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Louise Stead
Director of Nursing and Patient Experience
&
Sarah Maidment
Senior Sister Paediatrics
Royal Surrey County Hospital
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Culture
· · Much talked about · Incalculable · Immensely powerful · ·
What sort of culture do we want?
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• A learning culture
• A caring culture
• An open culture
• A safety culture
How do we measure culture?
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If the aim is to improve the quality of care, or the efficiency of a
service, then a culture approach should inquire into what those
terms actually mean to participants and how they would assess
themselves against those and other definitions. It cannot be
safely assumed that these things are already known, or that
participants share similar definitions and judgments.
Tim Scott, Russell Mannion, Huw Davies and Martin Marshall
DOI: 10.1111/1475-6773.00154
Issue
Health Services Research
Volume 38, Issue 3, pages 923–945, June 2003
How do we measure compassion?
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• Friends and Family Test
• Complaints and compliments
• Assessment pre appointment
• Staff Friends and Family Test
• Observation
Our responsibility
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“There is a moral, professional and social
responsibility on everyone in the NHS to know
what they are doing and how well they are doing
it. If you can't answer the question you shouldn't
Sir Bruce Keogh, NHS Medical Director
be doing the job.”
Leonard Cheshire Behaviours
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• You don’t walk past
• If you are not proud of it you shouldn’t be
doing it
• Never say something about someone you
wouldn’t say to their face
• Have you got the passion and compassion
to do the right thing
Leadership
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• You cannot do it well if you don’t care about
the people
• If people share your commitment and
values they will mirror your behaviours
• Public scrutiny
What makes a good leader?
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• Inspirational
• Integrity
• Lead by example
• Make people feel safe to speak up
• They build team relationships by being positive and
making you feel you want to follow them
All of us want to be good at our jobs…but how good?
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• Quite good
• Good
• Very good
• The best in our field
• The best in the world
Talent helps…but it won’t take you as far as ambition
Raising concerns
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• We all have policies to ensure staff feel safe to raise
concerns – Francis has ensured that but that is only
half the story
• It’s quite easy to get approval if you ask enough
people – seek the criticism not the praise – how can I
make this better you may get a great improvement
What am I doing well?
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• Find out what is good about your
ward and dramatize it like a
cartoonist - talk it up
• Give away everything you know
that gives you opportunities to get
ideas from other people
How are you going to make the culture on your ward/
department great?
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• We all want to be proud of where we work
• We are hailed as a great ward, our metrics are
good, the DON brings visitors to look round, nurses
clamour for our jobs
Simon Pawlin
What am I doing well?
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Not all of you work on wards like that
• What are you going to do to make it that high achieving ward
• Talk it up and challenge those who don’t
• Don’t expect the board to lead the way they are trying to run a hospital, it is
your ward
• Not everyone wants to make a ward great but at least they want to make a
difference
Ward reputation
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• A wards reputation is generally built on the attitudes
of one or two key people, aim to be one of those
people
• Advertising, marketing, selling your service; many
would say this is not about care or compassion or
culture, but it really is
Most people are looking for a solution
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• What is the answer to developing a great culture?
• I have no magic answer but a word of caution, not
many people are prepared to make the sacrifices to
get there.
• People confuse being liked with being great, they
both have merit but are not the same
How can you take on the whole ward – you are just one
person
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• If you find staff not demonstrating the attributes you want take issue with
them. You are a great ward you only want the best
• Patient feedback is a very strong tool use
that to your advantage
• Objectives and clear guidance is key