning and resources for leading through COVID-19, supporting health and care leaders in unprecedented times.
These pages aim to provide support to health and care leaders, whether you are working in the NHS, social care, public health or the voluntary and independent sector. We want to ensure this is practical, helpful and works for you. So please use the form below to tell us how we can help. After that, you’ll find the first of our quick-read practical guides and videos.
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Checking in with your team
Use this guide for a suggested exercise on how to do this.
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Enjoying Work Cohort 3 Appreciative Inquiry
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QI-Lite cherry picking techniques and tools
Using an Appreciative Enquiry with Cancer and Palliative Care Nurses.
Dr. Sara Rasool, from Macmillan Consultant Clinical Psychologist & Lead for Community Health Psychology Services. (Beds and Luton), updated the QI Department on how the use of an Appreciative Enquiry helped her and her team reflect at their team Away Day in February.
Adopting tools from QI methodology and applying them to novel situations can work very effectively.
I was asked to an away day for Cancer and Palliative Care Nurses from Luton & Dunstable Hospital, to help think about well-being. In my role as a Consultant Clinical Psychologist, I and most of my team of clinicians offer monthly supervision to cancer and palliative care specialist nurses and often among the clinical case discussion the theme of increased demands with limited resources emerge, negatively impacting stress experienced and in turn impacting up on their emotional well-being. A picture common to many areas in the NHS.
The away time was short but offered an opportunity to reflect up on their experiences of work and consider ‘what made a good’, rather than focus on a problem saturated story. An ‘Appreciative Enquiry’ technique was adapted by using a series of simple questions.
The nurses where first asked to discuss in pairs:
1.‘What matters to you when you come to work?’. 2.‘What was one memorable ‘good’ day at work for you?’ 3.‘What components made it a good day?’
The nurses were asked to think individually and write these components on post-it notes. Then they were asked to sort these in small groups silently into themes, once completed, to share the emerging themes with the wider group using some examples. The final question was –
4. What one thing can you do tomorrow to improve your chances of having a ‘good’ day?
It was important to acknowledge the wider organisational and process challenges faced in the work place, but in spite of these, the nurses generated many immediate change ideas which in QI we would call ‘quick wins’. Some included, a lunchtime walking group, starting the day with a coffee, organising a daily work plan, and an end of day reflection of what went well. Capturing these possibilities demonstrated agency in the nurses to make small changes to improve their working day.
The nurses reflected on the task and shared their appreciation of taking the time to have a meaningful conversation about ‘what makes a good day’.
By Dr Sara Rassool
Macmillan Consultant Clinical Psychologist & Lead for Community Health Psychology Services. (Beds and Luton).
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