“Be c ivil to one another” PROMOTING WELLBEING TEAM WORKSHOP 23 rd January 2018 Anne Forsythe Senior HR Manager (Workforce & Organisational Development)
Corporate Staff Survey Action Plan:- 30% consider that relationships at work are strained, 10% consider that they have personally experienced harassment, bullying or abuse at work from their manager, and 14% consider that they have personally experienced harassment, bullying or abuse at work from other colleagues. Action Plan Theme ‘Regaining Respect’ – 5 Fundamentals of Civility – now included in all Management Development Programmes, the new “Every Conversation Matters” programme and ELD are developing a tool for managers to share with all staff at Team Talks. Buy-in from SMT – CEO/Directors have signed up to this.
Leadership – the observations The Right Time, The Right Place – leadership model to deal with Donaldson 2014, “…a style of challenges and difficulties. leadership based on inspiration, Ben Goa ’s “ Systems not motivation and trust …” Structures ” and Francis , Berwick and Keogh – “ HWB 2026 - Delivering Together ” among their many – collective compassionate recommendations, each report cited leadership - ie everyone at all levels the need for improved leadership can be leaders, taking behaviours, values and responsibility, co-production , etc. competencies in dealing with change and difficult situations . King’s Fund – positivity, compassion, respect dignity, engagement and high-quality care are key to creating a cultures we need in the NHS. A collective
Donaldson said: ‘In Northern Ireland, as in many places, no effort has been made to influence culture on anything like this scale… …Culture is viewed with a degree of helplessness – but the evidence from elsewhere is that it can be changed, and that doing so is powerful.” Scattergun approach… a range of individual projects will not work!! International models and research evidence must be utilised…..
Culture Change Model Civility is an essential behaviour of all employees in all organizations. These are the interpersonal “rules of engagement” for how we relate to each other, our service users, and our stakeholders; the fundamentals of courtesy, politeness, and consideration. Respect connects us at a personal level. It reflects an attitude developed from deep listening and understanding, cultural and personal sensitivity, and compassion . It honours all the participants in an interaction by creating a safe place to have difficult conversations and leads to an environment of honesty and mutual trust. Engagement is the result of respectful relationships within an atmosphere of trust . It provides all staff with the charge, the parameters, the training and the support to make decisions “on the spot” in the best interest of the individual.
Civility and Outcomes - Veteran Army USA Patient satisfaction Productivity Sick Leave Performance results EEO Complaints Patient/employee safety Recruitment costs Psychological safety ICU mortality Employee satisfaction Accident, Injury, Worker’s Comp claims
The 5 Fundamentals of Civility Michael Kaufmann, MD – Ontario Medical Association
It’s too fluffy or soft! What about in certain situations – in the heat of the moment when the stakes are high? eg in theatre – rude jokes, use of bad language, sexism…is it really okay? We should be able to be assertive, directive, yet respectful to remain civil when faced with this kind of situation. Sometimes when people demand high standards in the name of the patient/service user they have difficulty understanding the impact of their behaviour on others. Sometimes we accept behaviour because of competence/excellence – but “if you permit it you promote it!”
Response re Overseas Travel Response re Overseas Travel
Civility Saves Lives Research: Incivility has been shown to reduce team functioning, clinical decision making and outcomes. “I saw incivility really impact the performance of an experienced registrar in theatre, that then caused all of the other theatre staff to make mistakes. It has a massive negative impact on performance.” “Nearly everybody who experiences workplace incivility responds in a negative way, in some cases overtly retaliating. About half deliberately decrease their effort or lower the quality of their work .”
What does incivility look like?
Everyday Incivility Skipped “Hello” Talking over, talking down Eye rolling or other demeaning gestures Rude use of technology Gossip Calling someone out, blaming publicly or in meetings Profanity, offensive jokes Minor boundary intrusions – sounds, aromas
#1 Respect for Others & Yourself… Regardless of role, even those we barely know, disagree with, or dislike. Accept and acknowledge the value of oneself and others. Be present, pay attention, listen – put phone aside. Be on time – their time is as important as yours. Be inclusive, value what others can bring to the table. Assume positive intent, seek to understand. Self-respect is key – “I don’t want to be like them!”
Cleveland Clinic Video Empathy – The Human Connection - If you could stand in someone else's shoes . . . hear what they hear. See what they see. Feel what they feel. Would you treat them differently? https://www.youtube.com/watch?v=cDDWvj_q-o8
Awareness Gap:
#2 Be Aware… Civility is a deliberate endeavour, requiring conscious awareness of oneself and others – making a choice to be aware. Mindfulness and reflective practice enhances awareness. Group supervision/reflection. Good effective feedback.
#3 Communicate Effectively… I t’s more about how we say it as much as what we say, or do. Words are powerful. They can flay like whips. When hastily chosen and self-serving, they can unnecessarily hurt and discourage. On the other hand, words that are well chosen, considerate and timely can lift spirits, motivate, heal, and connect us. “Listen to connect, not judge or reject”, praise, helpful feedback, receiving feedback positively.
ABC for tense moments: A for Aware B for Breathe C for Choose Civil Communication
#4 Take Good Care of Yourself… I t’s hard to be civil when personally stressed, distressed, or ill. “Fit your own mask first”. Build resilience. HWB – schemes available to staff eg “Take 5”, Stress Management Toolkit, don’t skip breaks/meals, use the stairs, etc. Seek out your ‘community’ - peer support, professional friendships, networks, alliances. You are responsible for looking after yourself.
Burnout Risk in Human Services/Caring Sector “A syndrome of emotional exhaustion, depersonalization, and reduced personal accomplishment that can occur among individuals who do ‘‘people work’’ of some kind. . . . Burnout can lead to deterioration in the quality of care or service provided.” (Maslach and Jackson, 1986:1). “A process in which a previously committed professional has disengaged from their work as a result of stress and strain experienced in the job .” (Cherniss 1995) “A characterisation of adverse reactions to work, primarily in the human services settings .” (Freudenberger, 1974)
Burnout in the Modern World Burnout is deeply rooted in the broad social, economic and cultural developments that have been part of the occupational landscape over the last 35 years. Shaufelli, et al, (2009) argue that the shift from being an industrial society to a service led economy underpins the major occupational transformation. Common concerns relate to over- bureaucratic and performance management systems (Parton 2012) dilution of quality face-to-face practice .
“Patient and staff experience are two sides of the same coin” “When my outpatient appointments go well for me, they go well for my consultant. And when they go badly for me, they go badly for him too – we are in this together ”. We understand that asking patients ‘what matters to you’ instead of ‘what’s the matter with you’ makes a big difference to their experiences of care. How much more difference could we make if we started asking both patients and staff the question: ‘What matters most to you?’ NHS England, March 2017
“Staff Experience and Patient Outcomes” “…there is a substantial amount of recent evidence that the experiences of staff, particularly in the form of support received from supervisors and others, and staff engagement, are associated with the care provided to patients, in the form of patient satisfaction, health outcomes, and ratings of quality of care, as well as staff absenteeism and turnover .” NHS Employers, July 2014
What is our Culture?...
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