How can I grow, if I don’t know?

As the year draws to a close, our team chose to each share with you our reflections on one to two stories that personally impacted us this year.

As I thought back on the stories, I realised that for me, the stand out was is less about an individual story, and more about a trend I’ve seen emerging over the past 12 months – or longer if I’m honest. It’s evident in the slightly critical stories about the ‘soft skills’ of the job. Staff language and the tone, how often information is being relayed (or not relayed), consumers witnessing the eye roll or not feeling listened to.

My reaction to these stories is not judgement but curiosity as I wonder what else was happening in the world of that staff member. Abruptness often comes from stress, tiredness, grief and even fear. These stories remind me that an experience of care doesn’t only belong to the consumer - it's the staff members' experience too. Don’t get me wrong, I’m not saying it’s ok to be abrupt, simply that we are all human. Mistakes happen and we aren’t all kind 100% of the time. It’s simply that in health and aged care, words and body language can have a greater impact than on a job site or in an office.

So, let’s talk about burnout.

When working with service providers, I often see a managerial instinct to protect frontline staff from critical feedback – especially when the feedback ‘soft skills’, come in. Because those stories are often felt on a personal level. As it is, retaining staff, and keeping up staff satisfaction and wellbeing in this sector is hard.

We find decision whether to share the feedback with staff or keep it quiet is usually influenced by the organisation's feedback culture. 

I recently stepped up into the Manager role at Care Opinion. Anyone stepping into a new role has to walk the learning curve and I hit the ground running, making my first mistake before the ink was dry on my contract. I am blessed to be under the leadership of a kind and wise General Manager. Her focus was not on my mistake, but on what I had learned from that mistake and what I was going to do to prevent it from happening again.

Now, whilst I have been taking on higher duties for over a year now, managing staff is reasonably new to me. My first priority was to speak with my team to better understand how they preferred to receive feedback. “Often, direct and to my face” was an answer that came back in a heartbeat. This was a person for whom kind words were nice, but having something from which to learn and grow was far more valuable. It gives this person something concrete to focus on – and focus she does. I rarely see the same mistake repeated.

I love her attitude towards feedback, so as a team, we’ve each committed to being open about our mistakes. In fact, we’ll be sharing them in our regular huddles. Not for performance management but for learning.

Already, it's paying off. One of the challenges we face is keeping across all the contacts for all of our different stakeholders. Different clients have different information needs and preferences. Keeping contact records current is a big job when they comprise extraordinarily mobile workforces. We thought the process for keeping records current was working until some clients were left out of a key communication. End of the world? No. Embarrassing? Yes!

If I had have spoken to each staff member separately, I would have seen each person following the same process and would have been none the wiser as to what went wrong. Instead, as we discussed the issue as a group, we discovered this was a version control issue. Each person followed the same process on a different version of the record. Group input didn't only identify the issue, it led to the development of a more efficient process we can quality control better than before. It was all because one person was open to sharing their mistake.

Now let’s relate this to stories on Care Opinion, and I use an example here to demonstrate this.

Example scenario: A number of stories are being published on Care Opinion about the appointment booking system from patients who are unhappy with the waiting time and feel the staff are rude and impatient. Reports are showing author 'feeling' tags most frequently appearing are ‘frustrated’, ‘not listened to, ‘disrespected’ and ‘ignored’. 

Use of feedback - Scenario 1

The Director of Nursing (DoN) for the department submits a response to the stories apologising that the patient felt they were spoken to rudely. In the response, the DoN explains that they will need further information to be able to investigate what happened and invite each patient to make contact offline. They thank the authors for giving them the opportunity to review their processes and make improvements. If the patient makes contact offline, the staff member is identified and then reminded of the importance of being courteous. If the patient does not make contact offline, no further action is taken and the feedback is not shared with the department's frontline staff. 

Use of feedback - Scenario 2

The DoN notices the trend and wonders if there is an issue with staff culture. They call a staff meeting and share the story with the team. The DoN explains that the purpose of the meeting is only to get feedback on

• the booking system
• the frequency of staff facing irate and/or aggressive patients
• the impact of patient complaints/frustrations on staff wellbeing and their ability to perform their role with empathy.

Staff were encouraged to be honest and given assurances that this was not about performance management but group learning. The DoN learns that reception staff are regularly having to deal with patients’ frustration with the booking system, some of whom become aggressive which is difficult to deal with. Clinicians are feeling pressured to get through their patient lists as quickly as possible and feel unable to give the patients the time they say they need.

As a group, there was consensus that:

1. The booking system is not efficient or transparent to patients.
2. It feels unfair for staff to be blamed for a system they did not create and can see issues with.
3. Burnout is creeping up and it is becoming harder to remain professional and compassionate as time goes on.

The DoN posts tailored responses to each story, communicating that a recent staff meeting was held about the story. They validate the patients’ concerns by sharing that the discussion held internally also identified some issues. The DoN also agrees that kindness and courtesy are critical, and thanks the patients for raising these issues. They warn that while they do not yet know what changes could potentially be made,  will look like, the stories led to an important staff discussion about the role of wellness in delivering empathetic care, and what support might be needed to help achieve this. Finally, the patient is invited to reach out to have a debrief on their personal experience.

I don't know about you, but I feel the use of the feedback in the second scenario showed staff that their experience matters too and has the greater chance of influencing culture for the better, not just improving a booking system. 

I challenge everyone to not underestimate their staff. A negative story might just be the prompt they needed to speak up about their own concerns. It’s incredibly important to remember that if you see a trend occurring in your stories, talk to the team working on the ground. Value their insights. Give them a voice. And don’t forget, never let the conversations steer into performance management but use it to drive the team into a culture of shared learning, wellbeing and growth.

We don’t all have to stumble together but we can learn together.