culture of compassion, Diversity, Leadership, NHS Leadership, Organisational development, staff engagement, wellbeing

Staff engagement – a matter of life and death part 2

The world of work is changing and our expectations of organisations and how we experience the 40 hours or more we spend working every week is changing.  Organisations that do not create environments where people can bring their whole selves to work will quickly find themselves without a workforce as people will make different choices.

Creating environments in which people feel their purpose is fulfilled, their passion is ignited and are proud to work in is the role of leadership in the 21st century.

My last blog post described the importance of staff engagement for the health of an organisation.  For an organisation like the NHS, it vital to have happy, proud, empowered staff as the levels of connectedness that staff feel in a healthcare organisation has been linked to the mortality of patients.

The happiness of our people is something that we work on every day however my personal belief is that the term ‘staff engagement’ is a passive term and instead we should talk about how we nuture our people to ensure that our staff feel involved, empowered and proud to be part of of our oganisation.

The 2016 NHS staff survey results are due to be published on 7 March 2017 and last year we took the approach that despite being the top in our category of acute and community provider, we were restless to improve our scores and so as well as celebrating and amplifying what went well we also acknowledged that there were 3 key areas that we scored in the bottom 20% on that we wanted to make a difference in, which were:

  1. Equal opportunities to career progression
  2. Staff experiencing discrimination from staff or patients
  3. Staff working long hours

We identified ways to support this at both a Trust-wide level as well as within the individual directorates.  Each directorate came up with their top 5 actions to support improving in the areas that their own staff had identified and as an organisation we have focussed on the top 3 listed above.  Througout the year we introduced the following:

Equal opportunities to career progression

  • managers to have ‘career coaching conversations’ with their team members during appraisals or other suitable times
  • Realising Your Potential conference for a cross section of staff with our partner trusts
  • Surveyed and ran focus groups with different generation groups (Baby Boomers; Generation X; Millennials and Digital Natives) to find out what is important to them to inform training and development (with more to come on this next year)

Staff experiencing discrimination from staff or patients

  • Leadership masterclasses on inclusion and unconscious bias
  • Unconscious bias training introduced into different training courses across the Trust
  • Violence and aggression campaign run in conjunction with the Metropolitan Police to support keeping our staff safe

Staff working long hours

  • Reduce our email usage culture and encourage ’email free Fridays’ and managers spending time out about in clinical areas with their staff
  • The Model Ward (Nightingale Project) which is rolling out standardised practice on the wards for the first hour and last hour of the day with a safety huddle in the middle of the day to ensure all staff start and leave their shifts on time.

A couple of weeks ago I took part in a webinar for the UK Improvement Alliance along with Caroline Corrigan from NHS England, talking about how to engage staff in change.  This webinar and introductory video focussed on some of the things that we have put in place to ensure that Guy’s and St Thomas’ is a place where staff feel proud to work.  If you missed it you can catch up here.

I hope that some of the things that we have experimented with this year have made a difference to our staff and to test this we have made sure we are full census for the next three years to ensure every one of our staff has a voice.  Watch this space for the feedback!

About the author

Sarah Morgan is the Director of Organisational Development for Guy’s and St Thomas’ NHS Foundation Trust.  An organisation in the English NHS with 15,000 staff that cares for patients in the London Boroughs of Southwark and Lambeth, across the South of England and both nationally and internationally.

Standard
Authentic Leadership, culture of compassion, Leadership, staff engagement

Staff engagement – a matter of life and death?

Most of us spend more time at work than we do with our friends and families.  Ensuring that the workplace is somewhere you can bring your whole self to work is incredibly important for our wellbeing.

In the 2015 NHS staff survey nearly 40% of staff reported feeling unwell due to work-related stress.  This suggests that staff are not able to bring their best to work and deliver high quality patient care.  In fact, in the same survey 41 % of staff would not recommend their trust as a place to work and 31% did not feel they would recommend their organisation to a friend or relative as a place to receive treatment.

These are stark figures, particularly when staff wellbeing in the NHS is proven to have an impact on patient mortality rates and patient care.  The Royal College of Physicians published at report in October 2015 stressing the need to improve work and wellbeing for NHS staff to keep patients safe.  Proving that in the NHS happy staff really is a matter of life and death!

I’m passionate about the need to create organisations that enable people to flourish.  I am not particularly keen on the phrase ‘staff engagement’ as I think it’s more about building organisations that people are proud to work at and can bring all of themselves to work.

On Monday 30 January 2017 at 10am I’m presenting a free live webinar on the topic of engaging staff in change.  I’ll be talking a bit about how we’ve been working hard to really make Guy’s and St Thomas’ an organisation that staff are proud to work for and recommend to their friends and family to receive treatment.

As a taster I’ve made a short video talking about some of the approaches we have taken over the past ten years, starting with our values and behaviours in 2006.

If you’re passionate about bringing more love into the workplace, have any questions or your own approaches to share then on the webinar, you can still register here.  It would be great to see you.

About the author

Sarah Morgan is the Director of Organisational Development for Guy’s and St Thomas’ NHS Foundation Trust and the lead for staff engagement and leadership for the Trust.

Sarah’s eight part blog series on ‘How to get more love into the Workplace’ was nominated for a UK Blog Award – healthcare in 2016

 

 

 

 

 

Standard
Authentic Leadership, culture of compassion, Leadership, Motivation, NHS Leadership, Organisational development, Resilience, wellbeing

2017 – My year of Focus

I was asked at the beginning of the year what my word for 2017 is and I decided it is ‘Focus’.

Just before Christmas I found myself in a complete state of overwhelm and was working inefficiently, flitting from task to task; meeting to meeting and trying to juggle too many variables at the same time.

Over the break I took time out to reflect and think about what I wanted to do differently in 2017 and came to the conclusion that less is more and I needed to re-prioritise.

I realised that in order to stay resilient I need to be more discerning and disciplined with my time, to not give it away too easily and spend more time on the things that energise me and make me happy in life including my spiritual and physical wellbeing. Most importantly I need to prioritise my time with my friends and family and ensure that I’m not taking them for granted.

I have decided to prioritise to five key things to focus on, which are:

1. The creation of a diary management system to prioritise both my work and social to have a much better use of time. This includes saying no more often and builds in protected time to think; write and research to ensure we stay ahead of the curve in leadership; OD and new models of care. This will ensure I can dedicate the right amount of time to the three major programmes that I am currently leading. I’ve designed a colour coding system so I know what is a must-do and what I can delegate or drop if necessary.

2. Limiting my social activities to only having one to two nights a week when I’m going on to an event after work. Prioritising things that I’m really passionate about. I became a Fellow of the Royal Society of Arts in November last year and am keen to connect with their Reinventing Work network as is connects with my passion of creating more love in the workplace – the theme of my 2016 blogging year.

3. Leaving work on time to go to the gym and making time to get enough exercise. Particularly reconnecting with the activities I love such as yoga; climbing and recently I’ve gone back to High-Intensity Interval Training (HIIT) . Even after a few short weeks it’s making a real difference to how I’m feeling.

4. Improving my sleep as before Christmas I was only getting 5 hours a night and I was finding it was affecting my decision-making and judgement. I’m experimenting with making sure that I’m winding down and in bed for between 10pm and 11pm to make sure I’m getting enough sleep aiming for between 7 and 8 hours a night to try and maintain my ability to stay focussed

5. Writing To Do lists is something that I have to really discipline myself to do. I’ve been lucky enough to have been able to rely on my memory for keeping me on top of my workload for my working career. However I noticed that as I became more overwhelmed, coupled with getting less sleep I found that I was starting to forget to do things until the last minute, which is very out of character. I find writing a To Do list quite cathartic and am using magic white board paper on the wall to write things down as well as using a To Do List book and a daily ‘plan of attack’ to make sure I prioritise every day. I find the discipline hard but rewarding when I do it.

I’m hoping that by putting in place these simple changes I’ll stay resilient; passionate; achieve more in my working day and have a greater sense of wellbeing. I’m starting to see the shoots of improvement and I’m encouraged to stick with it for now.

I hope you’ll stay focussed with me in 2017!

 

About the author

Sarah Morgan is the Director of Organisational Development for Guy’s and St Thomas’ NHS Foundation Trust

Sarah’s blog was nominated in 2016 for a UK Blog Award – healthcare

Sarah is passionate about getting more love into the workplace which was the theme of her 2016 blog series and nominated for the UK Blog Award

Standard
culture of compassion, Leadership, wellbeing

Put your energy in the right place – how to get more love in the workplace – part 5

I had a revelation this week; one of those Aha! moments that come along very infrequently but when they do they make a significant difference. It was about energy and the need to put your energy in the right place to increase your work productivity and sense of well-being.

It emerged during a coaching session when I was thinking about how to more effectively lead the programme that I am currently directing. What became clear was that as the programme is in the start-up stage and does not have a full team in place, my energy has been spent in the mechanics of the programme, administrating and being ‘in the weeds’ of the day to day rather than strategising and thinking through the policy implications.

My preference is for global (strategic) thinking, which is right brain dominant and leads to a focus on the future state; the big picture and people with this preference thrive on experimenting and spend time ‘thinking’ rather than ‘doing.’ This means that when I put my energy into detail; reactive activities and short term tasks, it results in a drain in my energy.

I had convinced myself that I was getting to the end of the week exhausted and lacklustre due to the fact I had been spending all of my time on intellectually challenging activities; however when I really thought about it and closely examined how I spend my time during the week it became clear that the majority of my time is spent in meetings and working on the mechanics of setting up the programme leaving only a small amount of time left for thinking and working on strategy and policy development.

This has started me thinking about energy and how to use it more wisely to be more productive in the workplace by focusing it in the right places. A further look into some tools and techniques for how to do this best revealed a really informative Harvard Business Review article about ‘how to manage your energy not your time.’ The article identifies that energy is defined in physics as the capacity to work, and comes from four main wellsprings in human beings: the body, emotions, mind, and spirit. It suggests that it is possible to systematically expand and regularly renew energy through specific rituals, which are described as behaviours that are intentionally practiced and intentionally practices so as to become unconscious thinking.

This article summed it up for me: “To access the energy of the human spirit, people need to clarify priorities and establish accompanying rituals in three categories: doing what they do best and enjoy most at work; consciously allocating time and energy to the areas of their lives—work, family, health, service to others—they deem most important; and living their core values in their daily behaviors.” Take their test to see if you are heading for an energy crisis and for top tips on how to prevent it.

My revelation has made me think more widely about the fact that, despite having the highest staff engagement scores in the country, my organisation is in the lowest 20% of Trusts scoring that staff are working long hours and we are noticing that for the first time stress due to workload is on the rise. Finding the approaches that are going to make the difference in busy, healthcare environments is very difficult. Working on helping staff to manage their energy may be the completely different approach we might need to consider.

Over the next few months I’m going to be trying out some of the new techniques coupled with applying the learning from Covey’s 7 Habits of Highly Effective People (more on this in a future blog) to see if I can change my energy balance; be more productive and fulfilled and hopefully make more quality time for my team and colleagues.

Resources used:

Identify the difference between strategic and global thinking http://www.selfgrowth.com/articles/are-you-a-linear-or-global-thinker

Test whether you have a strategic or a linear thinking preference http://www.harvardbusiness.org/blog/are-you-strategic-thinker-test-yourself

 Full article from Schwartz and McCarthy; 2007; Manage your energy not your time; Harvard Business Review https://hbr.org/2007/10/manage-your-energy-not-your-time

Covey; Stephen R; The 7 Habits of Highly Effective People; Rosetta; 1989 

About the author

Sarah Morgan is the Director of Organisational Development and the Vanguard Foundation Healthcare Group Programme Director for Guy’s and St Thomas’ NHS Foundation Trust

Standard
culture of compassion, Leadership, Organisational development, Staff development

How to get more love into the workplace – Part Two

What better day to talk about love in the workplace than Valentine’s Day? The day when we profess our undying love for the focus of our affection; we can choose to keep our identity a secret or reveal all; we wear our hearts on our sleeve and chance rejection. We take that risk in the name of love.

The workplace can be a minefield to navigate. There are different ‘tribes’; power dynamics and unsaid rules. It often takes courage to say what you really think; stand up for what you believe in and wear your heart on your sleeve. The question is why? Why do you sometimes feel psychologically unsafe if you speak out? Why are diverse views shied away from rather than encouraged? I can’t profess to fully know the answers to these questions, but I do suspect that it stems from a need to belong and our tribal instincts kicking in. This can lead to bad behaviour; exclusion and a general lack of compassion towards our workmates. There’s an interesting Switch and Shift article on this if you want to read more.

So, if it’s an innate part of us, how do we get more love and compassion into the workplace?

Well to me it’s about appreciating what others have to offer. There’s an old African proverb that says, “If you want to go fast, go alone. If you want to go far, go together.” This sums it up for me. Often we are imbibed with a sense of urgency; short deadlines; stretching targets and the volume of work and weight of expectations is ever increasing. Naturally, this gives us a tendency to lean towards the ‘going fast’. Other people, who may have a valid, but different point of view, could slow us down, and we haven’t got the time to ‘bring them round to our way of thinking’ so instead, divergent views are at best ignored or worse ridiculed and those offering them made to feel inferior or stupid.

Over time, divergent views stop being offered, which gives rise to a different challenge, that of ‘groupthink’. This was described by ACCA in their December 2015 article on the need to diversify Boards as a “psychological behaviour of minimising conflict and reaching consensus without critically evaluating alternative ideas.” Often this is found in highly regulated, performance target-led environments such as banking and healthcare.

The predominant leadership style in the NHS is ‘pace setting’(1) . At first glance this sounds like a style that would get results; sets high performance standards whilst exemplifying delivery themselves; however over time it can have detrimental impact as it depersonalises the work environment, making it all about hitting the targets whilst forgetting about the human aspects.

In healthcare, we talk a lot about the need for compassionate care but often we overlook the need to have compassion in our everyday interactions with our colleagues. We need a more human touch in the workplace. To me this includes treating others as you would want to be treated and showing compassion in meetings as much as on the wards. It also means having honest conversations with people, especially if they are not performing as expected, rather than avoiding the difficult issues and potential conflict and then letting things escalate, potentially leading to festering resentment.

To summarise I think compassion in the workplace involves the following three aspects:

1. Treating people as individuals – acknowledging we are all different and have divergent views and opinions. Building relationships and trust on this basis and being as open and honest as possible.

2. Being open and honest – it’s often much easier to develop a ‘parent/ child’ relationship between manager and staff member than it is to have an adult to adult relationship (2) . Having honest conversations and being open when things are not going as well they might takes quite a lot of courage for some managers. It is far easier to not address issues but this just builds ill will over time. Voicing your opinion and being true to yourself, colleagues and staff, will enable a much more positive and transparent environment.

3. Valuing others’ opinion – as well as voicing your own opinion, allowing others to voice theirs without immediately responding or trying to bring people round to your way of thinking. Often this is more difficult than it sounds, but really listening to other people and opening your mind to other possibilities is the key to working with colleagues from different professional backgrounds, organisations and industries. Working out how to collaborate and work through the net benefit, so there is a shared and collective understanding and an agreed way forward, takes real skill.
I think if we all listen a little more; talk a little less and think of the person in front of us as a fellow human being, we might just start to get a little more love in the workplace.

Happy Valentine’s Day!

image

 

1   Leadership that gets results; Daniel Goleman; Harvard Business Review; March 2000.

2.Eric Berne; Transactional analysis (parent, adult, child model); 1957.

About the author

Sarah Morgan is the Director of Organisational Development for Guy’s and St Thomas’ NHS Foundation Trust and a passionate advocate of creating conditions in the workplace to enable creativity and innovation to flourish

 

Standard
Authentic Leadership, culture of compassion, Leadership

How to get more love into the workplace – Part One

In my last blog post I shared my new years resolution for 2016, which is to get more love into the workplace.  This is part one of my approach.

I’m posting this from a snowy Colorado mountain on Martin Luther King Day; which seems very apt as MLK once said, “I have decided to stick with love. Hate is too great a burden to bear.”

MLK was a truly authentic leader who spoke out for what he believed in and empowered people to think and act in a different way.

It’s been a tricky start to 2016. With industrial action from junior doctors and the continued struggle with waiting times and financials; it’s starting to feel as though the old methods just aren’t working for us anymore and a new approach is needed.

It seems to me what is needed is a new leadership approach that moves away from traditional pace-setting, command and control styles that have dominated the NHS for at least the past decade, to a more authentic leadership style – MLK style. One that supports staff with the right tools and techniques to make the changes needed on a day-to-day basis, without the bureaucracy of committees that are – in some cases – far removed from the frontline.

The NHS has a good track record of supporting staff with training in tools and techniques, but what has always been lacking is a systematic way of improving the services and solving problems as they happen. Many healthcare organisations have trained up hundreds of their staff in various quality improvement techniques, though few have managed to leverage the benefits. What has been missing is the infrastructure and governance that allows decisions to be taken quickly, at the frontline, at the time it’s needed.

In the past, managers such as myself were trained to be ‘heroic leaders;’ i.e. it was their job to solve the problems (otherwise what are they doing?); however the time for this has now passed – if it ever really was the right approach – and it’s time to really think differently about how we support our staff.

In my view, there are three steps that leaders could take to become more authentic and to enable more effective decisions to be taken as close to the patients as possible:

Step One admit you don’t know all the answers and place the decision making in the hands of those who do; especially those at the frontline. That is a very big ask in this world of accountability and takes bravery; however it has been proven to yield effective results in healthcare systems elsewhere in the world.

Step Two give the staff the tools and techniques to make the necessary change. Supporting clinical staff by training them in quality improvement techniques; using data effectively and understanding how to manage change has the potential to make more of a difference in two months than a year’s worth of committee meetings.

Step Three take the governance to them. Don’t expect clinicians to navigate the intricacies of the corporate governance that many of us spend our days steeped in. Work with intention and develop a systematic approach that allows decisions to be taken quickly and easily. If needed, schemes of delegation can be drawn up to keep everyone safe. Knowing that the intention behind the decision is to ‘make things better’ for patients and staff whilst supporting clinicians to understand the constraints will unleash their creativity. As the saying goes ‘innovation loves constraint’. A really successful example of this is the Virginia Mason test: ‘What can you do with half the money, half the staff, half the space?’ This has supported them to radically change how they deliver healthcare at the same time as increasing quality and reducing cost – the holy grail.

In my view, these three steps will go a long way to bring about a more authentic leadership approach which will lead to a better engaged and enabled workforce and overall more love and wellbeing into the workplace. The question is, can we do it quickly enough to make the difference? In reality, do we have a choice?

I’ll leave you with the words of Mark Twain; “There isn’t time, so brief is life, for bickerings, apologies, heartburnings, callings to account. There is only time for loving, and but an instant, so to speak, for that.”

About the author

Sarah Morgan is the Director of Organisational Development for Guy’s and St Thomas’ NHS Foundation Trust

Standard
Leadership, Organisational development, patient centred care, Staff development

OD in the NHS III – visiting OD of the past, present and future

As a social animal I’ve always been a ‘joiner’, wanting to have a sense of belonging and a community to call my own. I’ve not had that feeling in the NHS since I was on the graduate scheme in the early 2000s; that is until today at the third DoOD ‘OD in the NHS’ conference.

The 200 delegates, representing 150 organisations found their way to the centre of London to share, learn, connect and grow. Building on the inspirational conference held in Bristol back in March, this was the ‘coming of age’ and a maturation of the OD community from its inception in February 2013.

After an hour of coffee and networking, the conference opened with plenary session led by the two stars of DoOD Paul Taylor and Karen Dumaine. In typical Paul and Karen style, they started the session by terrifying themselves (and us) by launching with not one but two ignite presentations. I was new to this concept (5 mins, 20 slides and 15 seconds per slide) but I absolutely loved it! It set the tone and energy for the rest of the day as Paul rattled through the story of DoOD – 1 million minutes told in 5 and Karen tantalised us with agenda for the day – a trip through an OD of the past, present and yet to come. The promise was the rare luxury of a safe place to stay sharp. So far, so energised.

Taking a steer from Peter Drucker’s premise that “the best way to predict the future is to create it” an eminent panel of speakers projected themselves to 15 July 2020 to have a rich debate Newsnight style, on how it feels to have achieved the goals of the Five Year Forward View (5YFV). Listening to the panel who spanned acute and mental health providers, Monitor, NHS Employers and the NHS Leadership Academy it was clear that the future is in our hands and OD has a huge part to play in supporting ways of working that bring ‘joy’ back into the workplace. ‘OD is the alchemy of great performance’ coined by Danny Mortimer Chief Executive of NHS Employers (home of DoOD) really resonated and his words ringing in my ears as we moved into our ‘thinking differently workshops’.

Stimulated from the panel discussion I headed into Mike Chitty and Kash Horoon’s session on Systems Thinking. I’ve been wrestling with concept of systems thinking and systems leadership so I’d been looking forward to this session. Kash told us the story of DevoManc and then we examined what this means for systems thinking (apparently different to systems leadership) in a wider discussion. My take away was that in essence in order to be a systems thinker you have to accept that we are in a complex and adaptive system which is unknowable and ask questions to reveal what the change should be. We need to resist the urge to analyse and become reductionist in order to try and solve problems. This made me question whether or not the NHS is ready for this and if not, what would need to be in place for it to become ready? It piqued my interest and I took away more questions than answers, so more musings required.

My mind blown and my tummy empty signalled it was time for lunch. I took the opportunity for some reflection before heading into the session straight after lunch with Practive on the power of changing our language and structuring our dialogue to bring about much more effective conversations.

Based on David Kantor’s Four Player model which examines the roles of Mover; Follower; Opposer and Bystander and how to take a positive position in each one to engender an effective dialogue. Kantor found that ‘when a team is capable of communicative competency, there is an exponential leap to effectiveness. By becoming more competent, the team accelerates it ability to define new outcomes.’ This took me back to the morning session of future-basing for the NHS and the fact that the key to success is not using the same thought processes and methods to define the new world as we have done the old.   Enabling the system to design the new world is a pivotal role for the NHS OD community.

This will require significant culture change, so my next session was perfectly timed. Having attended Stefan Cantore’s session at the last OD conference I was really looking forward to his session on Culture Change using the Theory of U as a change enabler. Stefan took us through a set of provocative questions delivered through a journaling technique that revealed thoughts I did not even realise I had.   I found this incredibly useful to frame a live issue that is on my mind at the moment and coupled with a few minutes of mindfulness, I came away from that session with more clarity than several weeks of thinking in a busy work schedule had managed to generate.

Saving the best until last (and believe me the bar was set high throughout the day) the final session with John Scherer and Amy Barnes took us through the history of OD and how the practice has developed through today and beyond, ‘in order to create the future you must respect the past’. This session gave us practical tools and techniques for how to use action research to really get to the heart of issues and co-create solutions with our clients. My favourite quote was John Scherer who said, ‘it takes courage and heart to be a really good OD consultant’. This was a high energy session where we explored how to formulate quantitative questions using a Likert scale approach and how to have really effective one to one interviews imbibing the ‘Vegas principle’, which is exactly what you think it is!

At the end John challenged us to think about ending every meeting by asking 2 Likert scale based questions:

  1. On a scale of 1 to 5, how interesting or useful was the content/ process of our meeting?
  2. How could we make it better for next time?

I’ll be trying that one out on my team.

I finished the day richer than I started. There were questions whirring through my mind with a hunger to find out more about the things I heard; the networking led to a conversation about the opportunity of a buddying relationship with another teaching hospital and to top it all off I won the prize draw – the book ‘A Field Guide to Organisation Development; Taking Theory into Practice’. A fantastic end to a fantastic day.

The OD community have definitely come of age and I feel honoured and privileged to be part of the movement, with two membership badges to pledge my allegiance.

 

Pin badges

 

About the author

Sarah Morgan is the Director of Organisational Development t Guy’s and St Thomas’ NHS Foundation Trust

Blog first published as guest blog on NHS Employers website on 21 July 2015

http://www.nhsemployers.org/campaigns/organisational-development/grow/grow-od-masterclasses/od-in-the-nhs-iii/visiting-od-of-the-past-present-and-future

Standard