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Elizabeth Robb
The Florence Nightingale Foundation
January 2014
2013 – The Year of the Report!
4 Key Themes:
Leadership
Culture
Openness and transparency
Workforce
Culture
Values
Patterns of Behaviour Competencies
Attitudes
CULTURE
Ref: C Vincent 2006
“You must be the change you wish to see in the world”
Mahatma Gandhi (1869 - 1948)
The 10 Essential Qualities for Leadership in the NHS 1. Demonstrate shared values
2. Don’t be, or become, cynical
3. Build bridges
4. Be resilient
5. Support new ideas
6. Communicate clearly and honestly
7. Manage upwards
8. Manage time carefully
9. Say sorry and thank you
10. Build a team that will challenge you Dame Ruth Carnall 2013
High-Impact Leadership Behaviours What leaders do to make a difference
1. Person-centeredness
2. Front Line Engagement
3. Relentless Focus
4. Transparency
5. Boundarilessness
Be consistently person-centered in word and deed
Be a regular authentic presence at the front- line and a visible champion of improvement
Remain focused on the vision and strategy
Require transparency about results, progress, aims and defects
Encourage and practice systems thinking and collaboration across boundaries
Swensen S, Pugh M, McMulland C, Kabcenell A. High-Impact Leadership: Improve Care, Improve the Health of Populations, and Reduce Costs. Cambridge. MA: Institute for Healthcare Improvement 2013. Available on www.ihi.org.
Leadership Scholarship Purpose
Scholars undertake a bespoke programme to:
Increase the individual’s leadership skills, confidence and personal impact;
Clarify and address their career objectives; and
Undertake a patient care improvement project with demonstrable impact on clinical care.
Aims of the Leadership Scholarship Evaluation The impact of the scholarship on the scholars’ careers,
personal practice, leadership qualities and behaviours, mindset and thinking.
The impact of the scholarship on patient care / safety / experience.
The expectations of the Florence Nightingale Foundation Leadership Scholars – how/if the award met their expectations.
Scholars’ plans for publishing their work.
Strengths of the programme and how to improve it.
Methodology and Response Rate The evaluation was undertaken by the University of
Southampton between November 2012 and January 2013.
Three cohorts of scholars were included –2009-10, 2010-11 and 2011-12 – a total of 43 scholars (33 Nurses / Midwives and 8 AHPs).
41 scholars completed the online survey, a 95% response rate.
Follow-up telephone interviews were conducted with 36 scholars.
Follow-up interviews were also conducted with 19 scholars’ sponsors (line managers).
Headline Findings
100% agreed that the Scholarship met or exceeded their expectations and would encourage others to apply.
98% rated the programme as excellent and had impact on their careers.
95% agreed that it affected their personal professional practice.
Between 88% -90% were able to report positive benefit on patient care – in particular patient safety and experience improvement.
Effects on Professional Practice The most common changes in professional practice
highlighted by Scholars include:
Identifying and presenting data at Board level to influence decisions;
Motivating others (including senior colleagues) to excellence;
Mentoring others and identifying “rising stars”;
Maintaining a strong, nursing-influenced, leadership voice;
Allied Healthcare Professional Scholars said that they were viewed as “peer leaders” by clinical staff;
Significantly increased self confidence.
Impact of Scholarships reported by Sponsors An increased ability to challenge and to suggest and implement
innovative and ‘out of the box’ approaches to difficult organisational problems;
An ability to manage and lead upwards (including to Board level) and horizontally (including influencing national and regional organisations);
Increased ability to delegate;
Pronounced awareness and appreciation of politics;
Understanding and using an organisation’s culture to bring about change and transformation;
Increased strategic thinking;
Using evidence, including benchmarking, to measure improvement.
Impact of Scholarships on Careers 20% of scholars demonstrated a direct impact on their
careers by gaining a significant promotion.
A majority said that the scholarship had helped them refine their career objectives and gave direction to job applications.
Sponsors reported key impacts on leadership behaviours, financial planning and delegation to and motivation of staff.
A large percentage of scholars said that the scholarship was “life changing” and increased their confidence and personal impact.
Projects Impacting on Patient Care, Experience and Safety Designing integrated pathways and integrated governance frameworks
Reduction of pressure ulcers by 25% in six months
Implementing the WHO safety checklist
Implementing Mayo Clinic human factors practice
Involvement in care by patients in a stroke rehabilitation ward
Quality improvement projects for leg ulcers, end of life care and dementia care
Development of KPIs on safety and experience in 35 acute wards
Benchmarking improvement initiatives
Family involvement in care, including administration of medication
Winning the HSJ Safety Award with an Early Warning System for Acute Mental Health Patients
Sponsors’ Views 95% of sponsors said that they would sponsor candidates
again “I would send all of my staff on this programme if I could” said one CEO
Value of scholarship learning to organisation as a whole One sponsor said “A huge opportunity for the scholar and lots of transferred learning back here”
Increased confidence and ability of scholar
Better able to challenge existing thinking
Use of tools to drive and measure improvement “The scholar has visibility and has stepped up a notch in performance” “He challenges staff and the clinicians (doctors) really listen”
Summary of the Scholarships Evaluation Scholars felt that they were valued both personally and
professionally
Many felt inspired by the process which led to feelings of energy and motivation
The scholarships had a wider ‘ripple effect’ on practice beyond the individual scholar
To conclude: the FNF scholarships allow for personal and professional development with a clear focus on the improvement of patient care
Key Strengths of the Bespoke Leadership Programme
Quality of the mentors provided
The Westminster Experience
Leading Change through Organizational Renewal
Florence Nightingale Foundation support
Networking and peer support
The flexibility, independence and autonomy which encouraged:
Personal and professional growth
Increased self reliance and self confidence
A broader perspective than from a highly structured programme
A step change in their skills and ability as seen by sponsors
What the Scholars said:
“This is a once in a lifetime opportunity”
“The scholarship completely changed my career”
“The scholarship was life changing”
“An amazing opportunity to undertake a bespoke programme of personal development”
“Truly transformational”
“The scholarship was a brilliant enabler that allowed me to learn, think and reflect. There is no way that this could have happened in my day-to-day work in the NHS.” Peter Blythin, Director of Nursing
“It made me think outside the box and see a world that is larger than the NHS. It inspired confidence and broadened my horizons.” Katherine Fenton, Chief Nurse
Other Key Areas of Foundation Work
Westminster Abbey Florence Nightingale Commemoration Service, 7th May 2014
Students’ Day, St Thomas’ Hospital, 7th May 2014 – Please Nominate!
Florence Nightingale Foundation Chairs in Nursing Clinical Practice Research
Contact Information Website: www.florence-nightingale-foundation.org.uk
Twitter: @FNightingaleF
Email:
General: [email protected]
Leadership: [email protected]
Address: 34 Grosvenor Gardens, London SW1W 0DH
Telephone: 020 7730 3030
Fax: 020 7730 6262