Time
can pass you by if you're not watching. As a nurse, revalidation is a triennial
expedition through mountains of files and rivers of paper. Scrambling through
the scraps of paper, one can get lost in the depths of despair trying to find
that golden piece of feedback. And yet as we go through life we receive
feedback almost constantly. From the person behind you tutting for taking
too long at the self checkout, to the 'nice outfit' comment from a co-worker.
Feedback is everywhere but how you use it is key.
Giving useful feedback to colleagues has never been something that we have been
very good at in the NHS. Most feedback has been focused around critical
reports, performance management or rag-rated tables with a big red mark through
the middle. Such approaches to feedback mean that it makes it almost impossible
for people to learn from these. Improvement is all about collaboration and
learning to do things better for our patients. Unless we can learn to give
open and honest feedback in a way that can engage people and also help
them to grow, we will struggle to make sustainable improvements to services.
The key to good feedback is summarised in “Thanks for the Feedback” and is broken into three key components. The first is appreciation and is area that we need to get better at in the NHS. We are always told when something isn’t going right but are too infrequently told when things are good. But there are groups of people out there that are trying to make things better. Programmes such as “Learning from Excellence” and the “The Academy of Fabulous Stuff” are all about sharing the great work that people are doing on a regular basis. There are pockets of real outstanding and innovative services and it is key that this work is promoted and shared. If we are to maximise improvement capability within organisations, we must work to be kind and collaborative and celebrate this when we get it right.
The
second is evaluation which is something that is systemic across the NHS. We
have Service Regulators, Professional Regulators, Commissioning Groups and
Advisory Groups. There are 126 organisations with
regulatory influence over the NHS all pushing and pulling services in
a variety of different ways. Through this cloud of performance and financial
targets it can often be challenging for teams to clearly understand where to
focus their energies. Whilst evaluation is important to ensure standards, we
must be careful that this doesn't become the basis of all feedback within the
NHS. We must continue to evaluate improvements in order to share learning
effectively but we must not lose that appreciation for people trying and
pushing to bring change in the NHS.
The
final key component to effective feedback is the coaching element. If we want
individuals and teams to grow we must provide them with the tools and support
to improve. Coaching is about helping people to improve their performance and
how to approach problems and come up with solutions. This form of feedback is
about being supportive and listening, discussing ideas to enable individuals to
grow and build improvement. The new offer of Hexitime is a modern community based
innovation that looks to build this sharing collaborative approach within the
NHS. It is a timebanking concept founded on the idea that you give an hour of
your time in order to share tools and skills and in return you can claim an
hour back to utilise another members strengths and experience. This is concept
that reflects the coaching methodology by providing an opportunity for a
community to share expertise in order for individuals to grow and develop.
Feedback
is a powerful tool and we must work in healthcare to give more valuable
feedback that is appreciative and constructive. Too often we have relied on the
red pen and we need to get better at understanding and listening to why
things aren’t working. Whilst challenging, we can start to build this, by
working collaboratively across services, professional groups and trusts to
share feedback on what really works in the NHS and what things needs fixing. We
must understand what the data is telling us, learn to listen to our
stakeholders and develop services together. Only by appreciating the difficult
realities of the NHS can we begin to make meaningful change. So now it’s
back to my pile of papers to dig out the smiley-faced sticker from my dentist
as some good solid appreciative feedback.
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To learn more about feedback and how to use it, I recommend Douglas Stone & Shelia Heen on how to utilise feedback. It teaches the art of how to give constructive feedback but also how to receive it so that you can grow and develop:
To learn more about feedback and how to use it, I recommend Douglas Stone & Shelia Heen on how to utilise feedback. It teaches the art of how to give constructive feedback but also how to receive it so that you can grow and develop: