Being True to ourselves….

Sam Foster – Chief Nurse

HEART OF ENGLAND NHS. FOUNDATION TRUST

Good Hope

3 acute sites + community

services, 10,500 staff, £650m

turnover

Challenges for Nursing

Build public trust and confidence in the nursing profession particularly in light of national adverse media coverage

Robust Board Assurance – lots of data not much info

Professional concerns re nursing practice

Nursing largest workforce and biggest paybill

Efficiency challenge

Proposition that is taken for granted

as if it were known to be true

Comfort, faith

A declaration to inspire full

Confidence, freedom from doubt,

based on evidence

Assume

Assure

Reassure

Knowing how we are doing - Where did we start?

Review of what we had

•Multiple audit tools reports, shared drives, Evidence base, NICE guidelines, NPSA, RCN ETC ETC……….

•Implementation of the NW Indicators using an in house developed IT solution, with a back to the floor approach. (falls, nutrtion,pain,Pressure area care, Medicines admin, obs,infection prevention, continence and diabetes)

−Then further development of specialty metrics , Community Neonates, theatres, out patients, A&E, Endoscopy etc.

−Development of an assurance framework, escalation , special measures etc

HOWEVER…

We recognised that we were measuring process which had its limitations

What else could we triangulate?

What would we do with all of this information?

Co-Chair – Deputy Director of Finance and Performance TOR adapted form Finance and Performance committee Monthly meet with head nurses Forward planner for suite of indicators/Triangulated scorecards Exception reports Performance notices Real sense of business like accountability

The data is wrong

DENIAL

It does not apply to me

ANGER

I will get the correct data

BARGAINING

There is nothing I can do about it

DEPRESSION

Acceptance and action

RESOLUTION

Adapted from Elisabeth Kübler-Ross 5 stage model

(Though more modern grief theories such as that of John Bowlby described as ‘ebb and flow of processes such

as shock and numbness, yearning and searching, disorganization and despair, and reorganization’ have some

attraction)

Culture: The five stages of grief

Measuring to improve really does work

Huge benefits with working with performance team

Increased accountability ward to board

Healthy competition

Opportunities to celebrate

Opportunities to share

Shared accountability

Robust proactive assurance both internally and externally

Stretch targets

Further triangulation for outcome

Benchmarking with other Trusts

Sharing Best Practice

Formally Join the NW transparency programme .

Thank you for listening