Aloha from the beautiful Hawaiian island of Maui.
Aloha means love and is the traditional Hawaiian greeting for friends, loved ones and strangers. This universal approach to love fosters fellowship and kindred understanding within Hawaiian culture; a culture of love which I think we need to bring into the workplace. Catch up with Part One and Part Two.
I was in the US on ‘Super Tuesday’ (Tuesday 1 March 2016), when eleven states voted for their favourite Republican and Democratic candidate. What fascinated me more than anything were the two questions that pollsters were asking:
“Do you think this candidate best represents change?”
“Do you think this candidate best represents your values?”
The results were quite astounding. More people rated Donald Trump as the candidate that represented change, however rated him least aligned with their values. Despite this lack of alignment with values he went on to win the majority of the states that day.
This started me thinking about what we mean by change and how that aligns with our values.
In the NHS we talk a lot about ‘culture change’ and ‘transforming services’ however we often can’t articulate a change from ‘what to what’ or describe what transforming services will mean for our patients and staff.
Is it good enough to have a culture that is strong on values; patient centric and spends a considerable amount of time getting the basics right rather than consistently striving for change?
Patients can find it difficult to judge great patient care as they are often having a once in a lifetime experience. What patients do know is how the staff make them feel, whether the healthcare provider feels like a good place to work and if the staff feel valued. Having a culture that is values-driven, brings more love into the workplace and has the ability to unleash the intrinsic motivation of staff to deliver the best quality care that they can is surely the Holy Grail for every healthcare provider?
This sounds a sensible and obvious approach, however it is not one that is found universally throughout our health system. Why is that the case when it seems to be a winning formula?
Well going back to the Super Tuesday, change is often regarded as the main requirement regardless of what the change will bring. Leaders have to be seen to be doing something and with the average tenure of a Chief Executive in the NHS being 700 days; then they have to be seen to be doing something quickly. Discovering the values of an organisation takes time and patience and therefore often doesn’t yield the results quickly enough. So how do we put values first?
Changing organisational culture through values was the topic of a Royal College of Physicians Future Hospital Journal article I contributed to in October 2015. This charted the leadership journey of Guy’s and St Thomas’ NHS Foundation Trust which spanned almost a decade to drive a values based culture. This work was undertaken with the staff through a process of discovery and has taken patience; fortitude and an unrelenting focus on the basics by the leadership team (1). The leadership team at Guy’s has been relatively stable with only a recent change in Chief Executive Officer after eight years.
This patience, hard work and focus on values has paid off. In the 2015 staff survey results, Guy’s and St Thomas’ came out top in acute and community trusts for staff engagement. The basics of staff feeling able to speak up; recommending the Trust as a place to work or receive treatment and feeling that the Trust considers patient care a priority were all top in class scores.
This approach has not been easy and, like many other organisations, in order to keep pace with the NHS finances and upward demand, we will need to adapt our approach, however we will do this through a continued focus on our staff and our values.
One thing is for sure, change for change’s sake has no place in high quality healthcare provision.
(1) 2006 Infection control
2012 Fit for the Future – quality, safety and efficiency
2013 Barbara’s story – focus on dementia patients 2013
2015 Speaking up
About the author
Sarah Morgan is the Director of Organisational Development for Guy’s and St Thomas’ NHS Foundation Trust