Improving the Safety Culture at Sherwood Forest Hospitals NHS Foundation Trust (SFH) Ceri Feltbower, Associate Director of Service Improvement and Safety Sarah Addlesee, Nurse Lead for Service Improvement and Safety @CFeltbower @SarahAddlesee Ceri.feltbower@nhs.net Sarah.addlesee@nhs.net
Session Aims • Background to the Programme • Approach • Outputs • Key Learning • Where next?
Introduction The background and culture of SFH in 2015/16 Meet The Team ‘Safety’ identified as part of the ‘short term priorities work’ raised by CQC Nick – Clinical Lead for SI and Safety Emphasis on ‘culture’ not just initiatives Sarah – Nurse Leader SI and Safety To empower and inspire staff and users to focus on, and define patient safety Ceri – Associate Director of SI Not ‘one size fits all’ Dr Andy Partnership between NUH and Sherwood Forest Haynes – Executive Sponsor
Join the Patient Safety Conversation Over 200 cards collected from the launch events Over 1600 staff engaged in the process overall
Aims To empower every member of ward staff : 23 Wards at Kings’ Mill • To lend their voice to a survey that captures the current patient Hospital safety culture in that specific ward • To define any barriers or issues that prevent a focus on patient safety • 3 Wards at To raise ideas and opportunities to trial new ways of working, with Newark support from the team Hospital • To celebrate and receive recognition for good practices that they can share in other areas • To learn from others, and from each other 3 Wards at Mansfield Community We want every patient, carer or family member to be fully Hospital engaged and involved in shaping the safety culture cross the organisation
Process Adopted ALL Ward Staff June 2016 – March 2017
43 questions divided between 9 categories:
The Culture Survey PASCAL global culture survey endorsed and used by EMAHSN in ED and Maternity Aim for a minimum response rate of 60% The ward with the highest response rate wins a Pizza Party. Results are recorded on the ‘Pizza Ladder’ in the Patient Safety Hub and communicated monthly
Staff Interview Comments: • If we could ask something for our well-being, would like the opportunity to go and talk to someone away from the ward who wont just say 'well that's the way it is' for mentorship or just to get it off my shoulders. I would volunteer to be one, if it helped • When I came on here on the bank I felt really welcomed which is why I wanted to come on here full time. I never felt like I was being a burden when asking things and staff would be happy to take a few minutes out to go through and explain things to me. On other wards I could go on and people might only say a few words to you in a 13 hour shift. • It would be nice for senior staff to mix with us, like this, and just talk to a group of us and see what we do. Come and see us when things are going right, not only when things are going wrong or the pressure is on • It is better now but we just used to have notes and signs everywhere you looked saying ‘this needs improving’ ‘you have failed at this’ but we were never told what we were doing well.
So What? Feedback to ward leader on staff conversations and outputs from Ideas Walls. Prioritise projects and identify ward leads. The team work with ward leads to complete a simple ‘project on a page’ and to support the improvement through to completion, if required
Examples of Projects Staff-owned learning boards set up to share and inform on local improvements Communal ward dining areas involving patients, family and staff to encourage nutrition, hydration and social inclusion Improved the Healthcare Assistant handover process to improve communication and team working Development and roll out of patient activities to encourage social interaction and to promote enablement Co-developing a Visitors Charter that resulted in improved cleaning audit scores
Programme Outputs • It changed how we communicated with staff • It influenced our strategies on Staff Health and Well-being • Staff are more open to sharing and celebrating their achievements • Less ‘dark corners’ • Over 50 projects on a page were completed • 4 th highest best acute Trust in UK for staff satisfaction for quality and care given in 2017 NHS Staff Survey results, and rated one of the best for staff engagement
A ‘Before’ and ‘After’ Ward Comparison - Pilot and Current Key Teamwork 100% 2016 90% Exhaustion/Resilience 80% Safety Climate 2017 70% 60% 50% 40% 30% 20% Nonpunitive Response to Errors Job Satisfaction 10% 0% Overall Perceptions of Patient Safety Working Conditions Perceptions of Local Management Perceptions of Senior Management
Organisation-wide Culture Footprint Domains by Staff Group - SFH Teamwork 100% 90% Exhaustion/ resilience 80% Safety Climate 70% 60% 50% 40% 30% 20% Non-punitive response to errors Job Satisfaction 10% 0% Overall perceptions of patient safety Working conditions Perceptions of local management Perceptions of senior management Registered Staff Support Staff Medical Staff Organisation Industry Median
Key Learning • This was about EVERYBODY’s Safety • Surveys provide only one lens of feedback; ‘what is a local/senior manager?’ • Executive support to move obstacles and to network across HR, Strategy, Governance etc • Focus on Feedback, and how best to support people • ‘Organic’ projects; not targets and impact on metrics • Lots left to do to move to ‘No Dark Corners’ Thank You for Listening
Where Next? • ED, Maternity and Theatres and ‘out’ to Departments • Working with NHSI and The King’s Fund on the Culture and Leadership Programme • Re-survey initial wards in 2018/19 • Focussing on developing the SFH QI Framework and QI training to support staff going forwards
Thank You for Listening
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