Cardiology team away day: working together to inspire and improve

Nicola Richardson, Cardiology Ward Sister, Oxford University Hospitals

I have been an Inspire Improvement Fellow since January 2018 and now just over halfway through my journey and it was time to involve my band 6 colleagues, people I lead and work alongside every day on the cardiology ward. On a beautiful sunny day in Oxford, I arranged for us to spend the day at a small local restaurant which had conference room facilities and catering. The team were all nervously excited to see what the day would hold and I was apprehensive but keen to promote the value of what I was experiencing and learning on our workshop days and how they had made me look at things from a different perspective. I started the day by using my newly purchased Evoke cards ( as the ice breaker to help everyone relax and asked everyone to choose a picture that reflected them as a person.  I went first and “put myself out there”. I realised that it feels much safer on our Inspire Improvement workshops, whereas this made me feel more vulnerable especially working with more creative methods. At first the team were apprehensive but people were very thoughtful about which picture they chose and what they shared with the team. I think we all got something out of it and people fed back it was a very different way of breaking the ice.

When Jo (Practice Development Facilitator from FoNS) arrived to help facilitate the day, everyone said hello and then we set to work on exploring our values and beliefs as a leadership team using a values clarification exercise with the focus in smaller groups. Although there was still a pensive atmosphere, people were openly sharing their ideas and getting their voice heard. It was clear to see that people were unsure about the creative methods being used but had great passion for their ward and workplace. Jo then suggested the idea of creating a collective visual representation of our values as a leadership team. People were reluctant initially to go all glitter and glue, but very soon we had created a poster with “our patient at the heart and a washing line of things that were important to us”. The poster showed that our collective values are very focused on the people we care for.

The greatest challenge at this point was trying to leave the ‘how can we fix this’ mentality and first establish “what it’s really like to work around here” and collectively understand our values as the leadership team. The only way we can create a positive workplace culture is to look at our own individual values and then our team values and work out what our ward culture looks like. We explored how we currently evaluate the care we provide and looked at where this sits on a prove – improve spectrum. Unsurprisingly, most of the evidence we gather proves we are safe, clean and providing a solid cardiac service but we do very little to gather evidence that helps us to improve the service we provide.

The day naturally flowed towards what we as a team will do next. We were given the tools to collect qualitative date in the form of patient stories and observation of practice, to help us further gain some insight into our service through the eyes of our patients and through stepping back and observing using all of our senses. By the close of the day it felt like there was real unity and collaborative working within the leadership team. We set tasks for the next few months and I am very excited to see where this leads and if we can keep the momentum going and not slip back into the ‘quick fix’ techniques.

Investing the time in the leadership team has been essential towards culture change within cardiology. The away day involved the participation of the whole team, was more work focused than previous away days and involved more creative methods and thinking outside the box. I was apprehensive about the logistics of freeing up the time for everyone to attend, ensuring that the ward was staffed appropriately and using the bursary money to provide a nice work setting away from the ward, but it was well worth the work. I was able to invest the time in our development as a team and expose people to creative ways of working together. It has positively impacted our workplace culture already and I can see people starting to feel more motivated and to take on new challenges and responsibilities.

Nicola is an Inspire Improvement Fellow.

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