Feb 082013
Tim Heywood

Tim Heywood

If you work in NHS Wales, I hope by now you’ve been asked to “have your say” in the staff survey. The need for the NHS to be honest with itself, as well as with patients and the public, has been very topical this week. Taking part in the survey is one way we can all start to do that.

I’ve been helping with planning for the survey to ensure the questions reflect how patient safety, staff experience and service user experience are all linked. A recent Kings Fund report quoted research that “happy staff make happy patients”.

It might be hard to see it in quite those terms when the workload pressures pile up, but the evidence shows that staff who feel engaged do a better job – and it’s not hard to see how that will result in a more positive experience for patients.

But we need to remember that engagement is not something you have done to you – it takes your active participation. If “have your say” is interpreted as letting rip about all the things that frustrate you  and then standing well back, then the survey could easily do more harm then good. We all have a responsibility here and it doesn’t end when we send off the completed survey form.

So what do we need to do next? A recent Harvard Business Review blog argued that big, top-down efforts to change culture at organisation level rarely solve the problems that were so frustrating in the first place and that a different approach is needed:

Just start with one problem, or a few, plan a couple of modest experiments to make progress…. Try it out. Pay careful attention to what works and how. Incorporate the successful ideas into subsequent steps”.

These are pretty much the same lessons as we are learning about how to go about improvement in front-line clinical services in Wales. It looks like we could usefully apply the same approach when we take action on survey findings.

And that applies at every level. When we get to see the survey reports, it may be they will show us things we think we already know. Some of it might be good news, but certainly not all.

When we face the messages that aren’t positive, negativity or defensiveness will be of no help. The right approach must be to get curious about how so many of us came to think like that and what we can do to change things in a positive way.

If you have already completed the survey and “had your say” that is a great first step. But are you willing to get curious about what the findings will show? Are you ready to talk to your colleagues about changes you could test? Don’t wait for someone else to tell you what to do. If we want to feel more engaged, it will need continued effort from us all.

Tim Heywood (@timjhey) is the 1000 Lives Plus programme manager for Leading the Way to Safety and Quality Improvement

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