Working Well Handy Guide
Introduction
This Working Well Handy Guide is designed to be used by teams and individuals to help them build staff satisfaction and wellbeing using a Quality Improvement (QI) approach. It is bite-sized and practical – ideal for the COVID-19 landscape where a formal QI project may not be practical. It has been built on East London NHS Foundation Trust’s (ELFT) learning from supporting over 40 teams through Enjoying Work projects over the last 4 years.
How to navigate:
- The graphic at the top of each page has clickable text that helps you navigate the sections of the guide in sequence. Start from the left and work towards the right as your improvement effort progresses.
- Each step in the sequence has a ‘Try This‘ clipboard. This is a ready-made activity you can try with your team to apply the theory.
- Be sure to see all the resources for a section by pressing ‘Click to see more…’.
Welcome message from Dr. Amar Shah – Chief Quality Officer
Table of Contents
Below is a brief summary of what is covered in each section of this guide.
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Identifying a Quality Issue (Working Well Handy Guide)
This is about paying attention to the sentiment of the team to identify emerging themes or recurring issues that are negatively affecting staff or the functioning of the team. Learn what approach to use or who to involve>>>
Try This:
Here is a simple activity you can do at your next team huddle or team meeting as you start on this journey.
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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. This will help shape what they work on together and what they want to achieve in terms of building up the team as a whole and the staff. This is where you will find information about Leadership, Measurement and What Matters To You conversation.
The roles of Leaders
The role of leaders in the wellbeing of people at work They are intended to help you reflect on your role in the wellbeing of the people you lead, and to help you to develop your effectiveness as a leader in promoting wellbeing.
Measurement
One core principle that can help any improvement effort to be meaningful and relevant is measurement. Just 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 and 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:
- The questions above
- You can ask these questions during team huddles
- You can use free online survey tools like Survey Monkey, Microsoft Forms, Menti
- The trust has access to the ImproveWell platform which is available both as an app and on the desktop, where you can also create surveys and have daily check ins with your team. For more information, click here>>>
Feedback Loop:
- Share back the data as close to real-time as possible
- Use the data and discussions from that data to plan test of change
A quick and easy option is to use emoji’s to get a sense of how the team are doing.
Checking in with your team
It can be really helpful to have a simple and easy way to check in with your team, it can be hard to judge this when teams are working remotely or under different conditions. This could just be sharing an emoji on a team chat and using this a basis for checking in, or perhaps asking people to share a number out of 10 for how they are feeling.
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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.
Example:
The QI Department ran through the exercise above and below is the hierarchy of needs we created.
See results below from the Quality Improvement Department.
Further Resources you might also be interested in:
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Developing a Strategy and Change Ideas (Working Well Handy Guide)
In this step you bring together everything you have learnt so far as a team about how things are and where there is opportunity for improvement. You use that to develop your strategy for what you are going to focus on specifically that will have the greatest impact on staff experience and wellbeing.
Nominal Group Technique
Find out how to use one of the most popular group engagement techniques in quality improvement, Nominal Group techniques. You will also find an interesting way of using it virtually.
How to involve everyone in generating ideas. (Dr. Amar Shah, Chief Quality Officer at ELFT)
Nominal Group technique is a quick and easy way of generating ideas in a group in a way that allows everyone’s ideas to be heard doing this.
How can we do this virtually?
One way in which you could do this virtually is to use the Microsoft Teams app whiteboard feature.
Whiteboard – Invite someone to collaborate on the board with you from your team
- Create a new whiteboard
- Invite those from your team to collaborate on it – Either by inviting or via the share to Microsoft Teams button
- Each person then adds a post-it note and then typing whatever idea they have
- Each person repeats this for each idea they have until you are all out of ideas
- Agree that a couple of people start to theme the ideas by dragging the post-it notes so they sit together
- Colour the different groups you have and give each a heading
- You can vote on individual change ideas by clicking on them and pressing the like button
Top Tips from Enjoying Work Project Teams
Below are some top tips for looking after yourself and your team which some of the 40+ Enjoying Work project teams from across ELFT have tested out. These might be things that you want to test with your own team.
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Testing and creating feedback loops (Working Well Handy Guide)
This is where your team will spend most of its time – testing ideas at a small-scale as quickly as possible and learning from those tests before scaling up successful tests.
Plan-Do-Study-Act Cycles
PDSA cycles allow you to test your ideas and learn what works or doesn’t work then adjust your approach. The idea is to start testing as soon as possible, don’t wait for the best conditions. Run a small test e.g. one staff member, one hour and loop back to review what you learnt from the test. In most cases, you will need to adjust your change idea through a number of PDSA cycles before it starts to work reliably. The key is to have a specific question you want to answer from the test and a prediction of what will happen from running the test.
Key concepts on how to test ideas. (Dr. Amar Shah, Chief Quality Officer at ELFT)
Example:
Have a look at two PDSA cycles run by one team around the possibility of working remotely in response to the COVID-19 pandemic.
Also see this example around how we have used PDSA to develop the Personal Protective Equipment (PPE) ordering process at ELFT>>
Further Resources you might also be interested in:
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Implementation and Sustaining the Gains (Working Well Handy Guide)
At this stage you will be taking steps to embed into business as usual ideas that have been tested and seen to work. This is something you do throughout the life of your improvement effort. Largely it boils down to thinking about how you can make the changes part of just the way you do things.
The six steps for adopting successful ideas into routine practice. (Dr. Amar Shah, Chief Quality Officer at ELFT)
Try This:
Follow the steps in this one-page guide which gives you a quick overview to what implementation is and how you might go about it.
Further Resources you might also be interested in:
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Celebrating Our Learning (Working Well Handy Guide)
One of the best ways to keep the momentum going in your team as you try different ways of improving wellbeing and satisfaction is to share stories regularly within your team and the rest of the world about how you are getting on.
The value and impact of sharing stories. (Dr. Amar Shah, Chief Quality Officer at ELFT)
Storytelling
A good improvement story engages people’s curiosity, emotions and imagination. It does not have to be a full summary at the end of a piece of work, be focused on success, be supported by data, a long account of an event, an answer to big problem nor does it have to take a lot of time to capture and share. A story can be an account of part of an improvement effort, a summary of someone’s experience, something that informs a debate or raises awareness of a subject, a simple picture, video, soundbite and the like.
See more examples of stories from teams who have used these tools and techniques as part of the enjoying work learning system
Illustration from Enjoying Work Cohort 2 Learning Set 5
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ELFT Employee Wellbeing
Find a simple summary of how the ELFT Employee Assistance programme can support you with your physical, emotional, financial, social and environmental health.
Care First 0800 174 319
Please direct any queries to Elft.employee.engage@nhs.net
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