Health and social care staff experience: report 2018

Part 6: "People Make Change Happen" - iMatter Team Stories

Introduction to Team Stories

Team Stories are a vital part of the iMatter programme. They illustrate the way in which individuals and teams have come together to review the results and share thoughts and ideas in order to develop and implement Action Plans. For the iMatter 2018 programme, 24 Team Stories have been put forward for inclusion in this report. They represent the majority of NHSScotland Boards and includes six Health and Social Care Partnership stories.

This section of the report contains a review of the content of the Team Stories that have been shared, drawing out recurring themes. It includes an overview of the Team Story formats, the role of iMatter and recurring themes, before then exploring individual topics in more depth. Links to the individual stories are also included.

Team Story Formats

Prior to reviewing the content of the stories, it is notable that the Team Stories shared are diverse in many aspects, reflecting the purpose and personalities of the teams involved:

• Focus: Team Stories cover a variety of topics, from individual actions to team activities, from iMatter process management to targeting specific areas of performance. This diversity is reflective of the team priorities and demonstrates the different areas of focus for each of the teams.
• Content: The level of detail provided differs greatly. This is usually reflective of the complexity or longevity of the team story. For example, some show the method used for the Action Planning process, others focus purely on the outcome.
• Teams: Stories differ in the size and composition of teams involved, from the single Line Manager team, through to amalgamations of multi-discipline teams that work together. This collaboration can be valuable in developing connectivity and efficiencies across team action plans.
• Style: With no prescriptive format for output the design of individual Team Stories differ considerably; from word documents to films, from infographics to PowerPoint presentations. It is assumed that the style is reflective of the author and/or the Team's usual style of communication. This freedom to produce the story in the way that is right for the team is an important part of their 'owning' the story and should not be stifled. Equally however, it may be helpful to provide an outline template, or even an author service for any teams who would want to tell their story but are perhaps less comfortable with the 'write-up' process.

The role of Team Stories in iMatter

The Action Planning process and Team Stories are an integral part of the iMatter process and in this section we look both at the relationship between iMatter performance and Team Stories, and the role of the iMatter programme within teams.

iMatter Team Stories and Engagement

There is a tendency for Team Stories to be provided by teams that already engaged, typically with above average scores and response rates. These teams are therefore likely to be more positive about the action planning process and sharing their story. Clearly maintaining great teams requires effort and commitment and this is being shown through an array of activities. Dumfries and Galloway Nithsdale Health and Social Care Locality Management Team in particular, celebrate the successes of the team, but also note the need to not be complacent. These stories demonstrate what can be achieved and have an overarching positivity to them. They do provide ideas and inspiration that other teams may draw on for themselves.

However, it is important that teams with greater challenges also look at how to address staff concerns and share their experiences, in order to help other teams in similar situations. Teams with issues and challenges should be encouraged and helped to develop action plans and to share their story, in order to inspire others. The learning opportunity for others will come both from seeing the success of strong team, but also from how teams with challenges are facing up to them and driving change. There are a few stories from such teams, one in particular from Scottish Ambulance Service Shotts Station is an honest and open assessment of the difficulties faced by the team.

"We had lost engagement with staff, due to a lack of communication, time restrictions, increased call volume, meal break randomness and consistent shift overruns."

This team manager has taken the opportunity to use the team iMatter report along with other team feedback to identify areas for discussion to improve staff experience. The ideas and suggestions put forward provide great food for thought for other teams facing similar challenges.

iMatter as an enabler

Many Team Stories recognise the role of iMatter as an enabler. This cuts across all teams but is particularly prevalent in H & SCP Team Stories who are typically newer to iMatter.

iMatter also enables staff to have confidence to speak their mind and share views and ideas:

" People need to have trust that they can say what they need to say, and know that if they are going to raise anything that here and now is the time to do so confidently and positively without repercussion." NHS Grampian Programmes Team

Teams talk of iMatter as the catalyst for them coming together as a team to review results and to discuss and develop action plans. There is a sense that without iMatter other activities would take priority and this forward focus on team improvement might not happen.

"iMatter provides the platform and vehicle to move on but does require someone to see it through." NHS Grampian Programmes Team

"The whole (iMatter) process allowed us the opportunity to have more reflective and planning time together, something we hadn't taken time to realise and implement until having discussed it in detail following iMatter." Glasgow City South H & SCP Health Improvement

"We are enthusiastic about Inverclyde H & SCP and our wonderful staff; spending more time and learning from and with them is both humbling and inspirational. IMatter has helped us focus on what is important to our staff and by focusing on this improvement journey we trust they will know that they matter, we all matter." Inverclyde H & SCP

Recurring Themes

Throughout the Team Stories, across the different content and styles there are a number of recurring themes:

Key to the success of all of the Team Stories is communication, whether that's between staff and management, within teams or across teams. There is a recognition that communication is key and there is clearly a lot of effort and energy going in to improving communications methods and content. There is also acknowledgement that considerable commitment is needed to address communication issues.

"We identified two main areas that we could improve as a team: communication and relationships. These were big, daunting issues to tackle, but by creating our iMatter action plan we were able to break it down and map out some of our solutions ……We all put in effort and bravery as individuals to improve our team relationships, stepping outside our comfort zone both at the coaching sessions and in day-to-day work." Health Improvement Scotland Maternity and Children Quality Improvement Collaborative

Collaboration

There is widespread focus on collaboration within and across teams.

"We are a good team to work in…..We work well together." NHS Orkney Quality Improvement Hub

Examples include separate teams working together to improve the patient experience, dispersed teams working out how they can work together most effectively, senior and junior staff creating opportunities to work and train together. The example below illustrates how the South Ayrshire H & SCP Dietetic Team visualised their discussions.

Celebration and Positivity

Many Team Stories demonstrate how success and achievement are celebrated. In some instances it is a celebration of what has gone well and scores accordingly in iMatter. In others it is an awards process that celebrates actions that improve staff and/or patient experiences.

"Collaborate as a team to celebrate National AHP day 15 October to share out practice at the Journal Club." The State Hospital (Allied Health Professionals) AHP Team

The example below from NHS Orkney conveys well the celebration of the team strengths and focuses on how to improve still further.

Patient Care and Experience

Many of the Team Stories are explicit in the link between their actions and the patient experience, prioritising actions that will benefit the patient. Examples include ward teams working together, awards that acknowledge great patient care.

"Greater efficiency will hopefully benefit women we look after." NHS Lothian South East Community Midwives

"This has reassured the team that changes can happen to improve how we work better together and in turn improve our services to local people." Glasgow City South H & SCP Health Improvement

"Improved joint working between all AHP groups for patient rehabilitation." The State Hospital AHP Team

"Greater efficiency will hopefully benefit women we look after." NHS Lothian South East Community Midwives

There are many examples of staff 'going the extra mile' to deliver on agreed actions:

"In addition to team meetings, staff agreed to put time in to catch up and work better together away from the core team meetings." Glasgow City South H & SCP Health Improvement

The Simple Things

There are many examples of teams taking simple small actions that will make a real difference. This takes nothing away from the effort and commitment to much larger actions, but demonstrates that commitment to action planning does not always need to be a daunting task, sometimes a quick and simple act can have significant impact.

"We have introduced name badges for the whole team which clearly state to patients and colleagues what our name is and that we work in pharmacy. We celebrated the role of Pharmacy Technicians on Pharmacy Technician Day in collaboration with our comms department." Golden Jubilee Pharmacy Team

Another such example came from NHS 24 where actions were taken to streamline the process for requesting access to call listening NHS 24.

Ownership

The Team Stories widely acknowledge the need for ownership at either team or individual level. Throughout this report there are numerous examples of individuals and teams taking ownership for agreed actions.

Fun/ Light hearted

Several of the Team Stories explicitly use the word 'fun', others demonstrate it through enjoyable team building activities etc. This is not to reduce the seriousness of the activity, but to increase its accessibility to the widest possible audience and improve staff experience.

"The aim being to fully utilise the skills of all the team - communication, negotiation, creativity and have fun together." NHS Health Scotland Awards Team