2 WHERE ARE WE?Diverse population with Hull identified as very deprived vs. more affluent East Riding of Yorkshire. Variety of geographical challenges from Inner city to rural countryside and coastlines
3 We employ approx 7500 (WTE) staff and our income for the year is £483m We serve a diverse population with needs ranging from reducing teenage pregnancy to reducing deaths from Heart Disease and cancerWe provide medical and surgical services for approx 600,000 people who live in the Hull and East Yorkshire Area. We also provide a range of more specialist services such as, cancer, neurosciences, cardiology, cardiothoracic surgery, renal medicine and dialysis to a wider geographical area in North Yorkshire and Lincolnshire.
4 Two main sites of inner city vs. suburbs Hull Royal InfirmaryHull Royal Infirmary is mainly an emergency site, but also has women’s and children’s services, an Eye Hospital, and extensive Outpatient and Diagnostic services.90,000 Emergency patients87,000 Elective Patients154,000 New Outpatients(2010/11)Castle Hill Hospital is an elective site with some emergency cardiology services on site (emergency stenting). There are also more Outpatient and Diagnostic Services based here.Castle Hill Hospital
5 Trust ChallengesQuality and Safety e.g. Recent High Mortality RatesFulfilment of Vision, Values, Behaviours and achieving Strategic Objectives
6 The Organisational Development Journey for HEY The Vision, Values and Behaviours for our Trust have been the “due north” for the development of our OD Programme of work.“Great Staff, Great Care, Great Future”This focus and golden thread underpins the OD design process and also ensures we are directly supporting the delivery of the Trust strategic objectives with a particular focus on:“demonstrating strong, respected, impactful leadership”“ A capable, effective, valued and committed workforce”
7 Branding that makes sense of the complex OD agenda…
8 Listening into Action “To fundamentally shift how we work and lead, putting staff - who know the most - at the centre of change”Embedding a new way of working - engaging and empowering staff around all our major challengesMoving to a new mind-set where we:Take responsibilityShare ownershipHelp to ‘unblock the wayLearn from our mistakesCelebrate successes
9 Listening into Action Sponsor Group Small group of 6-8 passionate, committed leaders who will be leading the spread of LiA –Their mission is to make it a great success and ensure it leads to better outcomes for patients, staff and the TrustIncludes: Phil Morley, Jayne Adamson, Lucy Vere, Myles Howell, Stacey Healand, Mark Pritchard, Sarah Bates, Janet Cairns, Mo Aye, Debbie Brown, Matt Clark
10 Listening into Action Over the last 12 months Five big LiA Staff Conversations...Personally led by our Chief Executive with a rich mix of staff across all levels and roles – to get an unprecedented view of ‘what matters’ and ‘what gets in the way’Trust-wide ‘quick wins’ and ‘enabling’ schemes...In response to what we heard, starting without delay and with direct involvement from staff to take action and improve the way things are around here3. LiA applied to our most important priorities...Engaging all the right people around our biggest challenges at a strategic, operational and frontline level, with an absolute focus on outcomes for patients, staff and the Trust – 10 Teams will pioneer the approach from September 2012-December 2012, then 10 more every 12 weeks.4. LiA embedded as ’the way we do things around here’…Supporting all teams to use LiA to engage people around the outcomes they want to see, so this gets it into the ‘lifeblood of our organisation’
11 Measuring Our Success: Baseline Organisational Measures Patient Safety ScoresPatient Satisfaction Scores (local and national)Staff Survey – Staff Engagement QuestionsPulse Check - around 2000 staff have filled in (every 2 months going forward).
12 Focus on - Staff Survey Results on Staff Engagement These are the staff survey results that should be positively influenced by the success of the staff engagement process led by the Hey, Its in Our Hands approach.
13 Questions (N = 1971 13:00 15/06/12) 44.92% 55.08% 26.19% 73.81% 27.8% Positive Responses (4-5)Room for Improvement (1-3)1) I feel happy working in my work area/team/department44.92%55.08%2) I am involved in deciding on changes introduced that affect my work area/team/department26.19%73.81%3) Senior managers encourage staff to suggest new ideas for improving services27.8%72.2%4) Day-to-day issues and frustrations that get in our way are quickly identified and resolved13.69%86.31%5) This Trust communicates clearly with staff about what it is trying to achieve31.12%68.87%6) I believe we are providing the very best services to our patients and their families31.75%68.25%7) How satisfied are you with the extent to which the Trust values your work?16.22%83.78%8) I am proud to work in this work area/team/department53.64%46.35%9) I feel that I understand the connection between my role and the wider vision of the Trust39.72%60.29%10) Communication between senior management and staff is effective19.48%80.52%
15 Summary of progress Phase two – Engaging staff around what matters Five Big Conversations – over 300 staffManagers’ Big Conversation – 80 staffIT held their own eventOver 800 staff having had a big conversationFeedback identified common themesPatient Care Issues – bed managementCommunication – talking to the frontlineResources (staffing)Processes – bureaucracy and policiesIT– frustrations with technology
16 Summary of progressStaff voted for their top five priorities for the next 12 months:Introduce competency levels for managers who want to be promotedA staff engagement assessment for service changesCreate a dedicated LEAN teamCreate system to match timely bed capacity to patient needIntroduce a nurse ‘bench’ to give newly qualified nurses opportunities for experience and to address staffing gaps
17 Big Wins BIG WIN PROGRESS COMPLETION Do not authorise any service change without evidence that staff consultation has taken placeValues- based change guidance in development. System to make staff accountable under discussion.March 2013All managers will be required to reach a specific level of expertise in their role through formal training and assessment and cannot be promoted without this evidenceIdentify key areas for development for managers. Part of the change management process – change agents, Achieve Breakthrough.July 2013Employ a set number of newly qualified nurses on a nurse ‘bench’ who can be deployed on a daily basis to areas of need without the requirement to use agency staffFull review of nurse strategy, staffing in progress.September 2013Create a dedicated team to identify where processes and systems are not working efficientlyReview of Service Improvement service underway.April 2013Create system to match timely bed capacity to patient's needsElectronic whiteboard implemented. Comms campaign launched to focus on the benefits of the system for patients and ward staff
18 Summary of progress Quick wins from the Big Conversations Link Listeners scheme launchedMake it Happen FundMoments of Magic monthly winnersGuest wi-fi zonesORMIS log-in for theatres staffNew format for meeting agendas
19 Link Listeners - pioneering communications Our staff told us that we needed to do more to communicate with the frontlineCorporate communications were stuck in the vanilla layer!Staff wanted regular face-to-face briefingsOver 100 staff make up our Link Listener network, representing all areasacross the Trust.They meet with the Chief Executive every two months and with their senior management teams on interim months.They have access to a ‘bat phone’ whichthey can call 24-hrs a day to speak to aTrust Executive Director.Their briefing sessions have been very well attended.Feedback has been almost 100% positive.Health Groups and Directorates meet with their Link Listeners on the interim months when they don’t meet with Phil
20 Summary of progress Phase three – pioneer teams Ten teams with director sponsorshipEach with their own mission and set of outcomesSupported with project and change management skills90-days to complete their piece of workEach will conduct a pulse check and hold a Big ConversationTheir stories will be communicated widelyIn January they will pass on their experiences to the next set of pioneer teams
21 Achieve Breakthrough Vision and Goals Achieve Breakthrough is about delivering real mindset change within the OrganisationIt is about releasing the potential of teams and individuals to unhook themselves from all the back ground noise and see what is possibleIt focuses on delivering real and breakthrough results for teams and individuals
23 Conversation before Pioneer Team I’ll support you but you should know…We have done things like this before you know…Wow, that sounds like it would be a great Pioneer project… why don’t you think about applying…But we’ve done all of this…It’s fine working with us but you’ll need Social Services in the room…Will it involve post its?!I’ve heard all of this before…
24 Results Cancer Survivorship 70% increase in referrals to the service 100 Referrals into exerciseCertainty over future of the serviceOrthopaedic FractureLOS reduced from 19 days to 14 daysPatients 28% less likely to die in hospital40% less likely to develop pressure sores53% less likely to have a slip trip fall
25 Pioneer Teams – Real Results A 70% increase in referrals in to the cancer survivorship serviceThe creation of an IBD biologic unit in the gastroenterology wardAccess to remote paperless working for all neurology nursesHip fracture patients are now 28% less likely to die whilst in hospitalOne lift in HRI is now isolated for patient use only to improve privacy and dignity6 out of 7 anaesthetic rooms in HRI theatres have been remodelledPatient therapy sessions to be scheduled through the Cayder boardsA standardised Bereavement service has been developed for the relatives of deceased patients
26 SECOND PHASE OF PIONEER TEAMS Achieve an efficient neurosurgery journey with cancellations and ‘delay’ the exception rather than the rule.Reduce the burden of answering telephone calls on wards.Create Enhanced Recovery for Patients undergoing Breast Surgery.Provide the best possible catering service for Trust staff.Develop Nurse Led Follow up clinics for Hip Replacements, Open Reduction Internal Fixation (ORIF) and Acumed Plating of wrist fractures, to reduce the follow up burden on medical staff.Build an efficient, sustainable dietetic outpatient service for Oncology and Haematology patients.Improve the patient experience and dignity of care for obese patients.Community Midwives to improve the way they order, organise and use stock and equipment. Ensure that their time is freed up to spend with women.Reduce the number of lab results that are printed out and then have to be filed in the notes.Reconfigure Urology inpatient and day service facilities in order to ensure patients are assessed and appropriately managed in the right place, at the right time, by the right people.
27 Conversation nowHave you seen the LoS stay figures?It’s really good work…Wow, that Pioneer thing seems really good, maybe we should apply next time…It’s been hard, but worth itI haven’t got as far as I’d like with this, but I’ve found another way…I’m really glad we’ve done it…You should be nominated for a Golden Hearts award…
28 Link Listeners and changes to Phil’s Brief Influence of pioneer teams?These issues are reflected in our staff survey results – Topics to be picked up by this summers Big Conversations
30 The Golden Hearts Awards A clear focused reward programme for teams and individualswho show outstanding commitment to our values and behaviours and strategic objectivesCategories align with our brand pillars