The global Covid-19 pandemic created enormous challenges for healthcare providers and left them facing an unprecedented backlog of people waiting for treatment. In the UK, for instance, there is a ‘visible backlog’ of more than 6 million people waiting for elective procedures and a growing ‘hidden backlog’ of patients who require care but have not yet looked for it. There has never been a more urgent need to maximise the capacity and productivity of our healthcare facilities and services, but how do we do this?
In IHLM’s upcoming Healthcare Operations and Patient Flow Management programme we’ll be taking an in-depth look at some of the many ways healthcare teams can transform productivity, while also improving the quality of their working lives. These solutions include:
seeing patients in turn and treating them in order – allowing a patient to jump the queue for non-clinical reasons means everyone else behind them waits longer
ensuring that capacity meets variation in patient demand by reducing staffing levels on some days and increasing it on other days
making sure every stage in the patient’s journey is planned for and scheduled so that everyone knows what to expect and when to expect it
reducing the time spent doing things that don’t add any value for patients – such as coming to hospital on different days for different tests
Delivered via IHLM’s online e-learning platform, through live interactive Zoom webinars and one-to-one coaching, our upcoming programme will help you become part of a global community learning how to transform patient flow together.
Celebrating International Nurses Day With Course Discounts
Today, we celebrate International Nurses Day on the anniversary of Florence Nightingale’s birth.
The theme of this year’s celebration is Nurses: A Voice to Leadwhich focuses on the need to protect, support and invest in the nursing profession to strengthen health systems around the world.
Nurses are, and have always been, at the frontline of care. They have worked bravely and tirelessly despite their extreme workloads during the COVID-19 pandemic. But too many nurses continue to be underpaid, undervalued and to work in unsafe environments.
As a special thank you gift from IHLM to both nurses and the entire global healthcare community we’re offering a 30% discount on all our upcoming courses. Simply enter the discount code IND30 when you register.
This discount reduces the price of a 10 week course from £895 to £626 and reduces the price of an 8 week course from £695 to £486.
Hurry though, because this sale is available for four days only and expires at midnight on Sunday 15 May.
Did you know that this week has been World Health Worker Week? Unfortunately, despite being networked with many thousands of healthcare staff across the world neither I, nor any of my colleagues here at IHLM, heard any mention of it. No one posted about it in our Linkedin feeds or mentioned it in the many emails that arrived in our inboxes this week. 😥
Another reason we, at IHLM, were sad not to be able to organise our own events over the last week was because this year’s theme – “Build the Health Workforce Back Better” – is one that is very strongly aligned with our own mission to help transform the competencies and capabilities of the healthcare workforce and, in so doing, support improved health outcomes.
We shall certainly make sure that, this time next year, we organise a number of activities to support this important week. But, for now, one small and immediate contribution we can make is to offer a 20% discount on all our upcoming online courses for registrations received over the next three days.
To claim 20% off an IHLM online programme simply register and make payment using the discount code WHWWeek2022 before midnight this Sunday.
– Benedict Stanberry
Fight The Sludge!
I’ve heard many words used to describe the things that cause unnecessary waits, delays and aggravations for both patients and caregivers.
The US Institute for Healthcare Improvement, for instance, encourages healthcare leaders to help their teams identify ‘the pebbles in their shoes’ – ie, the things that get in the way of doing what matters. Fans of Lean Thinking, on the other hand, will be very familiar with the term ‘muda’, the Japanese word for waste, which is defined as any human activity that absorbs resources but creates no value.
Now, however, we have a new word to help us identify healthcare improvement opportunities: ‘sludge’.
The word was first coined by author Cass Sunstein to describe situations in which systems are seemingly designed to impede people from doing what they need to do. He concedes that it’s okay to impose a little bit of sludge to make sure that those who are trying to get something actually have a right to that thing. So being triaged before being given a GP appointment or having to wait for your medical insurer to approve a consultation is probably acceptable as long as it’s done as quickly as possible. The problem, however, is that healthcare systems frequently create sludge that prevents people getting timely access to care or deters them from seeking it in the first place.
Fortunately, in an insightful recent Harvard Business Review article, three senior healthcare managers have described how they use ‘sludge audits’ to measurably improve patient care and increase employee engagement by eliminating or reducing anything that adds unnecessary time and cost to healthcare encounters.
So next time you’re casting around for ideas for an improvement project, maybe think about rolling up your sleeves and clearing out some sludge!
– Benedict Stanberry
IHLM Announces New Strategic Partnership with THE Institute
IHLM is delighted to announce a new collaboration with THE Institute: an international and independent non-profit organisation that provides education and other knowledge-transfer services to healthcare providers and systems.
The partnership with THE Institute will broaden access to IHLM’s courses and programmes, enabling us to reach an even larger audience of healthcare professionals and executives in Europe, the Middle East and Asia. It will also make our programmes available for the first time in the Benelux market of Belgium, the Netherlands and Luxembourg, as well as bringing opportunities to involve French- and Dutch-speaking experts in our growing faculty of instructors and coaches.
European healthcare faces many challenges – including a growing and ageing population, the increasing prevalence of chronic diseases and a shortage of skilled healthcare workers. But it also has an unprecedented opportunity to exploit the latest advances in digital technologies and design thinking to deliver better health outcomes and a more responsive patient experience. IHLM’s expanding portfolio of specialised programmes enable hospitals and health systems to overcome these challenges and exploit these opportunities by transforming the skills, knowledge and performance of their greatest asset: their people.
We are very excited to be working with THE Institute to make our online, blended and in-person programmes available to more healthcare leaders and managers than ever before and to developing new learning experiences that address their ever changing needs.
Among all the many skills, abilities and competencies needed to deliver great healthcare there’s probably none more important than effective teamworking.
Not only does our own lived experience of working in healthcare tell us this, but so too does the wealth of research that demonstrates a consistent link between teamwork and patient outcomes. This is why IHLM have made effective teamworking the subject of the first in a series of free books that we will be publishing over the coming months. Launched in Bangkok at the recent Hospital Management Asia conference and exhibition, Effective Teamworking in Healthcare shows you:
the characteristics of healthcare teams
why teams and teamworking matter in healthcare
the most common obstacles to effective teamworking
how to measure the effectiveness of a healthcare team, and
how to develop healthcare teams and improve teamworking.
Whether you want to reduce medical errors, improve staff engagement, use limited resources more effectively or simply enhance patients’ experiences of their care – developing teams and improving teamworking are absolutely essential. Follow this link to download your own copy and after you’ve read it, tell us what you think!
Improving the Patient Experience with Executive Walkrounds
For the last 10 to 15 years, walkarounds have been widely used in healthcare organisations to improve safety and there is evidence that they lead to a better safety culture and increased understanding of safety risks (Singer and Tucker, 2014).
However, there is also evidence that walkarounds only lead to such results when they are implemented authentically, and with the full commitment of higher management and senior physicians who are actually able to act upon and resolve problems. Half-hearted, insincere or ineffective walkarounds can backfire. I have personally seen situations where walkarounds became a form of surveillance and control, rather than enquiry and support. I have also seen situations where managers controlled or restricted conversations with patients and staff in order to avoid topics they didn’t want to discuss, or where higher mangers said they would address problems but, in the end, did not do so.
So, while there seems no reason why walkarounds cannot have a very positive impact on patient experience, they have to be designed, planned and implemented in the right way.
There are seven things to get right:
(1) Higher Management Support– You must have the full commitment and participation of higher management and the patient experience department must provide the necessary resources in terms of time, staff, budget etc.
(2) Tools – You must design and develop the orientation and training materials with which to prepare higher managers for walkarounds. These should include defining what patient experience is and the staff practices and behaviours on which it depends; the purpose of walkarounds; the aspects of the patient experience that they should be focusing on during a walkaround and guidelines for initiating conversations with patients, families and staff.
(3) Scheduling– You may need to schedule walkarounds many weeks or even months in advance in order to accommodate the schedules of higher managers, senior physicians, department/unit managers, patient experience specialists, and other walkaround participants. You will also need to decide where to conduct the sessions and may choose to pilot walkarounds in just one or two departments to begin with.
(4) Communicating – There needs to be a clear communication strategy for the walkaround programme so that all staff know about walkarounds in general and what their aim is. There also needs to be focused communication immediately before, during and after a visit with information leaflets for patients and families, as well as for staff.
(5) Visiting – The walkaround itself needs to begin with a proper briefing on the department/unit to be visited, including any existing areas of concern or previous complaints received. The team needs to agree on the aspects of the patient experience they will focus on and the questions they will ask. There must be an immediate debriefing, after the walkaround, to agree the issues that must be taken away for action, quick fixes that can be resolved straight away, actions that staff can take immediately if empowered to do so and feedback or praise that should be given where good practices have been identified.
(6) Supervising and Following-Up– You must set-up processes for collecting information during walkarounds, for sharing that information, for assigning action items to the right people and for making sure actions are done and that feedback is given to staff, patients and family members. A follow-up walkaround should be arranged to monitor progress.
(7) Measurement – You must set-up a measurement process to evaluate whether or not walkarounds are delivering the objectives you require. Metrics could include the number of walkaround visits performed, the number actions identified and completed, decreases in patient complaints and/or increases in compliments and satisfaction levels.
Appreciative Inquiry: Investigating the Root Causes of Success
In patient safety we spend a great deal of time focusing on what goes wrong and why. But isn’t it time we started investigating and celebrating success?
We often preface teaching about patient safety by noting how amazing it is that care works so well almost all of the time. Nonetheless, when something does occasionally go wrong we tend to lose sight of the good things that we do and dwell heavily on the bad. This leads to two very serious and undesirable outcomes. The first is that healthcare staff – the very people upon whom we depend to deliver safe, compassionate, patient-centred care – begin to feel victimised and undervalued. At best, this erodes their motivation. At worst, it leads them to leave the healthcare profession altogether. The second problem is of not seeing the wood for the trees. In the words of Professor Erik Hollnagel, our focus on the lack of safety does not show us which direction to take to improve safety.
What is Appreciative Inquiry?
I was fortunate to recently attend a two-day course on Appreciative Inquiry and positive psychology in healthcare, hosted by West Midlands Academic Health Science Network. I had read a little bit about Appreciative Inquiry and was keen to explore how this philosophy could benefit my own work as a patient safety teacher and consultant.
Whereas in Root Cause Analysis we look at clinical systems and investigate what is wrong with them, Appreciative Inquiry teaches us to see how and why they work so well, and how we can build on that to create something even better in the future. First suggested in a 1987 research paper by organisational behaviour experts David Cooperrider and Suresh Srivastva, Appreciative Inquiry encourages us to understand clinical systems by asking questions and engaging staff in appreciative conversations. Conversations that bring people together to share learning and in so doing, can take an entire team or organisation forward.
What could be the benefits of Appreciative Inquiry in healthcare?
“Every health worker begins with a desire to alleviate suffering and to help patients recover from illness and injury. The capacity for compassion is innate.”
This mirrors my own thinking, fifteen years ago, when I noted in my masters degree dissertation that the National Health Service in England: “is in the deeply privileged position to have as its employees, professionals who almost universally have an inherent desire to care and whose greatest motivation and satisfaction arises from fulfilling their caring potential.” I observed that it was devaluing by colleagues, not by patients, that led healthcare staff to feel unappreciated and unvalued.
As professional carers, our compassion can fade or be eroded as we struggle to maintain our sense of inner value and our capacity to care. But Appreciative Inquiry offers us the tools with which to bring people together and enable them to feel recognised and valued once more.
Can Appreciative Inquiry help make healthcare safer?
In From Safety 1 to Safety 2, Professor Erik Hollnagel offers a refreshing perspective on patient safety, which encourages us to move from ensuring that “as few things as possible go wrong” to assuring that “as many things as possible go right”. He notes that the rare cases of failure attributed to human error do not explain why human performance practically always goes right. He believes that patient safety professionals should use Appreciative Inquiry to look at the many cases where things go right and try to understand how that happens.
I couldn’t agree more. I have read too many incident reports describing failures to recognise and respond to deterioration and have analysed the failings in detail to try to elicit root causes. I’ve never been asked to investigate success, yet I can imagine so many healthcare scenarios where things have gone well and there is great practice that needs to be celebrated and shared. Hospitals are brimming with what Professor James Reason calls “Humans as Heroes”. We should pay more attention to that heroism.