MyPreceptorshipRationale and directions.

This template is for internal use only as part of your development on the QEH Preceptorship Program. This is to enable you to think about and reflect upon effective teams and to develop insight into the ways in which teams can be measured. This can be used as a synthesis for new practices based upon your observation from the perspective of audit and inspection. In developmental terms, one can then reflect upon the implications for one’s practice and the ways in which you can influence team working.

You do not need (nor is it possible within program limitations of time) to complete every point. Rather, take a look at your assigned area during a walkthrough and reflect on key points to gain a representative picture of the team.

Safety and professionalism.

Each of the areas you visit are functional services. You will:

Introduce yourself to the team leader or equivalent and explain the purpose of your visit as a developmental exercise.

Wear correct Trust ID at all times.

Observe the correct procedures for social distancing and hygiene including hand washing and masks.

Observe appropriate professional behaviours – this is not a formal inspection and whilst it is important to observe and take notes, staff should not feel intimidated by this process. Where safe and appropriate, you can talk with staff or ask questions but it is important that they are not detained in their work and that they are happy to engage with you.

At the end of this document is a reflection template to summarise your key findings and to identify how you will apply this to your own practice.

Are teams well led? Team working assures quality person-centred care, supports learning/innovation, promotes open/fair culture. By well-led, the CQC mean that the leadership, management and governance of the organisation assures the delivery of high-quality and person-centred care, supports learning and innovation, and promotes an open and fair culture

Outstanding The leadership, governance and team culture are used to drive and improve the delivery of high-quality person-centred care.– strategy/objectives are stretching/challenging/innovative but achievable, systematic approach to working with other organisations,governance/performance management arrangements reflect best practice, motivated satisfied staff, leadership drives continuous improvementGood – The leadership, governance and team culture promote the delivery of high-quality person-centred care.clear vision/values/strategy/objectives, accurate/valid/reliable/timely/relevant performance information reviewed to make improvements, finance not compromise quality, identify/understand/monitor/address current/future risks, engage/involve staff, focus on continuous improvementRequires Improvement – The leadership, governance and team culture do not always support the delivery of high-quality person-centred care. Regulations may or may not be met.No developed vision/values, governance not effective with no recent review of arrangements, Risks/issues/poor performance not dealt with, staff identified risks/issues not same as reported, Staff not engaged/empowered/raise concerns, leaders not have the necessary experience/knowledge/capacity/capability, improving culture/staff satisfaction not priority., service delivery/improvement reactiveInadequate - The delivery of high-quality care is not assured by the leadership, governance or culture. Normally some regulations are not met.no vision/guiding values, unclear governance arrangements, performance information inaccurate/invalid/unreliable/out of date, risks/issues not identified/captured/managed, lack of openness/transparency, quality/safety not top priority, staff dissatisfied, staff concerns not treated with respect. culture is defensive, minimal stakeholder engagement, little innovation/service development, minimal evidence of learning,

Are teams well led? Team working assures quality person-centred care, supports learning/innovation, promotes open/fair culture. By well-led, the CQC mean that the leadership, management and governance of the organisation assures the delivery of high-quality and person-centred care, supports learning and innovation, and promotes an open and fair culture

KLOEs Evidence of Compliance/Successes

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Is there team capability to deliver high-quality, sustainable care?Is the team consistent in its approach to care? Observe your experience at the ‘point of contact’. Are all members of the team helpful and responsive to inquiries?Do patients feel part of the care team? Do you observe examples of this?Do all team members feel that they have a voice? Is there evidence of this?What is your intuitive impression of the area? Is a ‘team spirit’ discernible?What is the team ‘mood’ at the time of your visit? Do teams appear motivated and energised?Are all members of the team encouraged to contribute to the development of the service?Do staff take decisions in the absence of designated managers or leaders?

Are teams well led? Team working assures quality person-centred care, supports learning/innovation, promotes open/fair culture. By well-led, the CQC mean that the leadership, management and governance of the organisation assures the delivery of high-quality and person-centred care, supports learning and innovation, and promotes an open and fair culture

Do staff feel listened to? Do staff feel that their ideas are shared and acted upon?Is there evidence of compassionate, inclusive and effective leadership?Is there evidence of team values and behaviours? Do these permeate the general team?How is information shared or cascaded within the team?

Do staff feel they receive development and support to progress

Are visitors able to approach team members?Are teams encouraged to innovate and share ideas? Ask team members how they contribute to success.How evident is positive role modelling across teams? What qualities are observed?Do all team members have a clearly defined role? Are you able to observe this?Do teams work together? Is there a willingness to help each other?What team qualities are observable to the visitor?

Are teams well led? Team working assures quality person-centred care, supports learning/innovation, promotes open/fair culture. By well-led, the CQC mean that the leadership, management and governance of the organisation assures the delivery of high-quality and person-centred care, supports learning and innovation, and promotes an open and fair culture

Is team working apparent at all levels of the service and team?

Do teams have a common objective? Is this stated anywhere?What resources are available to support and develop the team?Are there regular team meetings?Is there evidence of inclusivity in teams?Do safety huddles and handovers involve all members of the team?Is there a strong emphasis on the safety and wellbeing of staff? Do staff feel looked after?

Do staff feel that the team is well led? How do they define this? Is evident from your own observations?Does the team work collaboratively, share responsibility and resolve conflict quickly and constructively?

Is there cohesion within the team are there meetings and opportunities to discuss issues as a team. Is there team spirit, do staff feel supported by their team

Are there processes to manage current and future performance? Are these regularly reviewed and improved?

Are staff aware of ward performance, is there evidence in

the area of performance

Are teams well led? Team working assures quality person-centred care, supports learning/innovation, promotes open/fair culture. By well-led, the CQC mean that the leadership, management and governance of the organisation assures the delivery of high-quality and person-centred care, supports learning and innovation, and promotes an open and fair culture

Are there robust systems and processes for learning, continuous improvement and innovation?Is there evidence that leaders devolve responsibility and creativity to staff teams?Do teams have access to resources for development and do staff have the skills to use them?Do all staff regularly take time out to work together to resolve problems and to review individual and team objectives, processes and performance?Does this lead to improvements and innovation?

Are there staff Meetings, activities are staff encouraged to bring new ideas

Clinical Development Immersive Observation: QA Team

assessment

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Each of the headings follow the same format. There are some questions and prompts help your observations.

These are not designed to be used as a checklist or “clipboard” exercise but to help you to structure some of the quality indicators that you may have subconsciously noticed.Undertake service & team observations

Ring the visitor bell to gain access to the ward (don’t swipe in!).

With your 15 Steps Challenge team take 15 steps into the ward (not always literally – the point is to walk into the main space of the ward environment and get a feel for how the ward operates).

Let the nurse in charge know that you are on the ward and that you are the 15 Steps Challenge team. It is good practice to ask if there are any infection control or safeguarding concerns that put parts of the ward “off limits”.

Use your senses to build up your first impressions and then explore the ward further

The focus is on first impressions. What do patients and visitors see? What is important to them?

Use the headings and observation prompts to structure your thoughts and record your comments.

Generating Feedback

Generate jointly agree some key points to feed back.

Share the highlights with the Preceptorship group.

Make sure the feedback includes the great things that were observed. Celebrate the positives; this is about sharing good practice!

Ensure that areas that could be improved are also identified.

In addition to the feedback for each individual ward, identify any key themes that are emerging across the organisation.

Agree actions and next steps

If there was good practice to share, agree how this will be done and who will do it. There may be a number of improvements identified in the ward walkarounds that can be put in place quickly, some may be more complex.

Agree what actions can be taken forward by the ward team, what needs to be taken forward by the Project Co-ordinator and where the organisation sponsor needs to have

strategic input.

Clinical Development Immersive Observation: QA Team

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Which aspects could be improved?

Summarise the key points from your visit.

What were the positive aspects which you would like to feed back? Why?

Can you learn from the foregoing? Applying insight(s) to your own practice and team, what will you:

Continue to do?

Do more of?

Do less of?