Kindness, compassionate leadership and putting people first – FCA reflections on Sheffield’s Improvement Expo 2022

We attended sessions spanning a whole range of topics including various FCA representations from the Sheffield Sepsis Big Room and their experience of team working to improve outcomes, an FCA-hosted panel about improvement in the virtual world and a live Lancashire Colorectal Cancer Big Room.

Throughout the week we noticed that a key theme of conversation from these Keynotes surrounded putting people first – being kind, leading compassionately and ultimately recognising that the system is only as successful as the people within it.

This is a principle that is very much shared by the Flow Coaching Academy with our mantra that improvement in healthcare is 80% human and only 20% technical.

Bob Klaber, Paediatrician & Director of Strategy Research & Innovation at Imperial College Healthcare NHS Trust

Bob hosted an insightful session titled ‘Leading for kindness in healthcare’ where he presented some challenging questions encouraging everyone to incorporate more kindness as part of their day-to-day role. He posed that the current collective leadership challenge should be to reconnect healthcare with its mission and purpose and how this could then improve patient and population outcomes. He closed the sessions with some questions for the audience to reflect on including: What am I going to do to increase the focus on kindness and to reconnect myself and my colleagues with the real mission in healthcare? When I see unkind behaviours, what am I prepared to walk past and ignore?

Michael West, leader in compassionate care in health services

Michael’s session centred around Compassionate Leadership for Compassionate Cultures. He discussed the four main elements of compassionate leadership including Attending, Understanding, Empathising and Helping. He emphasised the need to intervene and address stress at the primary source, by modifying and eliminating the stressors in the work environment to reduce workload and empower teams to work more effectively and humanly. He also shared the power of having time to reflect, learn and adapt, reminding the audience of the ‘Inverse Recovery Law’ – that those whose work is most stressful are least likely to do activities that aid recovery.

Dr Anne Kinderlerer, Consultant in Rheumatology and Acute Medicine at Imperial College Healthcare NHS Trust

As a trained FCA coach and clinical coach for the first Sepsis Big room, Anne took us back to pre-pandemic times to look at Imperial’s improvement journey to implementing a new EPR system, Cerner. She talked through the process of building a Sepsis dashboard in the system and how vital working with an analyst was to ensure the correct data, in the correct timeframe and correct order was available to view.

One part of the session that especially stuck out for us was how involving junior doctors in this process led to a slight change in language on the closing alert. They found that when asking if the patient has Sepsis or Severe Sepsis the existing ‘No’ and ‘Yes’ options made making this decision hard. Instead, changing the wording of the ‘No’ option to ‘I don’t think the patient has Sepsis’ felt more comfortable for Junior Doctors to pick and therefore made the process more efficient, despite the effect of the alert being the same. This really reinforced the value of the FCA Big Room in bringing various stakeholders in the pathway together to work on, and develop changes together that they may otherwise have had zero awareness of – all of which ultimately improve the care that patients receive.

Marjorie Godfrey, Research Professor, Department of Nursing Founder, Executive Director Institute for Excellence in Health and Social Systems

Marjorie’s session ‘Micro-Meso-Macro Healthcare Recovery: Workforce Resilience and Wellbeing’ talked about the current issues that are impacting the workforce and learned some possible strategies to change and improve these. Marjorie shared data to support her conclusions from the Gallup Global Emotions Report, McKinsey’s Physician Survey and first-hand reflections from the audience amongst others.

Key themes of conversation were that for most people the self-awareness that they are stressed at work and often working beyond capacity is there, however having the time and authority to proactively improve this for themselves and their teams is not. This theme resonated strongly with the FCA team and is something we hear often from our coaches that they simply do not have the headspace to work on themselves and their systems.

This is one of many reasons the FCA programme is designed to allow coaches the time to reflect not only on the pathway, system, and network that they work in but about themselves for their own development also. Over the past couple of years, we have found that this element of the programme has become more valuable than ever. Giving our coaches that time to offload, share and support each other encourages them to embrace being human and recognise that everyone else involved in the work is human too. Then, as part of their improvement work, bringing everyone together in a Big Room context to do the same really highlights the power of people – something that was evident throughout the Sheffield Sepsis Big Room session too.

Medicine is transactional… healthcare is personal

Marjorie also suggested that the turmoil of the pandemic has created a perfect opportunity to undergo a ‘team reset’ for teams to step back and reimagine how they will best work together moving forward. She placed emphasis on the role of professionals as the most asset in healthcare and suggested that it is just a case of getting started, going back to basics and focussing on communication and relationships. A tool she suggested to do this is Relational Coordination, something that is taught as part of the coaching element of the FCA programme, which is a framework to assess and improve timely, efficient, accurate, problem-solving communication and relationships that have shared purpose, shared knowledge, and mutual respect.