WELCOME! – and a big congratulations for taking on the Well Connected Challenge 2016!
Well Connected is about making small changes throughout 2016 to create better connections with your consumers. Based on an experience I had with a relative in hospital at the beginning of 2016, where a shared understanding between staff and consumer and family was difficult to achieve, yet so important to the consumer’s well-being, this is my commitment to improving the connections that health, aged and community care staff make with their patients, clients and residents! Read the story here.
Scroll down for this month’s Well Connected challenge.
How does the Well Connected Challenge work?
Well Connected is based on the premise that small steps, taken regularly, add up to a big impact over time. Over the course of this year, I’ll give you monthly steps to create a better connection with a group of your consumers. This map is based on best practice change and improvement knowledge and experience, so we’ll also be discussing that along the way. Well Connected is learning in action.
Information gaps, misunderstandings and tensions cause suboptimal care, delays and confusion. It doesn’t help consumers’ confidence, and causes re-work, fixing up and frustration for staff. Not good for anyone! The great thing about connection is that small changes make a BIG difference, so this shouldn’t be some huge, unwieldy, overly ambitious project. My challenge to you is to find one service or interaction in your organisation in which more meaningful connections between consumers, families and staff would have a real impact – and implement the change, using the steps I’ll give you each month.
All you need to do is check in here every time my QualityNews bulletin comes out – to get the next steps. Then – just do it! and follow the map. At the very least, you’ll learn a best practice change and improvement model you can apply anywhere. But what I’m really aiming for is that you make a significant change to you consumers – and your staff.
Together we can make a difference – So what are we waiting for? Let’s get started! And let me know how you’re going in the ‘Reply’ section below!
WELL CONNECTED SEPTEMBER/OCTOBER 2016
STEP F: WHAT’S NEXT? Spread and sustain – but only if your pilot passes the test!
In Step E you assessed the pilot to see whether the change had panned out the way you wanted it to and achieved the desired results. You may have had to do some ‘course correction’ if things didn’t work as planned and may still be piloting. Or you may be ready for sustainability and spread. Either way, this month is an easy one as we introduce a critical test to your plot that will tell you a lot about whether sustainability and spread will be successful. Introducing the ‘threats to sustainability’! This month, spend some time talking to the project team and the pilot managers and staff who had to change their practice to make the project changes. You want to find out the answers to these questions:
- Do those who piloted the new approach have doubts about its usefulness?
- Are the consumers affected still complaining about the same things?
- Are the associated rules and protocols easy to violate?
- Are extra rules required to comply?
- Are extra resources required to comply that are difficult to source?
- Are there negative side effects of implementation for the consumers, staff or other departments/services?
- Does it conflict with other policies and priorities in certain situations?
- Does it work better for some shifts, or parts of the service, than others?
- Do staff speak negatively about the change?
If you get a resounding ‘yes!’ to any of these – you’ll need to deal with it before you go to large scale spread. This isn’t failure – this is how real life works in the complexity of our organisations. So gather your intelligence about what’s not working and make your plan for turning ‘yes’ into ‘no’!
And then…spreading the change to other parts of your organisation is just a big pilot. Pick it up at Step B. And don’t try to change in too many places at once. Effective, embedded change takes time and effort as you’ve no doubt discovered! Better to do it slowly and properly than fast and failed!
That’s it for Get Well Connected 2016! Congratulations! – and thankyou for applying your nous and skills in 2016 to make something significantly better for your consumers and staff. And now that you’re skilled in consumer focused change – apply this model to all your changes!
WELL CONNECTED JULY/AUGUST 2016
STEP E: WHAT HAPPENED? Take stock.
This it the time to evaluate what’s happening in the pilot.
- Gather the data you’ve been collecting and do some analysis (comparing the results to the ‘pre’ data you collected, as well as to any targets you’ve set – for example: ‘85% staff to correctly complete the new consumer background form’; or ‘zero family misunderstandings regarding the care plan’) to answer these questions:
- Process: Are we doing the new things we planned to do in the pilot? Are they being done as often as we wanted them to be? Are as many people doing the new things as we planned? Are the new things being done properly? If not, why not? Is the new way harder than we thought or more time consuming?
- Outcome: Are we getting the outcomes and results we wanted by doing things a new way? For example, are things consumers better off, getting better outcomes, having a better experience? Are staff better off – more effective or efficient in what they do? Happier in their work? And the big one: Are consumers and staff feeling better connected?
2. Are you able to answer these questions? If not, you need to think about your data collection – you may not be collecting the right data, or enough data to give you the answers. In that case, change your data collection to do so. There’s no point having beautiful data that doesn’t tell you what you need to know.
3. If your answers to some of the above questions are ‘no’ – don’t give up! Identify if the issues are in the Actions, Attitudes, or Systems that you’re trying to change and perform a pilot reset. Consult with the brains trust of people involved in the planning and implementation of the new way – including consumers. You might rethink and tweak:
- The new process – does it need a re-think to make it work better? Are the actions required to do things differently the wrong ones or too hard? Is the new way having side effects on other parts if the organisation we didn’t anticipate? Can we get the same result in a different way?
- The attitude – have we got the message across in the right way to help staff think differently about connecting with consumers?
- The systems – are we supporting staff have to implement the new way? – do they have clear Direction, the right Knowledge, the right Resources and active support to make the Change?
Be brutal in you assessment – honesty is the best policy. this isn’t about success and failure – this is about curiosity and learning. Very rarely does a pilot work first off, so you and the team must assess the pilot as it really is, not how you’d like it to be. Work with the staff and consumers involved to do a course correction – most pilots need at least one, maybe more.
Re-set your pilot: actions and data collection as needed – and keep going for another month.
That’s it for this month – good luck!
WELL CONNECTED JUNE/JULY 2016
STEP D: JUST DO IT! Trial the solutions – implement a pilot.
1.Get your pilot team together. It should comprise your Well Connected Action Group, including, if it doesn’t already, a senior manager sponsor, a project leaders, project drivers, who make the changes on the ground, and project communicators – people who are good with telling the story about the need for the change and the process of the change.
2. Get your project communicators out and about talking to all the staff who will be affected by the change, and who will have to change they way they do and say things. Tell the story of why it’s important to consumers and staff – be creative! Video, audio, photos and posters (all with permission of course) create a big impact. Make sure everyone know well in advance of commencing what the changes will involve and how it will affect staff day to day habits and processes.
3. Discuss the plan with the people who will have to change the way they do things. Get their input into the fine tuning of the plan. What will work? What won’t? What will solve the boulders and barriers to success? Work through with them exactly what will be different about their routine. Don’t be afraid of their negativity – ask their advice. Develop flow charts to show how the flow of the day will vary doing things the new way. Minimise the surprises.
4. Work our how you’ll track progress. What does the Action Team need to know? What will interest the staff? What does the sponsor and committee expect to see reported to inform them of progress? What do you need to collect to know if the plan is getting you where you need to go? What process indicators will you track – are people making the changes we planned to make? What outcomes will you measure – are we achieving our goals as a result? How ill you know if things are going off the rails and you’ll need a course correction?
5. Put the plan steps into action. Remember – big goals, small steps. Small steps made every day beats big leaps intermittently. Work through the project tasks, making sure =those responsible for each step check in with you regularly.
6. Keep people in the loop. Decide how often you need to share information with everyone making the changes – and triple it. When they beg you to stop telling them how it’s going – you’ll know you’re successful in you communications.
And overall, keep asking – are we more connected?
That’s it for this month – good luck!
WELL CONNECTED MAY/JUNE 2016
STEP C: HOW WILL WE MOVE THE NEEDLE IN THE RIGHT DIRECTION? Develop a plan to pilot a solution.
1.Get a group of staff together that showed real interest when you talked to people about the issues in Step A. This is your ‘Well Connected Action Group.’ Discuss and define what ‘success’ will look like when you’ve helped create a deeper connection between consumers, families and staff. Create a rich picture of things working really well. How will people feel? What will work better? How will that flow onto other staff and consumers?
Compare the rich picture to what really happens now, as shown in the data and intelligence you’ve gathered. Where are the gaps? What do we already do well?
Then – with the Action Group of staff, for each cause you’ve identified, brainstorm solutions. Ask affected consumers and their families for ideas about what would work better for them. Put the suggestions together and develop trial solutions to be piloted for each key problem in the process.
Better and more meaningful connections require:
Actions – things that will have to be done differently
Attitudes – different ways of thinking about and approaching situations
Systems – how the service can be reorganised to support new ways of thinking and behaving: eg – procedures, job descriptions, meetings, measures, relationships with other services.
So – your solutions and plan must include changes in all three.
Give the project a catchy working title and a fun logo. Link it to the organisational strategic and/or quality plan. How will this project help the organisation meet a standards or achieve a goal?
2. Develop the trial solutions into a pilot plan – what will need to be done in each of these three areas to make these changes? For example, education may help with attitude change, but it will take more than that – it also needs telling stories about the issue and its impact, respected staff to lead the attitude change by their example, and perhaps an agreement that staff will support each other to connect better. Changing actions requires more than just procedure change, but also needs reminders and systems that support the new way.
How will you make the change less confronting? Ensure the plan is designed with small, easy steps. What part of it do you already have in place? What is one small first step that’s easy to take? How will you provide feedback along the way so everyone is in the loop re progress? How will you celebrate wins and learn from mistakes?
Grow your people. How will you make your staff look good through this process? What skills and knowledge will you make sure they have? How will you showcase their great work?
NOW THAT YOU’VE GOT YOUR KEY SOLUTIONS TO PILOT, WHO ELSE NEEDS TO BE CONSULTED AND INVOLVED? WHO WILL THE CHANGES AFFECT?
GET ENTHUSIASTIC EARLY ADOPTERS A ROLE IN TAKING THE LEAD ON MAKING THE CHANGES – PEOPLE LIKE TO SEE THAT OTHERS CAN DO IT.
Who will be responsible for what? When? How will you track progress?
3. Take the plan to the senior manager for endorsement and support. Ask them to help you with the things your team may not be able to get done, such as policy change or inter-service procedure change. Get the project on the agenda of the relevant committee for support and oversight.
That’s it for this month – good luck – and let me know how you go!
WELL CONNECTED APRIL/MAY 2016
STEP B. WHAT’S REALLY GOING ON? Analyse the problem
1.Write down clearly the connection problem you’re going to tackle. Something like:
‘We want to improve the connection between our staff, consumers and their families when… ‘(for example, the consumer is moving between subacute and transition care.)
‘Currently the problems caused by a lack of connection at this time are’: (list problems for consumers and staff)
‘When we’ve improved these connections, consumers, their families and staff will be better off in these ways.’
Take these completed statements to a senior manager to seek their support for pursuing the project further.
2.Collect some baseline data about the current problems. First, get the story. Observe the situation and talk to those concerned. What’s the story for the consumers and their families? What happens? How do they feel? How does it affect their care? What’s the story for the staff? how does this situation affect their ability to provide the best care they can?
Then, collect quantitative data. Can you count how many times things go wrong as a result of a lack of connection and shared understanding between staff and consumers? Are there incident reports such as falls or medication issues or complaints associated with the problem? Is there other data such as delay in treatment or discharge?
3. Get the story and the quantitative data together and paint the picture. ‘when we don’t develop a meaningful connection and shared understanding with the consumers and their families in this situation (the issue being addressed): this is an example of what happens (a consumer and family story) this is how it affects the staff ability to do their job, and this is how it affects the quality and safety of our care’ (quantitative data.)
4. Write down the steps in the process (eg, getting a consumer from subacute to transition care) and identify the steps where the problems occur. Write the problems next to each step. With a group of interested staff, ask the 5 whys for each problem- why does this happen?, So, why does that happen? etc until you get to what you think is the cause of each problem for each step. Do not assume or take people’s first thoughts about cause – that can often be wrong and send you off on a wrong track.
That’s it for April/May – good luck and let me know how you go!
WELL CONNECTED MAP FEBRUARY/MARCH 2016
STEP A. IDENTIFY THE CONNECTION YOU’D LIKE TO IMPROVE
1.Identify a service or group of consumers in your organisation, where developing a shared understanding and connection between consumer, families and staff is vital to provide great care. For example, this may be cognitively impaired patients on the medical ward; new aged care residents in their first week; drug and alcohol adolescents over their first three community appointments; or one service, for example, the obstetric or palliative care service.
Talk to your colleagues and staff in this area about the interactions with these consumers and their families that have a big impact on the consumers’experience, and their ability to provide great care. This is about one on one and group interactions between staff and consumers and their families, in order to exchange important information and develop a shared understanding of the care process that is key to achieving the best care and outcomes.
What you’re trying to identify is – if the staff and consumers/families could read each other’s minds – what information/understanding problem would immediately be solved, resulting in better care?
In your discussions – ask that question! – and here are some others to help tease out a useful issue to tackle:
- What causes consumers and their families the most frustration about their interactions with us?
- What causes the biggest problems for care delivery when consumers and/or their families misinterpreting instructions or information?
- What important information do staff have trouble getting from consumers?
- What’s the most frustrating thing for staff in trying to learn more about their consumers?
- What’s the most common thing staff get wrong about their consumer’s issues?
- What do we spend the most time trying to teach consumers?
Ask the staff as you go who’d be interested in doing something about these issues.
2. Ask 10 consumers and/or their families, what they wish they better understood about your service and their care: either right now – or, if they’re a ‘frequent’ flyer, or a resident, what they wish they’d understood better in their first encounters with your service.
For example, you might ask a community health client this on their second visit. Or an acute patient and their family on their third day. Or an aged care resident and/or their family, who’s in the first two weeks in your facility. Or ask a resident and/or their family in their first three months in your facility what it was about their new home that took them a while to work out – that would have been useful to know much earlier.
3. Write each response from staff and consumers on separate post-it note, and stick them on a wall. With the group of interested staff, group the similar responses. Identify any overlaps; are there any issues that are the same for consumers and staff? Or very similar?
That’s it for this month! – Good luck!
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