@NHLC2018 #NHLC2018

Supporting healthcare workers – promoting new promising practices in psychological health and safety

Presenters: Ed Mantler, Mental Health Commission of Canada Dr. Graham Dickson, LEADS Canada Dr. Merv Gilbert / Dr. Dan Bilsker, Vancouver Psych Safety Inc.

Supporting healthcare workers – promoting new promising practices in psychological health and safety

June 4th, 2018

Today’s Agenda

1. The Issue

Ed Mantler, Mental Health Commission of Canada

2. LEADS for Change

Dr. Graham Dickson, LEADS Canada

3. Measuring change

Dr. Merv Gilbert, Vancouver Psych Safety Consulting Inc.

Dr. Dan Bilsker, Vancouver Psych Safety Consulting Inc.

The Issue

Ed Mantler, Mental Health Commission of Canada

Stigma

500,000 $51 Billion

Everybody's Business

National Standard for Psychological

Health and Safety in the Workplace

• Change the culture

• Voluntary

• Non-prescriptive

• Applicable to any

organization

• Measure progress

• Continuous improvement

• It’s a journey…

By Health, For Health

Collaborative

#jointhemovement #prenezpartaumouvement

The Declaration is a public commitment from

healthcare organizations to show that they value

the psychological health and safety of their staff

and commit to taking action to improving their work

environments.

Working Groups

BY HEALTH, FOR HEALTH COLLABORATIVE

TOOLKIT MEASUREMENT

OUTREACH & PROMTTION

SYSTEM TRANSFORMATION

LEADS for Change

Dr. Graham Dickson, LEADS Canada

Joint Project:

Leading psychologically

healthy organizations

Using the

LEADS in a Caring

Environment Capabilities

Framework

With thanks to:

Doug Blackie, BCMOH Josee Dumas and Leslie Brown, Eastern Heath Paula Harrington and Ken Bascom, The Centre for Addiction and Mental Health Christine Devine and Wolf Klassen, Michael Garron Hospital Laura Mullaly and Sandra Coppert, MHCC Bill Tholl, By Health, for Health, Collaborative Karen Baillie, Menno Place Jonathan Mitchell, HealthCareCAN Brenda Lammi, LEADS Canada Steering Committee, By Health, For Health, Collaborative

The LEADS in a Caring Environment Framework (LEADS) outlines the capabilities required to lead in all sectors and in all levels of the health system.

The National Standard for

Psychological Health

and Safety in the

Workplace outlines 13 conditions for psychologically healthy workplaces.

Research says: effective leadership creates healthy work- places

LEADS

The Standard

Psychologically healthy

clinicians and employees

So, What is the synergy

between the two?

Philosophy

• Both emphasize caring for others • Both are aspirational frameworks • Both seek to shift cultures in the

workplace

Differences

• The Standard emphasizes the organization as a unit of analysis for all sectors.

• LEADS targets the individual (or collection of individuals) who choose to lead change in healthcare.

Content

• The Standard’s 13 workplace conditions map to all the LEADS domains and capabilities, to varying degrees.

• LEADS domains most strongly represented are Engage Others; Develop Coalitions

Example

12. Psychological

Protection

A work environment where

employees’ psychological

safety is ensured.

Engage Others:

Foster the development of others

Contribute to the creation of

healthy organizations.

Achieve Results:

Set direction

Strategically align decisions with

vision, values and evidence

Take action to implement decisions

Assess and evaluate

Develop coalitions

Mobilize knowledge

LEADS can also be used to

engage people in creating the

culture change so desired…

LEADS as a guide to leadership action

• Individuals who practice LEADS are modeling the leadership actions that contribute to psychologically healthy workplaces.

• Psychological health and safety is embedded in

the way people interact with one another on a daily basis (CSA, 2013, p. 1).

LEADS as a guide to leadership action

Toxic leadership behaviour destroys psychological health…

LEADS as a guide to leadership action

We cannot assume all formal leaders are themselves mentally healthy…

LEADS as a change discipline

• LEADS is also a disciplined approach to leading change.

• 7 steps

Organization

LEADS as a change discipline

Step 1: Create

Vision & Results

Step 2: Assess Current

State

Gap

Step 3: Prepare Leaders

Step 4: Engage Others Step 5:

Focus on Results

Step 6: Engage Stake-

holders

Step 7: Use a

Systems Approach

Thank you

Questions? Comments?

AND = 3

Measuring Change

Dr. Dan Bilsker, Vancouver Psych Safety Inc.

Dr. Merv Gilbert, Vancouver Psych Safety Inc.

“You can observe a lot just by

watching”

Berra, Yogi (1960)

“Healthcare organizations, like non-health organizations, have limited access to indicators

specifically reflective of psychological health and safety issues”

Implementing the National Standard in the Canadian

Health Sector

A Cross-case Analysis (2016)

Commissioned by HealthcareCAN and the Mental Health

Commission of Canada

MHCC and HealthcareCAN needed

change measurement tools

Change Measurement.

Tools

Consistent with the Standard

Tailored to healthcare

Sensitive to change

Reliable and Valid

Universal

Evidence-based

The Staff Perspective: Psychosocial Survey for Healthcare (PSH)

Adapted from GM@W, lit review and consultation

Covers 13 Standard Factors

and 3 areas of concern

Focuses on Organizational

Action to mitigate risks (Hazards)

Two additional healthcare-

specific factors

Brief, customized language, can be

segmented Reliable & Valid

The 13 Psychosocial Factors

Psychological

Support

Organizational

Culture

Clear

Leadership &

Expectations

Civility & Respect

Psychological Job

Fit

Growth &

Development

Recognition & Reward

Involvement & Influence

Workload Management Engagement

Balance

Psychological

Protection

Supportive

Physical

Environment

Two new factors

PF14. Protection From Moral Distress: staff feel

supported in doing their work in a manner consistent

with their personal and professional values.

PF15. Support for Psychological Self-Care: staff

are actively supported in caring for their own

psychological health and safety.

The Organizational Perspective: Organizational Review for Healthcare (ORH)

Organizational Self-Assessment

Recommendations

Organizational ratings on 15

PFs

Identification of key indicators

Identification of key actions

Implementation pilot by four

healthcare settings differing in:

Type of organization

Size of organization

Administration

37%

28%

41%

33%

49%

47%

16%

34%

22%

26%

26%

46%

43%

11%

28%

41%

36%

27%

35%

31%

32%

35%

31%

45%

55%

35%

51%

32%

46%

53%

40%

47%

27%

45%

24%

36%

19%

17%

53%

21%

23%

39%

23%

22%

11%

36%

32%

11%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

PF1: Psychological Support

PF2: Organizational Culture

PF3: Clear Leadership & Expectations

PF4: Civility & Respect

PF5: Psychological Job Fit

PF6: Growth & Development

PF7: Recognition & Reward

PF8: Involvement & Influence

PF9: Workload Management

PF10: Engagement

PF11: Balance

PF12: Psychological Protection

PF13: Protection of Physical Safety

PF14: Protection from Moral Distress

PF15: Support for Psychological Self-Care

PRI: Psychological Risk Index

ALL - Psychosocial Factors

Low Medium High

8.3%

18.4%

3.6%

8.7%10.1%

3.5%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

20%

S2Q1. In my workplace, I amexperiencing discrimination because of

my cultural/ethnic background,disability, sexual orientation, gender

or age.

S2Q2. In my workplace, I am beingbullied or harassed, either verbally,

physically or sexually.

S2Q3. In my workplace, I am beingtreated unfairly because I have a

mental illness.

Items Related to Inappropriate Behaviour

MHCC 2018 - ALL Ipsos

Barriers to implementation

Inconsistent Leadership

Competing priorities

Lack of employee awareness

Facilitators of implementation

Transformational Leadership

Clear communication

Embed PH&S in organizational culture

Next Steps

Finalize tools

Create user guide

Make tools available

Thank you

“If you don’t know where you are going, you’ll end up somewhere else.”

Berra, Yogi (1962)

Questions?

Thank you!