"Yellow Hats are not just for Builders" An Improvement Lab for University Hospitals Birmingham NHS Trust

This was the latest of a series of workshops facilitated by Yvonne Sawbridge and Alistair Hewison.

A wide range of evidence indicated that there was a lack of the staff support necessary to enable care staff to deliver compassionate care.  The aim of this programme of work was to address this deficit.

It is recognised that supporting and engaging staff who work in health services results in tangible benefits for patient care, including reductions in patient mortality and morbidity.  Staff well-being is essential if high quality compassionate care is to be provided. However if staff are to manage the emotional demands of their work, avoid burnout, and continue to provide care for patients, systems of support are needed in the workplace and caregivers have opportunities to recover during the course of a working day.  However the provision of such support is limited.

The aim and focus of the programme is to empower and enable staff working in a range of health and social care organisations to develop context sensitive staff support systems.  The requirement that teams of three attend from each ward/unit helps ensure that mutual support is available to implement any identified changes.  A senior, middle, and operational level leader attend the workshop and devise the system to be introduced in their setting.  Prior to this an organisational readiness tool is completed to ensure the organisations are at the right stage to derive maximum benefit from the lab.  In this way multi-level leadership involving nursing staff is undertaken to introduce and roll out the system.

The Improvement Lab is a new and developing approach to service improvement which has emerged from the work of the Q initiative.  The Q initiative was launched in 2016 to connect people with improvement expertise across the UK and create opportunities for people to share ideas, enhancing skills and collaborating to make health and care better. The rationale for improvement labs is that by bringing people together to work on complex but bounded problems, creating space to work on the problems, and supporting this work with insight and analysis from topic experts, improvements in health and care can be spread and sustained. 

The strategy for change was based on the underlying principle of the Q vision of improvement labs that the ultimate measure of success will be in catalysing change that improves the quality and safety of care of patients-this may require collaborative innovation for new ideas and in others systematic review of existing good practice and collaborative work to spread these ideas into different environments and contexts.  The improvement lab reported here incorporated both of these elements.  The first lab was conducted in September 2016.  There have subsequently been six further iterations of the Yellow Hats are not just for builders improvement lab.

The approaches to staff support examined in the labs are as follows:

  • The Samaritans Staff Support system
  • Restorative Supervision
  • Group Supervision
  • Mindfulness
  • Creating Learning Environments for Compassionate Care
  • Schwartz Rounds
  • Relation Centred Leadership

Compassion circles, as an approach, was added to the most recent improvement lab.

In the early iterations experts/originators of the approaches were present, however as the work has progressed the facilitation is provided by the team. The evidence for each of the approaches is included/presented on posters which are used in the Improvement lab.

Further details can be found at: https://www.england.nhs.uk/atlas_case_study/improvement-labs-to-support-staff-in-delivering-compassionate-care/