leadership making it matter - nwpgmd.nhs.uk leadership... · outward and the other inward ......
TRANSCRIPT
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7th Annual North West
Leadership Conference
Leadership – Making it Matter Friday 21st April 2017
#NWleader17
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Annual North West Leadership
Conference
21st April 2017
Professor Jane Mamelok
HEE NW - Postgraduate Dean
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Leadership – Making it matter
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Change, adversity and opportunity
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• The pessimist complains about the wind
• The optimist expects it to change
• The leader adjust the sails
John Maxwell
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Hardships often prepare ordinary
people for an extraordinary
destiny
CS Lewis
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Change introduces a man to himself – Albert Einstein
Final thoughts………..
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Developing the will, the capacity and the commitment for leadership in health: lessons from around the world
Jonathan GoslingEmeritus Prof of LeadershipUniversity of Exeter
@jongosling
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Research Questions:
What are the qualities of a good leader in your sector?
What does a leader do?
What are the results of leadership?
7-year olds
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A Head Teacher should have
big ears
to hear naughty children whispering
long arms
to make sad children OK
high heels
so that everyone can see her in assembly
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A Head spends a lot of time in her office
eating biscuits
A Head must make sure
that everything stays alright
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Developing
the willthe capacitythe commitment
for leadership in health: lessons from around the world
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Academics asked: What traits or behaviours describe your leaders?
Bolden, R., Gosling, J., O’Brien, A., Peters, K., Ryan, M. & Haslam
A. (2012) Emerging Concepts of Academic Leadership, for
Leadership Foundation for HE DOI: 10.13140/2.1.1957.6009
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3.6
2.91 2.84
5.094.7
4.45
0
1
2
3
4
5
6
7
Head ofSchool
Director ofResearch
Director ofEducation
InformalLeader 1
InformalLeader 2
InformalLeader 3
Who provides academic leadership?
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Who provides academic leadership?
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Who provides academic leadership?
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1. You cannot create a manager in a classroom. (i.e.
management is neither a profession nor a science).
2. But you can enhance significantly the capabilities of
people who are already practicing management.
3. This is best done by leveraging the managers’ own
experience, to reflect on it and share their insights
with each other.
4. Then the managers can carry their learning back to
the job for impact (action and teaching).
The idea is to use work, not to make work.
Developing Managers in Context
Gosling and Mintzberg, Sloane Management Review, 2004
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PersonPracticesPerspectives
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What works in Health Care?
•Halton Health – public health integration (Canada)•Institute for Urban Indigenous Health (Australia)•Nurses in Social Care (Japan)•Waitemata Hospital reform (New Zealand)•International Masters in Health Leadership (Canada)•Malaria Elimination (Swaziland& Zimbabwe)
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Personal
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“Effective political leaders are like the Roman God, Janus.
They wear two faces; one looking outward and the other inward”
Sir David Varney, “Leading with Political Awareness”, CMI 2007:2
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Pablo Picasso"Tête de Femme" / "Portrait de
Jacqueline de face. II" IV. Zustandlinolcut 1962
75,3 x 61,8 cm, image 64 x 52,5 cm
Bloch 1063, Baer 1280 IV B.a.
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Leadership Exchange at Halton Health
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Practices
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Institute for Urban Indigenous Health, Brisbane
and
Miyuki Hospital, Kyoto
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Understanding the impact of history on communication
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© Institute for Urban Indigenous Health 2015FILE: IUIH CIIP COMS - Black in my heart - PERUSAL ONLYLOCATION: Z:\WORKFORCE DEVELOPMENT\Renee Brown\Workforce Initiatives\Cultural Integrity Investment Program\CIIP Coaching Ourselves\Black in my heartDATE: Monday, 29 February 2016 PROJECT OFFICER: Renée Brown, Workforce Development Project Officer, IUIH
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© Institute for Urban Indigenous Health 2015FILE: IUIH CIIP COMS - Black in my heart - PERUSAL ONLYLOCATION: Z:\WORKFORCE DEVELOPMENT\Renee Brown\Workforce Initiatives\Cultural Integrity Investment Program\CIIP Coaching Ourselves\Black in my heartDATE: Monday, 29 February 2016 PROJECT OFFICER: Renée Brown, Workforce Development Project Officer, IUIH
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42
Miyuki Hospital, Southern KyotoYasuko Jinda
“Reflection Round Tables”
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Dis
cove
ry o
f w
hat
is a
t th
e co
re o
f n
urs
ing
Repractice
Self-concept
re-
realization
1
Individual
System Model of On-Site Nursing Study
Team:team building
Experience is the accumulation of “nursing knowledge”
3. The organization as a whole
4.So
ciety/ the fu
ture
Reco
gnizin
g anew
Intellectual learning
Practice
Cooperative practical body that
shares values ーPromotion of
conceptualization in the workplaceー
Life learning on-site
2.The team
Practical knowledge
The promotion of self-reflection
Thought in action
Having strong
fieldsWisdom
Knowledge
Informational
Data
Knowledge hierarchy and conceptualization
On site: "Nursing knowledge" of me and my team from a
practical and technical viewpoint
Form
Build formations and move the field freely
Bodily
knowledge
Tacit knowledge
Dynamic/complex system
H15. H16
H18 H21
H22 H26.12
H27.8
Essence
Structure
Nursing phenomena
Indu
ctiv
e
De
du
ctiv
e
1. The process of intrinsic development 2. The direction of intrinsic development3 . Intrinsic development: from individual, to team, to organization, to society
Good nursing
Contextual learning
Internalization-individual
Practicing anew
Reco
gnizin
g anew
Self-concept
1.Th
e ind
ividu
al
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①A scene that I cannot forget ②Why do I remember this particular scene?
④What has become visible? ③What area of nursing am I particular about?
☆What I consider important in my nursing care practice
⑤How should I think about this as I move into the
future?
Conceptualization Sheet (to be filled out individually)
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Stage Theme
1. Remembering (data) Someone you cannot forget
Description of a scene that remains in your memory
The scene/the reality (concrete/phenomenal)→as a whole/as an abstraction
2. Introspection
(what I considered meaningful)
Why didn’t I forget it? Bringing unconscious awareness to consciousness (self-questioning)
3. Focalization
(fields that relate to what I understood as a result of the thought process)
What situation in nursing was it?
Focalizing the area of nursing
4. Instillation (new understandings to be gained from judgments made)
5. Evolution/Towards the future
What did I want to think about?→henceforth
Spreading and Deepening
Questioning the essence of nursing
Conceptualization Process
Conceptualization Sheet Stage (spreading and deepening of knowledge)
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Perspectives
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Waitemata District Health Board: values-led organization development
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Patient experience manager
“working in health is more than a job” but many made it clear that having a good job is crucial
Waitemata District Health Board: values-led organization development
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Value Based Reporting at Waitemata
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Impact of values based reporting
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Perspectives on institutional and professional leadership
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A model of academic leadership…
Self leadership
Academic work
Academic tasks &
processes
Academic values & identities
Purpose, goals & objectives
Leading others
Informal role and interpersonal
influence
Formal role and institutional
responsibilities
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Academic work???
Academic tasks &
processes
Academic values & identities
Institutional brand, market position and performance
Academic purpose
Corporate goals and objectives
Line roles such as ‘HoD’ focused on performance
management, not academic leadership
Global marketplace and‘student as customer’ drives competition for funding and
resources
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Implications for leadership development
1. Being one of usleaders as ingroup prototypes
2. Doing it for usleaders as ingroup champions
3. Crafting a sense of usleaders as entrepreneurs of identity
4. Making us matterleaders as embedders of identity
Haslam et al., 2011
The 3 Rs of identity leadership:
1. Reflect (find out about the group)2. Represent (stand for, and stand up for, the group)3. Realize (provide structures and outcomes that turn the group’s ideals into reality)
Haslam et al., 2011
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PersonalPractices
Perspectives
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What works ..
1. Make managers matter
2. Reach every rung on the ladder
3. Draw on your own resources
4. Blend personal and organizational development
5. Match the scale of solution to problem
6. Ground the design in reality
What works: the trillion dollar quest – how the world’s best healthcare organizations develop managers and leaders. KPMG, 2016
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Developing the will, the capacity and the commitment for leadership in health: lessons from around the world
Jonathan GoslingEmeritus Prof of LeadershipUniversity of Exeter
@jongosling
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Developing people: Improving Care
Stephen Hart, Director of Leadership Development, Leadership Academy
Prezi link - https://prezi.com/yzciq1u1g7zk/developing-people-improving-care/
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Outstanding Leadership – Making it Matter
• Background at LHCH
• Starting the leadership journey
• Achieving the vision – ‘to be the best’
• Listening and learning
• Focusing on patients, families and safety
• Living the values
• The leadership model and ethos
• Recognising and thanking
• Key messages
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Background to LHCH
2.8m people
served –
very high
deprivation
20.2%
31.9%
60.5%
LHCH
DGHsCommunity clinics
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1,100 blue light heart attacks (PPCI)
2,200 cardiac surgery procedures
1,300 thoracic surgery procedures
13,000 inpatient hospital spells
79,000 outpatient visits
29,000 patients seen in the community
1,000 cystic fibrosis / respiratory hospital spells
Our work
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Our facilities
£135mturnover
193 inpatient beds
9 operating theatres
5 catheter laboratories
10 community venues in Knowsley
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Our people
7%Support
28%Science, Clinical
& Therapists
21%Non-clinical
9%Doctors
35%Nursing
1,575
staff
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Starting the Leadership Journey
Doctors
10%
Non-clinical
21%
Series of whistle blows
Cultural audit undertaken
Some worrying feedback
Staff engagement
New governance model
Listening organisation
Clinical leadership model implemented
Strategic services review
Listening into Action
Organisational Learning Strategy
2014
2015
2016
2013
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Achieving Our Vision – to be the best
Achieving our vision
To be
the best
Excellent, compassionate and safe care
People; quality & safety; service & innovation;
value; partnership working
Clinically Led
Patient
& family
centred care
PACTContinuous
improvementAccountability
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Listening and Learning
Achieving Our Vision – to be the best
Listening to our staff
Learning from
mistakes
Learning through
innovation
Listeningto patients
and families
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Achieving Our Vision – to be the best
Listening to patients and families
• Speaking out patient and families RET
(Respond Escalate Talk) scheme
• Introduced our care shadowing programme
• Implemented patient and family centred care model
• 5* in NHS choices
• Set our quality priorities
• Designed our new care facilities
• Developed our care partners
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• Invitation for carer to take active
role in care of loved one
• Examples:
– Walking & exercise
– Washing & bathing
– Taking medications
– Eating & drinking
– Dressing
• Provides support for staff
• Carers appreciate the opportunity
“I was anxious to be close to my husband while he was recovering from surgery. During this difficult time I was never felt to be the in the way - quite the contrary, I was encouraged by the staff to participate in my husbands care, like washing and dressing him and helping him back and to the toilet.We both appreciated being able to do this knowing that the staff were always there to advise and support us should we require it. I thank you all so much for being able to stay close to him.”
TRAILBLAZING
Achieving Our Vision – to be the best
Care Partner
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Achieving Our Vision – to be the best
Listening to staff
• Introduced Listening into Action
• External assessment of our culture (PASCAL)
• Increased our staff governors
• Developed our PACT values
• Focus on human factors
• Bespoke education partnership programme
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Achieving Our Vision – to be the best
Learning from mistakes and incidents
Safety bulletin Athena
Local & Trust
huddles
Organisational
learning
policy
Departmental
newsletters
Organisational
Learning
Process
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Focussing on patients, families and
safety
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What makes us outstanding
Staff engagement score (4.02)
Independent Views
1st Provider
1st provider
1st in country
2nd in country
Outstanding –1 of 18 trusts
Top 100
2nd in country
Recommendation to work or receive treatment (4.27)
Staff not experiencing harassment or bullying (16%)
Staff agreeing their role makes a difference to patients (94%)
Transparency table – ‘Learning from Mistakes’
Best places to work
Overall patient care – National Inpatient Survey
TOP in countryNurses within the hospital; care and treatment of our patients;
cleanliness of wards - National Inpatient Survey
CQC Outstanding First Specialist Trust rated at this level
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Living the Values
Doctors
10%
Non-clinical
21%
Discussed
Designed
Driven
Owned
Team LHCH
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Living the Values
Doctors
10%
Non-clinical
21%
• Written into objectives
• Tested at appraisal
• Spotting talent
• Supporting personal development
plans
• The conduit for succession plans
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Focussing on Patients, Families and
Safety
• Multidisciplinary meeting focused on patient
safety
• Every weekday – (coordinator cover at
weekends)
• CEO, Executives, Heads of Department
and anyone else who wants to attend
• Rapid identification and resolution of
problems
• Benefits
– Improved communication & culture
– Organisational agility
– Reflected in staff survey TRAILBLAZING
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Please speak
out
We will investigate
I will keep
you safe
45referrals
A leadership model and ethos that
makes us outstanding
Our approach to safety
Using patient experience based design
Encouraging staff to speak out
Community based patient & family events
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What makes us outstanding
Our clinical outcomes
Our empathy and personalisation
Our approach to innovation
Our teams
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https://www.youtube.
com/watch?v=jpQqX
OUuvH4
What the staff think
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Outstanding Leadership – Key Messages
• Outstanding care is delivered to and by people
• Listen and involve them
• Empower improvement
• Show empathy
• Communicate your vision
• Be clear on the standards
• Treat as you would be treated
• Be visible
• Be authentic