Title : Speaking up ..who me!
In the United Kingdom, following a series of significant breakdowns in patient care, a major investigation* was carried out and one of the findings was that over a lengthy period of time, nursing staff were concerned about the level of care they were being asked to deliver but there was no system in place for them to safely discuss their views. All NHS organization were then required, by law, to appoint Freedom to Speak Up Guardians (FTSUG’s)
The bedrock of delivering high quality care to our patients is a skilled, confident team in which speaking up is just part of day to day business. By speaking up we mean interacting with each other in a professional and respectful way which allows us to challenge any issue that might be interfering with our ability to provide the best possible care to our patients. Is this the reality of nurses experience or does a culture of authority, status, hierarchy make speaking up a risk to their career development and psychological safety in the workplace?
The role of FTSUG’s was to be a point of contact for all staff to voice their concerns which would then be investigated as an opportunity to learn lessons and improve the quality of care to patients and the way we support our frontline staff.
At the same time, Leeds Teaching Hospitals was entering a partnership with The Virginia Mason Institute in Seattle to use Improvement Methodology (originally developed by Toyota) in creating a safe, efficient and high quality model of healthcare. Now here is the ‘light bulb moment’ both approaches depend on the same thing .. An organizational culture in which staff routinely express their opinions on how the care they are being asked to deliver could be improved.
What emerged from this simultaneous launching of two unconnected pieces of work was that if we could empower the frontline staff with their amazing expertise to influence change in the way they work, the floodgates of improvement would open.
My presentation would be a description of how this can take place in real healthcare settings including what are the barriers to this approach and what needs to be done to create the ‘psychological safety’ in teams where respectful challenging of existing arrangements and methods of care is not just ‘tolerated’ but embraced and celebrated