Starting to develop ‘Behavioural Indicators’
A practical guide
Session guidance for facilitators
This practical guide is intended to support you and your organisation to develop
behavioural indicators that underpin your values. At the Oxford University Hospitals
NHS Trust, we held focus groups with 750 employees and stakeholders to develop
our behavioural indicators for our 6 values. This equated to 6% of our workforce at
the time.
We also included in depth interviews with our patients and stakeholders. We found
that this was sufficient to reach our ‘saturation point’ however; we would advise that
you speak to 10% of your staff to increase your evidence base for your behavioural
indicators. These sessions are intended to build your organisations language into
your behavioural indicators which we see is an essential step for your organisation if
you are developing values based recruitment.

Focus group purpose and objectives
The objectives of the focus groups are:
1) To hear the views of key stakeholders on what are the essential values,
behaviours and attitudes of our staff.
2) To record examples of positive and negative behaviour related to our values
which can be used to create values interview questions and criteria for
recruitment purposes.
3) To translate our behaviours into language which can be understood by
applicants and which can be recruited against.

Outcomes
The focus groups will aim to record the views of key stakeholders and use that
information to influence and inform the formation of questions to be included in the
recruitment process at your organisation.
The session should run for 90 minutes and we advise a minimum of 15 attendees for
any session. The setup of the room should ideally be set up in 3-4 small tables.
Around the room, we advise having flip charts with your values written on them to
guide the room.
The tables should have post-it notes so attendees can note down their input and it is
easily transferred to the appropriate values for summing up and further discussion.
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Suggested Timescale
Time
10 mins
Activity
Welcome and introductions; ensure
confidentiality and a safe environment
to feedback as a group.
5 mins
Provide a background to your works
aims and objectives.
20 mins
Activity 1 ‘What do the words mean to
us?’
Feedback on Activity 1
Activity 2; case studies
Activity 2 follow up
Wrap up and close
10 mins
20 mins
20 mins
5 mins
Comments
Let by a facilitator. This
should include
introductions from the
group.
Reiterate information sent
in advance and stress
confidentiality.
Split into groups
5 minutes per flip chart
Split into same groups
10 minutes per case study
Summary and thanks from
the facilitator and “what
next”. Further explanation
of actions to take.
Activity 1
Compassion
Confidentiality
[insert your organisations values]
[insert your organisations values]
Dignity
Respect
[insert your organisations values]
[insert your organisations values]
1. What do those words mean to us?
2. What would it look like in terms of someone’s values and behaviours if
someone was acting appropriately at work and demonstrating that
value?
3. What would it look like in terms of someone’s values and behaviours if
they were not acting appropriately at work and not demonstrating
that value?
Attendees work as a group for 20 minutes writing their notes. The groups should be
asked to focus on two or three particular words depending on the group size.
Facilitator prompts for the summary or the post it notes:



Can you explain the ‘behaviour’ further?
What would motivate you to behave this way?
When you demonstrate this behaviour, what value are you demonstrating or
what value aren’t you demonstrating?
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Activity 2
The groups will be given two case studies to discuss in their smaller groups and
asked to make notes on a flip chart to feedback on the following questions:
1) What would it look like if someone acted well and appropriately in this
situation?
2) What would it look like if someone didn’t act appropriately in this situation?
Facilitator prompts for the summary:





Why might they be behaving that way?
How else should they behave?
Why would this be important?
What does it mean when they behave the way you have described?
How are they making the person feel when they behave this way?
Wrap up and close
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EXAMPLE SHORT CASE STUDIES FOR USE IN YOUR FOCUS GROUPS
1. You are a staff member and you are standing outside of the entrance of the
hospital waiting for a lift home. You notice an elderly patient standing in the
door way. You saw the patient from the front earlier walking through the
hospital but now you notice that the patients dress has caught in her
underwear at the back and they have not noticed.
2. You are a staff member and you pass a ward reception area on your way to
your ward. You overhear a receptionist talking to a patient who is hard of
hearing and you stop to listen. The receptionist is leaning over the reception
telling the patient quite loudly that they will have to keep their urine sample
with them until they see the doctor. There are other patients in the waiting
area who can all hear what the receptionist is telling the patient. The patient
looks visibly embarrassed by the conversation.
3. You walk onto a ward to deliver some paperwork and you notice that a patient
is being attended to by two nurses. They are helping the patient onto a
commode. The ward has 4 beds and you can see that the curtains have not
been pulled all the way round. Another patient can see into the patient’s bay
through the opened curtain. Other staff can also see into the bay and have not
said anything to the staff toileting the patient.
4. You observe a consultant talking to a patient. The patient has brought in a
leaflet about an alternative therapy and is asking to discuss it with the doctor.
The doctor laughs and tells the patient not to talk such rubbish.
5. You are walking through the hospital on your way to get some lunch and you
see a patient standing with a letter. They look confused and are looking at the
signs directing them to a ward. You can see that they are speaking to a staff
member who is telling them, quite abruptly that they have come in the wrong
entrance and should be at the other side of the hospital. The patient asks the
staff member for help and he says he doesn’t work on that side of the hospital
and they will have to find their own way there.
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Example output from the focus group
Below is an example of the notes/raw data from a focus group session with 15
attendees. Key words have been highlighted which begin to build a picture of the
language the organisation is using to describe the value of DIGNITY.
Aligned Behaviours
Speaking tactfully to all of them
Non-Aligned Behaviours
Let it happen and speak to them
afterwards
Ignore it completely
Gossip
Ignore
Say that you don’t want to deal with it
Deny it
Pull her dress down, invade her privacy
Breach confidentiality
Leave it for someone else
Let it happen and speak to them
afterwards
Tell her in normal volume or shout
Ignore it
Act as an advocate
Act Sincerely
Listen to the patient
Approach the patient
Talk to the patient
Preserve confidence
Recognise their needs
Put yourself in their shoes
Act Discretely – whisper, don’t draw
attention to them
Pre-empt their needs
Challenge the doctor away from the
patient
Take action to preserve their dignity
Show understanding
Reduce the embarrassment
Tell them [Take Action]
Treat as confidential
Feedback discretely to consultant (selfawareness)
Look at the person in the situation, this
will tailor your approach
Think – should it be a man, should a
woman approach
Show an understanding of how they
could be feeling
Minimise the embarrassment
Call for assistance
Review the process to improve
Find superior to intervene
Help to regain dignity
Speak to the nurses and suggest
Analyse what we do [Take Action]
Maintain privacy
Embarrass the patient
No confidentiality
Increase the embarrassment
Condone, the behaviour or join in and
support the consultant
Take staff members away
Ignore
Dismiss
Inappropriately approach by the male
Inform on them
Patronise
Public confrontation of consultant
Shut the curtain yourself, take
inappropriate action because you want
to; not because the patient needs you to.
Distrust the other patient and their
opinion
Comment publically
Speaking directly to the patient
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