joy at work (primærsektor konference) - patientsikkerhed ·...

Joy at Workhvad, hvorfor, hvordan…

Simon Tulloch, Chefkonsulent

• Dansk Selskab for Patient Sikkerhed -‐ Annual Conference

• Institute for Healthcare Improvement (IHI) priority

• National context:

-‐ Shift from and to Quality Improvement

-‐ Focus on ‘mental health & violence’

Background

Plan

DoStudy

Act

Mental health and violence in the media

“Management’s overall aim should be to create a system in which everybody may take joy in his work” (W. Edwards Deming)

“Every provider should aspire to create an environment in which there is joy at work and that avoids the risk of staff burnout” (Don Berwick, 2016)

Introduction

Joy is more than the absence of burnout, just like health is more than the absence of disease.

What is ‘Joy at Work’?

Antonovsky, A. (1979) Health, Stress and Coping. San Francisco: Jossey-‐Bass.

“Intellectual, behavioral and emotional commitment to meaningful and satisfying work.”

“By joy, we refer to the feeling of success and fulfilment that results from meaningful work… without joy and meaning in work, the workforce cannot perform at its potential. Joy and meaning are generative and allow the best to be contributed by each individual, and the teams they comprise.”


Sirota D & Klein D. (2013) The Enthusiastic Employee: How Companies Profit by Giving Workers What They Want (2nd edition). Pearson FT Press.

Sikka R, Morath JM, Leape L. (2015) The Quadruple Aim: care, health, cost and meaning in work. BMJ Qual Saf.;24:608-‐610.

“The most joyful, productive, engaged staff feel both physically and psychologically safe, appreciate the meaning and purpose of their work, have some choice and control over their time, experience camaraderie with others at work, and perceive their work life to be fair and equitable”


https://www.youtube.com/watch?v=3JTdHStR6KI

What ‘Joy at Work’ is Not

• Something you announce • Flavour of the month • Superficial one-‐time actions • Pizza parties (Smørrebrød fest?)• Tokens not linked to purpose, e.g. ‘thank you’ notes • Something done ‘to’ or ‘for’ team members not ‘with’

Systemic factors:

• Lower levels of empathy• More mistakes • Less patient satisfaction• Reduced adherence to treatment plans • Overuse of resources

Human Factors:

• 60% Of doctors are considering leaving practice• 70% Of doctors know at least one doctor who has left practice due to poor morale• 37% Of newly qualified nurses are thinking of leaving • 13% Vacancy rate in nursing

Why is ‘Joy at Work’ important?

Lucian Leape Institute. 2013. Through the eyes of the workforce: creating joy, meaning and safer health care. Boston, MA: National Patient Safety Foundation.

What about ‘happy’ Denmark?

• 1809 hospital staff (Bispebjerg University Hospital) • 26% reported that they would quit their job if economically possible

• 6 factors independently associated with the wish to quit or not: omeaningfulness of the jobo quality of collaboration among colleagueso trustworthiness of closest superior(s) o exposure to bullyingo self-‐assessed health status o age


Suadicani et al (2013) Job satisfaction and intention to quit the job. Occupational Medicine

• Trusting relationships• Supportive management• Clearly organised work• Clarity of goals & tasks

What about ‘happy’ Denmark?

• Yngre Læger surveyed it’s members in April 2016 about experience of ‘violence and threats’

• The study showed that 45% had been victims of violence and / or threats and that 81% do not report the incidents to police

• 47% do not report the incidents to anyone

• At this years Yngre Læger annual conference the results of the study will be discussed – focus on how to change the culture so that the incidents are reported.


• What brings you joy in your work:

How to build ‘Joy at Work’?

Swensen, Balik & Kabcenell (2016) IHI Expedition Build Joy in Work and Prevent Burnout Session 1: What is Staff Joy and Engagement? –The Wind in Your Sails.

Being part of something bigger than myself Leaders

• Working towards a common goal that serves the community • Supportive relationship

• Mission engagement • Feeling valued, appreciated

• Feeling that I am contributing; making a difference • Recognized, feedback

• Making a difference to patients

Teamwork & Colleagues Growing/Learning → Achieving

• Great people to work with • Continued learning

• Team camaraderie • Accomplishments that improves work for all

• Creating high functioning teams • Innovative projects

• Working collaboratively with other teams • Making process changes that help

• 5 factors:

How to build ‘Joy at Work’?

Bassi L & McMurrer D. (2007) Maximizing your return on people. Harv Bus Rev;85:115-‐123.

Drivers1. Leadership Practices

2. Employee Engagement

3. Knowledge Accessibility

4. Workforce Optimisation

5. Learning Capacity

Practices Communication Job Design Availability Processes Innovation

Inclusiveness Commitment Collaboration Conditions Training

Supervisory skills Time Information sharing Accountability Development

Executive skills Systems Systems Hiring Value and support

Systems Systems Systems

1. Measure it!

• NHS staff survey – ‘Engagement’

• Staff ‘Friends and Family Test’ (FFT) -‐ a single question which acts as an overall barometer of staff experience and views on quality:

How to maintain ‘Joy at Work’?

“Would you recommend your organisation as a place to work or to be treated?”

Questions for organizations to ask:


Sirota & Klein (2013) The Enthusiastic Employee: How Companies Profit by Giving Workers What They Want (2nd ed.) Upper Saddle River, NJ: Pearson Education, Inc.

• “How would you rate your organization on taking a genuine interest in the well-‐being of its employees?” Equity

• “Do you agree or disagree: my job makes good use of my skills and abilities?”Achievement

• “How would you rate the cooperation and teamwork within your work unit?”Camaraderie

• “Considering everything, how would you rate your overall satisfaction with the organisation at this time?”Overall morale

2. Line of sight

• Leaders are responsible for ensuring ‘line of sight’ for all staff

• A clear line of sight to the strategy and the mission is the best way to ensure they make the best decisions as often as possible

• To understand, appreciate and act on the connections between their daily work and the organization’s mission and strategy

• Creates connection to purpose and joy in work


IHI Improvement Blog -‐ Do You Have a Line of Sight to Your Organization's Mission? By Derek Feeley, Friday, June 24, 2016

• Iris had made the connection between saving lives and sanitizing doorknobs, cleaning TV remote controls and changing sheets in a sanitary way. And, of course, her work did save lives. The better she did it, the more patients left hospital safely.

• Iris had joy in work. She found the meaning and purpose. She came to work with a mission, with her colleagues, to save lives.

• How did her joy in work improve care for patients? The environmental services team saw surgeons with checklists, so the cleaners put together their own checklist. They made a list of all the items in a room that needed to be sanitized to make sure the next patient didn’t get a hospital-‐acquired infection.

• That’s the discretionary effort and increased productivity that happens when organisations connect with staff and help them find joy in work.

Iris the cleaner: “My job is to save lives.”

IHI Improvement Blog -‐ How Iris Found Joy at Work By Kimberly Mitchell, Wednesday, February 3, 2016

• Clarity of purpose – connect staff with the aims of the organisation

• Clarity of performance

• Celebrate achievements

• Emphasise the importance of teamwork

• Build strong internal social networks

• Build learning networks

• Encourage mutual respect

Summary• Reward employee behaviour

• Maintain optimism (employ optimists!)

• Equity of work, i.e. safe & respected

• Make work challenging, use peoples intelligence, abilities & skills

• Provide appropriate resources, authority and information to staff

• Recognise the importance of all staff to the organisation, to the patients and to society

• Encourage shared learning/cross training

• IHI Creating a Joyful Workforce: http://www.ihi.org/Topics/Joy-‐In-‐Work/Pages/default.aspx

• Dansk Selskab for Patientsikkerhed: http://patientsikkerhed.dk/

Further reading

[email protected]

@simontulloch

(+45) 20 20 43 92

joy at work (primærsektor konference) - patientsikkerhed ·...

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