Session 4 Chat log JIW - IHI



from Wendy Hunt to All Participants:Good Afternoon-This is Munson Medical Center in Traverse City, Mi here joining you for this Expedition-Thx Wendyfrom Liz Reilly to All Participants:Hi Julie, Liz Reilly joining from Bonnie Sunny Scotland. from Julie Landsman to All Participants:welcome everyone! from Barbara Balik to All Participants:What ideas did you hear from team members?from Sue Sloan to All Participants:have integrated 4 key questions into all workshops I have with staff- encouraging them to also have similar conversations with their teams.from Jessica West to All Participants:Our group learned that communication was a universal barrier for our team's work flow. We have started brainstorming ideas to increase communication both internally to our work team and externally to the rest of our Agency.from Susan Silverthorne to All Participants:Would you post the four questions for us?from Sue Sloan to All Participants:its been interesting asking staff and hearing some ideas about how to have more days when staff feel at their best - have joy in workfrom Sue Sloan to All Participants:things like asking for support, having a laugh at work, choosing to stay positive, getting enough sleep, playing to team strengthsfrom Liz Reilly to All Participants:iMatter our new staff experience continuous improveent model highlights that communication and seniors within our health boards are "stones in shoes" , teams wanting to engage but a command and control culture. iMatter starting to now evidence that a number of teams are highlighting their concerns and removing their stones - fantastic to see and even better to evidence.from Jessica West to All Participants:We noticed that communication was inconsistent especially if it was communicated through a third party/"middle-man'; we are working on having more intentional conversations with the people that need to receive the information directly.from Sue Sloan to All Participants:Our Exec Nurse Director( hopefully he will join us on this tonight) has invited his Corporate Management Team to engage in conversations about 'joy in work' and what matters to themfrom Liz Reilly to All Participants:That is interesting Sue and keen to see how all that is mapping over to iMatter journey within NHS Lothian to then share with othersfrom Lane Bandanza to All Participants:This is Barbara - I'm borrowing "Lane's" computer so you'll see her name when I chatfrom Lane Bandanza to All Participants:Liz - it helps to talk about behaviors when teams are talking about 'command and control' - it helps us each see how we contribute rather than broader terms - Barbarafrom Liz Reilly to All Participants:Agree and within iMatter staff experience framework one of our components that staff highlighted to be measured is Supportive Relationships and Appropriate Behaviours. So all managers within 22 Health Boards will be measured by end of implementation period 2017.from Lane Bandanza to All Participants:Steve gives wonderful examples of 'the ability to give and receive kindness noted by Surgeon General Marthy' as essential to healthy work environments - Barbarafrom Liz Reilly to All Participants:Agree it is not just about listening to staff it is also acting upon that they can see and believe from Lane Bandanza to All Participants:Liz - your focus on Supportive Relationships & Appropriate behaviors links with what Steve identies as Supportive leadership behaviors - Barbarafrom Lane Bandanza to All Participants:And improving joy in work saves resources through improved quality, safety, decreased turnover, experience for patients/families - Barbarafrom Lane Bandanza to All Participants:When a new mother said 'I never would have thought I could take care of my baby without your help' - Barbarafrom Susan Silverthorne to All Participants:A great day for me is when I know I have made a positive change in someone's lifefrom Sue Sloan (privately):what matters to you?when are you at your best? what are the stones in your shoe? what will you do to work on your personal level of effectiveness and resiliency? If working with a team or existing group I ask what will they do collectively. So all questions from the sessions!from Liz Reilly to All Participants: Best Day - seeing small changes within teams in NHSScotland and staff beginning to drive their team bus which makes them feel good in the workplace. from Lane Bandanza to All Participants:Noting the small things that are so big in our impact - asking people why they got into healthcare and why they stay - Barbarafrom Lane Bandanza to All Participants:Yes, Liz! Paying attention to and celebrating the small changes are so key! - Barbarafrom Liz Reilly to All Participants:For your own psychological well being and others Barbara.from Lane Bandanza to All Participants:So true, Liz; starting with 'why in healthcare' and 'what makes a good day' builds on strengths and provides energy to work on the things that aren't going well - Barbarafrom Jane McNulty to All Participants:Reactive with no time to stop rather than proactivefrom Jessica Perlo to All Participants:Hear more stories about "why i got into healthcare" on IHI's website: Jessica Perlo to All Participants:Scroll to the bottom to hear individuals describe their motivations for entering the health care professionfrom Liz Reilly to All Participants:Yes Jane, staff feeling they are on hamster wheels and it just never stops rotating - they all laugh when I bring in a hamster wheel and the visual is to get them to think how do you stop the wheel running to allow proactive thinkingfrom Lane Bandanza to All Participants:the ongoing hamster wheel is often made up of a range small issues that can be tackled through improvement every day rather than trying to fix everything at once - Barbarafrom Liz Reilly to All Participants:Agree Hans, our NHSScotland Staff Experience is built around Person Centredness for staff as well as the patients and the 3 key ambitions - Person Centred, Safe and Effective - does every manager/director/board in Scotland believe . promote and evidence this for our staff - Through The Looking Glass is a visual we use during iMatter management sessionsfrom Lane Bandanza to All Participants:Liz - you are describing some of what Edgar Schein describes as the set of behaviours and skills for all but especially leaders; have you had success in identifying what those actions look like in action? - Barbarafrom Liz Reilly to All Participants:The beginnings of Barbara and now have 8 Health Boards signed up to work with us to write our narrative story and build an evidence base - we will work with 60 managers and teams and also linking in with Scottish Govt Person Centered team. Each team will choose a patient/client experience measure and use iMatter as the staff experience and hoping in Scotland to identify correlation. We have Directors of Acute Service, Nurse Directors and CEOs supporting phase 2 of our iMatter journey linked of course to What Matters Person Centered work that Shaun Maher and others are taking forward.from Jessica Perlo to All Participants:More on Don's Era III is available here: Sue Sloan to All Participants:commitment, working together and chipping away to really embed our values is our ongoing shared responsibility. we can choose to really make a difference. hopefully imatter will support and encourage teams to engage everyone at all levels- linking in 'what matters to you' and how can we enable that more of the time will strengthen this I think from Lane Bandanza to All Participants:Sue - have you found that by asking 'what matters to you?' focuses what you work on? - Barbarafrom Sue Sloan to All Participants:yes I think so- it also encourages the person to think about their part to play in making it happen more often and take ownership for reducing the stones in shoesfrom Jessica Perlo to All Participants: Liz Reilly to All Participants:Really like the Highly Adoptable Improvement Model and have quite a number of teams/directors/boards resisting change, where the teams who are seeing, now believing and as you say feel the difference advocacy is created and the culture is quite tangiblefrom Lane Bandanza to All Participants:Great idea - but does it actually work? Testing over & over - Barbarafrom Lane Bandanza to All Participants:"Work with those who do the work" - Chris key point -- Barbarafrom Liz Reilly to All Participants:Very true Chris. I met a team who have received their iMatter team report and they wanted to design car pool, managers were not happy and senior manager encouraged managers to "dance with the staff, not wrestle with them". The staff did design, costed and evidenced they saved ?8,000 and also increased number of client visits and outcomes from Liz Reilly to All Participants:Hamsters need to come of their wheels for that to happen Chrisfrom Liz Reilly to All Participants:using laptopfrom carrie horwitch to All Participants:would be helpful is to have some papers that show the financial benefit how some investment into these strategies has led to reduction of loss of staff, improved joy of medicine and saved cost to the organization- are there any studies that show this in true dollars and other values?from Tom Konrardy to All Participants:Can you provide info on "An Energy Map"?from Sue Sloan to All Participants:some leaders need lots of encouragement/support/permission to step off hamster wheel! Its not a luxury its a necessity as an effective leader ... to pause, to think, to appreciate what gives them energy and joy... then they can support, model and enable their stafffrom Liz Reilly to All Participants:We are seeing a lot of that coming through - disconnect between teams/manager and senior organisation.. We are now asking managers/teams - what do they want to say to the seniors within the organisation, how can you make that happen, who do you want to speak to and how do you think can make that happen. An example we filmed last week is a team where seniors now meet with staff every 2 months for staff development conversations. Another example Director of Nursing and non exec now contracted to meet with team every year. A head of nursing now gone back to the floor and working with multi disciplinary team. from Jessica West to All Participants:Chris, can we find the "6 themes for practical and sustainable change" on your website or do you have an additional link? ................
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