a key role in the facilitation process to support staff to consistently deliver high ... A further workshop, revisited t
World class healthcare for Wales Transforming Care – The Facilitators Journey Judith Bowen, Clinical Practice Development Nurse, Hywel Dda Health Board Angela Marshall, Clinical Practice Development Nurse, Hywel Dda Health Board Helen Thomas, Clinical Practice Development Nurse, Hywel Dda Health Board Helen Humphreys, Clinical Practice Development Nurse, Hywel Dda Health Board Emma Thomas, Service Improvement Manager, National Leadership & Innovation Agency for Healthcare
Context and Problem Context: To support the implementation and sustainability of the Transforming Care programme within Hywel Dda Health Board, a group of five educators within the practice development team has a key role in the facilitation process to support staff to consistently deliver high quality, safe and cost effective person-centred care.
Problem: The team wanted to ensure that staff on the wards across the Health Board (HB) gained the skills required to continue to improve and sustain the Transforming Care programme so that they could continue to make improvements if the facilitators were not there to support them. Improvements such as reductions in adverse events and ensuring time is used efficiently and effectively need to be sustainable, with good practice spread across the whole HB. To allow these skills to be transferred effectively, the team needed to understand its own strengths and weaknesses.
Assessment of problem and analysis of its causes: The problem for the facilitators was to ensure the sustainable spread of improvement methodology across the HB. They needed to utilise their skill mix to its fullest advantage in addition to communicating well as a team. As more wards implemented Transforming Care they needed to ensure their facilitation skills had been transferred to the ward staff to allow them to withdraw their support and move onto a new ward.
Strategy for Change Intervention: A reflective learning workshop enabled the team to consider the purpose of the facilitator’s role and identify priorities. To aid reflection and explore key areas, a “Wheel of reflection” was utilised. This highlighted the team’s satisfaction in relation to each aspect, identified areas of achievement and refocused and reprioritised objectives. A further workshop, revisited the ‘Wheel” and considered changes made as a result of the earlier reflective session. For example communication processes had improved resulting in improved links with stakeholders. Consideration of Neurological Levels and team goals allowed the team to structure planned tasks over the next two years in addition to developing a Quad of Aims as a structure for their ongoing work. The use of coaching questions developed an identity for the team
Strategy for change: The work of the facilitators is not to enact or deliver change themselves, but rather to provide the mechanisms, tools and interventions to enable individual practitioners and teams to
We’re
TRANSFORMING CARE!
identify their own requirements for change. They then provide the necessary support to empower practitioners so that they, and their practice, can flourish; thereby producing improved outcomes for patients. They achieve this by sharing our own values and beliefs; providing support where necessary to create the right conditions for growth; recognising and celebrating achievement; collecting, with practitioners, the evidence of the effects of the change; and disseminating good practice. They also work with practitioners to ensure that any change is sustainable, and that lessons learnt are fed back into the system to provide information for others.
Effects of Changes Measurement of improvement: Measures of improvements were taken using a “Wheel of reflection”, with comparison of the changes in the scores over the reflective learning sessions.
Effects of changes: Transforming Care has now spread to 31 wards within the HB and the facilitators have gained insight into the person-centred focus of their work.
Lessons Learned Lessons learnt: • Recognising the range of experiences and skills, strengths and weaknesses within the team • Supporting each other in further developing facilitation and teaching skills • As a team being able to reflect on roles, critically analyse and evaluate progress regarding Transforming Care and constructively move forward
Message for others: The use of a simple tool can allow a team of individuals to recognise its collective strengths and weaknesses which can be used to further develop the skills of the groups which in turn impacts on the people they are working with. Apr 11
Wheel of reflection Time 10 Engaging teams/ complexity drivers
8 6
Patient Feedback/links to fundamentals of Care
4 2 Engaging wider team/stakeholders
Balance between uniformity/flexibility
WOW
0
Being flexible with TC
Facilitator teamwork & communication
