The Face of AfPP Competition - Overall Winner
Released on - 01/10/2020
The Face of AfPP Competition - Overall Winner
We are delighted to announce that the overall winner of our Face of AfPP Competition is the Paediatric Recovery and Day Surgery team at the Cambridge University Hospital. Congratulations to the team and all involved in this initiative, below is their submission.
Our team consists of 20 staff, 17 registered Children’s nurses and 3 health care assistants. In addition, we welcome Student Nurses and Adult Nurses as learners. We care for children, young people and their families in 7 different areas across our trust following General Anaesthetic for surgery or radiology procedures. Within our Trust, there are core values of Safe, Kind and Excellent. The team worked to these, and there were no concerns regarding their behaviour. However these values are adopted rather than created by the team.
After reading about the positive impact that a culture book had within “Zappos”, an online shoe shop, we decided to explore the benefits that this could have to our team. In Zappos the Culture book aims to provide a glimpse of the Zappos culture to new starters, their vendors and partners – and anyone else who is interested. It is made up of unedited employee submissions about what the company culture means to them.
We started by asking each staff member to create a list of 10 words for their “core” and “wish” values. These were then themed, and prioritised anonymously by the whole team using Mentimeter. This is an easy to use, online feedback and presentation app. The top 5 “core” values are used to focus care and action plans and the top 5 “wish” values are used to focus training and education.
Following this, each appraisal team was given a morning where they were asked to consider:
- What is important to you about the way we look after our patients?
- What is important to you about the way we look after each other?
- What is important to you about the service?
- What is your vision for the service over the next 5 years?
- How are we going to get there?
We then bought together all of the ideas and suggestions and identified theme actions. The actions were prioritised by the whole team, and all members took ownership for individual actions. We now share updates weekly through our mini-meeting, and review our vision monthly as a team. We encouraged the importance of regular small changes to make a big impact to our patients and team.
The service leaders serve as supportive and credible role models, and by relinquishing control have created empowering attitudes, encouraged innovation and commitment to quality of care. We have increased the engagement of staff within the Paediatric Recovery and Day Surgery team, by developing a culture of two-way trust by aligning values and strengthening workplace culture.
To date, we have made 43 improvements to our service. Some have been “small”, some larger. Some examples of these changes are:
- Changing the structure of morning handover, to incorporate a safety huddle style, rather than a simple list of patients and procedures.
- Creating a crib sheets to support staff during pre-operative visits.
- Adding reflection into 1:1 meetings.
- Restructuring the learning opportunities to learners.
- Developing a Braille Bravery Certificate.
Some of the benefits are demonstrated by the Paediatric Recovery are:
- Patient feedback has increased from 1-3 FFT survey responses per month, to 15-29 per month, and we continue to achieve a 100% recommender score.
- One action was to collect feedback for our day surgery ward (previously unrecorded) and in September 2019 we achieved a 100% FFT response rate.
- We have 0 Vacancies. Up until this point, the lowest vacancy rate we had over recent years was 20% of Band 5 Staff Nurses.
We always celebrate our successes – even the small ones. We can do this in a range of ways (by giving a “Sticker” for colleague of the month, by nominating someone for a trust recognition award, or by celebrating on social media). This gives the team a pride in the work, and some healthy competition, which in turn encourages further ideas and ownership. We have shared our learning, via a poster presentation at the “FAB change” event within the trust. It has also been presented to the divisional Patient Experience group, Divisional Matron Forum and at a Trust Education and research showcase and at a regional study day.
The team goals are reviewed monthly at departmental team meetings, then progress is discussed at the weekly “mini-meeting” to continue to drive us forward, ensure focus and that improvements are sustained and consequently we hold ourselves to account. We will hold an annual review of the work, re-evaluating our values and priorities in order to ensure that the culture book remains relevant and valid, and so that it reflects the whole team views, takes into account patient feedback received and considers current service needs.
We have taken our Trust’s values and priorities, then used these and asked the whole team to develop our focus and prioritise how our service will evolve. Throughout this journey, it was important that the team culture book did not undermine the Trust values. I feel that they add a depth, rather than detracting away from them.
This project aimed to improve staff engagement and service ownership, unleashing the potential of the whole team to adjust and adapt rather than using a typical bureaucratic, top-down approach to service improvement.
In this instance the role of the leader is to create an environment and conditions necessary for transformation, not create the innovation itself. It was important that the changes came from the team, as by enabling behaviours and creating opportunities, transformation is naturally developed.
The Paediatric Recovery and Day Surgery team
- Annelie Seiler, Staff nurse
- Jonty Sweetman, Staff Nurse
- Katie Bagstaff, Senior Sister
- Tanaya Saleh, Staff Nurse
- Lisa Axford, Staff Nurse
- Rachel Horsfall, Staff Nurse
- Claudia Iorio, Junior Sister.
There were no costs to our project.