Be c ivil to one another PROMOTING WELLBEING TEAM WORKSHOP 23 rd - - PowerPoint PPT Presentation

“Be civil to one another”

PROMOTING WELLBEING TEAM WORKSHOP 23rd 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

• f 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 – Donaldson 2014, “…a style of leadership based on inspiration, motivation and trust…”



Francis, Berwick and Keogh – among their many recommendations, each report cited the need for improved leadership behaviours, values and 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 leadership model to deal with challenges and difficulties.



Ben Goa’s “Systems not Structures” and



“HWB 2026 - Delivering Together” – collective compassionate leadership - ie everyone at all levels can be leaders, taking responsibility, co-production, etc.

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

 Sick Leave  EEO Complaints  Recruitment costs  ICU mortality  Accident, Injury,

Worker’s Comp claims

 Patient satisfaction  Productivity  Performance results  Patient/employee safety  Psychological safety  Employee satisfaction

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

• vertly 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

• thers.

 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…

 It’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…

 It’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

• ccupational 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

• ccupational 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?...

Mid Staffs - The daughter-in-law of a 96 year old patient:

“We got there about 10 o’clock and I could not believe my

• eyes. The door was wide open. There were people

walking past. My mum was in bed with the cots side up and she hadn’t a stitch of clothing on. I mean she would have been horrified. She was completely naked and if I said covered in faeces, she was. It was everywhere. It was in her hair, her eyes, her nails, her hands and on all the cot side, so she had obviously been trying to get herself up or move about, because the bed was covered and it was literally everywhere and it was dried. It would have been there for a long time…”

Disengagement:

”Perhaps I should have been more forceful in my statements, but I was getting to the stage where I was less involved and I was heading to retirement….I did not have a managerial role and therefore I did not see myself as someone who needed to get involved. Perhaps my conscience may have made me raise concerns if I had been in a management role, but I took the path of least

• resistance. In addition….most of my patients were day

cases and there was less impact on those patients. There were also veiled threats that I should not rock the boat at my stage in life.”

Trust Whistleblowing Survey 2015

 61% have confidence that the Trust would carry

• ut a robust investigation of any concern you

might raise.

 53% would feel comfortable raising a concern

with a Senior Manager / Director in the Trust and giving your name.

#5 Be Responsible…

 For ourselves – the way we treat people

matters.

 Reflect on Mid Staffs – ‘bystander syndrome’ -

lack of communication/speaking up led to a culture of systemic neglect, etc.

 “If you permit it, you promote it”.  …even if an area you don’t have responsibility

for.

 “See it, Say it”.

If you want to make minor changes work on your behaviours, if you want to shift in the long term change your mindset… “ . . . concerned with a shift of mind from seeing parts to seeing wholes, from seeing people as helpless reactors to seeing them as active participants in shaping their reality, from reacting to the present to creating the future.” Peter Senge, 1990

Learning Organisation…

(Personal Accountability)

www.youtube.com/watch?v=QaqpoeVgr8U Chief of Army, Lieutenant General David Morrison’s message about unacceptable behaviour

Staff Survey Workshop Feedback:-

 Being listened to and team spirit, a sense of fun.  Take time to say hello, be friendly, open door for people,

create a friendly environment, better customer care.

 Staff appreciation, look at what has been achieved and not

what hasn’t, positive rather than negative reinforcement, culture of support.

 Overuse of emails, lack of face to face…get to know staff.  Improve quality of Supervision, Team Talk/Time out for

Teams, Appraisals.

 SMT visit departments, listen to staff, how to staff make a

difference to the organisation (all staff so that they feel valued), management need to come to the floor, regular praise and acknowledgment of working well with pressures.

Back to Basics…

 …being civil, kind and caring to one another.  Close the civility gap…between good intentions

(eg demanding high standards) and negative impact on others.

 Think of our Trust Logo and Strapline:–  …it’s about working ‘together’ to get the best

possible outcome for ‘you’ (and your family) as a service user as well as a member of staff.

Resources…

 Slides  Leaflet  5 Minute Video Clip  PageTiger  Posters

Questions & Answers