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Culture Change Resources

Looking at what is happening in practice and identifying

gaps between what we say and what we do

How do I use the shared purpose?

A shared purpose can be used to reflect on or evaluate your current practice – helping you to look at what is happening in practice to identify gaps between what you and your team say and what you do. In effective workplace cultures, the values and beliefs that people hold and talk about are reflected in their behaviour and put into action every day(Manley et al., 2011). That is, what people say is what they do. For example, if a nursing team agree that it is important to know ‘patients as people’:

  • You should see staff spending time with patients – asking them about what matters and what is important
  • You should hear staff talking about patients as people, not bed numbers or diseases
  • Documentation should reflect patient preferences and involvement in decision making

A shared purpose provides a baseline for you to evaluate your current practices and cultures against, helping you to think about and identify:

  • What you are doing well and could build upon
  • What you might need to create, develop, change or improve to achieve your purpose

How do I do this?

Describing and measuring where you are starting from helps you to identify what you need to change or develop:

  • In yourself
  • In your team
  • In your workplace setting

In most organisations, there is already a lot of activity to ‘measure’ aspects of care and practice, often using audit tools. Whilst this information is useful, it tends to focus on ‘what’ has or hasn’t been done/happened rather than the ‘why’ or ‘how’. For example, a safety cross for pressure ulcers or falls, identifies how many people have acquired a pressure ulcer or fallen, but it does not highlight what is being done well to prevent pressure ulcers, or the circumstances under which people are falling – missing an opportunity to learn in a way that can inform future practice.

Additionally, this activity is often done by only a few people, for example senior members of the team or staff from other departments, who take the data away and interpret it for the team, perhaps making the activity and information that it provides less meaningful to those that it primarily relates to.

To enable culture change it is essential to involve all staff in evaluating practice against your shared purpose. You can do this by looking at what is happening and how things are done (e.g. by observing practice – thinking about what you see, you hear, you feel); by listening to the experience of patients and staff (e.g. asking what has been done well and what could be improved, collecting stories using emotional touchpoints (Dewar et al., 2009)); and by discussing what you find, helping staff:

  • To gain new insights
  • To deepen understanding
  • To identify actions
Resources

Observing practice

Collecting stories using emotional touchpoints

References

Dewar, B., Mackay, R., Smith, S., et al (2009) Use of emotional touchpoints as a method of tapping into the experience of receiving compassionate care in a hospital setting. Journal of Research in Nursing. Vol. 15. No. 1. pp 29-41.

Manley, K., Sanders, K., Cardiff, S. and Webster, J. (2011) Effective workplace culture: the attributes, enabling factors and consequences of a new concept. International Practice Development Journal. Vol. 1. No. 2. Article 1.