Healthcare. A Just Culture... where are we now?

A Just Culture…where are we now?

Doing The Right Thing

Patient safety through a just culture in Healthcare

Tracy Boylin Maria Paviour

© Maria Paviour Company Ltd 2015mariapaviour.com

What will change culture?

Attitude

Values

Targets


Targets = Threat = Poor Performance

© Maria Paviour Company 2015mariapaviour.com


You can’t change culture

CULTURE = result of actions taken

ACTIONS = emotional environment (how we treat

people)© Maria Paviour Company 2015mariapaviour.com


The effects of threat

1. Tyranny – rewards bullying2. Self preservation at any cost3. “Bendable” values4. Arrogance – as a survival mechanism



Answers? Break the Psychopathic Cycle

The PSYCHOPATHI

CCycle

TARGETSTHREAT CULTURE, LOW

MORALE, LOSS OF EMPOWERMENT

REACTIVITY

ERROR INTOLERANCEILLUSION OF PERFECTION

PSYCHOPATHIC FICTIONS

NARROW FIELD OF VIEW – LOSS OF PATIENTCENTRICITY

EMPATHYLITE

DISCHARGE OF RESPONSIBILITY& BLAME GRANDIOSITY



The AspirationBreak the vicious cycle of the

disenfranchised

PATIENTCENTRIC – DRIVEN FROM “BOTTOM”

UPACCOUNTABILITY Cycle of

courage

LEARNING CULTURESHARED PURPOSE

CO-CREATION, COLLABORATION



Cohesion & shared

values

Recognition of what works

Mutual support

Innovation,

creativity and

change

The Manifestation

PATIENTCENTRIC – DRIVEN FROM “BOTTOM”

UPACCOUNTABILITY Cycle of

courage

LEARNING CULTURESHARED PURPOSE

CO-CREATION, COLLABORATION

Break the vicious cycle of the disenfranchised



What are the answers?

Build Emotional Engagement

Substantially reduce the 3A’s

Increase the Value for Money and Patient Satisfaction


Transactional/Emotional Engagement and Wellbeing



Financial Reasons - Absence EXAMPLEIndustry statistics

Day sickness absence per annum per

person

average salary

per annum

No. of employee

svalue of days lost

to sickness paSavings on lost days

UK Average sick days 9.5 £30k 7500

£8.4mCost of agency

staff:

£18.1m

UK Engaged Company Aspirational

2.5 £30k 7500 £2.2m

Savings on lost

days £6.2m

plus Cost Agency Staff

£15.9m


EXAMPLEIndustry statistics

Attrition Rate

average salary

per annum

No. of employee

s

Cost of attrition/

Replacement @ 150%

Savings on lost days

UK Average sick days 14.6% £30k 7500

£49.2m

UK Engaged Company (Aspirational) 5% £30k 7500 £16.2m

Savings £33m

Financial Reasons - Attrition


Where do we start?

PRIORITY 1

Diagnose your Well being and Emotional Engagement levels

1 SD point improvement in engagement would save NHS £24m from absence alone in acute trusts.


PRIORITY 2

Well being FIRSTPull people out the riverGo upstream – stop people

falling in

Where do we start?


PRIORITY 3

Invert the pyramid - Increase Autonomy Patient satisfaction is the driver Clinicians care requirements supported

by creative managers “Only do what only you can do”

Where do we start?



PRIORITY 3Focus on development for 1st Line Nurse Managers Autonomous management of patient

care at the point of need

Creativity Innovation Change

Where do we start?



Co-creating a Just Culture Actions NOT Words

What we model NOT what we demand Only one target Change … starts from the top…

...the very top

mariapaviour.com


What is the NHS culture?Target/threat driven (led and

managed)Hierarchical in conflict with

Existential (values mismatch)

The Emotional Engagement SpecialistsMaking Sense of Psychological Well-Being for Peak Performance

mariapaviour.com01825 830884 | [email protected]

Healthcare. A Just Culture... where are we now?

Health & Medicine

Transcript of Healthcare. A Just Culture... where are we now?