Friday, 20 December 2013

Why staff engagement is vital for healthcare innovation

Why staff engagement is vital for healthcare innovation
Frontline staff can design solutions to the big challenges for the NHS, but they need freedom, confidence and encouragement.
Genuinely informed, engaged and empowered patients are a force for good. They help us to improve quality, reduce costs and manage expectations.
But what comes first? Research published at the World Innovation Summit for Health (Wish) in Doha this month looked at eight countries around the world and assessed what drives healthcare innovation.
Supporting champions was ranked globally as the most important driver, followed closely by harnessing the efforts of patients and the public as co-producers – interestingly, with the exception of the UK, which put patients first. In third place was addressing the concerns of healthcare professionals about outcomes and sustainability.
Inadequate training and teamwork were identified as barriers. I'm not sure we needed more proof, but it's a stark reminder. We can't effectively engage patients and innovate unless we put our staff first.
We know that frontline staff, when provided with enough freedom, confidence and encouragement, can be capable of incredible things – improving care, reducing costs and designing solutions to our big challenges. From home dialysis to paramedics on bikes, the list of life-changing innovations combining science with commonsense is a long one. Plus, they are designed by, and more importantly implemented by, staff.
Despite this, however, we often don't prioritise them or have in place the framework to fully engage them in the process of improving their NHS.
Real staff engagement needs real investment. Not just a financial commitment but investment in genuinely facilitative leadership – the kind that is prepared to "walk the talk" and make engagement a truly two-way exercise.
The pressure on budgets and resources creates an urgency that is not conducive to genuine dialogue. The question is whether this is time and money saved or wasted?
Research is beginning to tell us that many staff are so disconnected from the wider system outside their own clinical area that they don't understand what's happening in other parts of the system. A study into inappropriate A&E attendance in the South Central region, for example, found that a quarter of patients were misdirected by staff who had limited knowledge of local alternatives to the A&E route.
This health illiteracy, in terms of a wider system understanding, extends to NHS staff at all levels – improving it will require commitment. but investing the time and effort will produce enormous benefits.
Just like patients, staff come in all shapes and sizes. Engaging them effectively will require an acknowledgment of the differences among them and an understanding of their context – what motivates, influences and inspires them. We need to apply our behaviour change principles to staff, not just patients.
We also need to combine this with new ways of showing – rather than simply telling – staff about innovations and best practice from the UK and beyond. PowerPoint presentations and the odd staff meeting are useful but not enough. They need to see, touch, feel and spend time building understanding and considering how they can make things work in their context. Peer-to-peer networks are where real solutions will come.
All the evidence points to the fact that we need to do it properly, which might have financial consequences in the short term. But the potential results, in terms of empowering staff to get it right first time, are likely to deliver a number of longer-term benefits.
The good news for the NHS – and this should inspire every one of us – is that once staff do become engaged, there is evidence that they are both willing and able to pick up and run with the baton of responsibility.
Take NHS Change Day, which is surely the ultimate symbol of the power of a workforce inspired by colleagues and given the unspoken freedom to try something different.
From a single tweet to 189,000 pledges in space of a few months is an unmissable signal of intent. So powerful, in fact, that health leaders from around the world, represented at the Wish summit, are already considering how they can harness the "power of the pledge" in their own systems.
NHS Change Day shows us the spark for collective action is there. We don't even need to ignite it. We just need to provide the right conditions for the flame to burn more brightly.
Who knows, within a few years we could see NHS staff emulating patient networks such as patientslikeme.
So, when we think shared decision making, co-creation and service design, health literature, patient literature and patient centered leadership: think staff. When patients are ignored, they are most at risk – that was the central conclusion of the report by Robert Francis into Stafford hospital. I'd add to that and say that when staff are ignored, the NHS is most at risk.
Claire Cater is founder of the Social Kinetic and a member of the Wish Forum for Patient Engagement Guardian Professional.

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