Allison Evans & Fiona Williams - Epworth - Improving Culture in the Perioperative Environment

EpworthRichmondCultureinPeriopera5veareas

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• Largestnotforprofit• 8Divisions• Totalof950beds• Carefor120,000pa=entsperyear• 3500nursingstaff

Divisions

EpworthRichmond

EpworthEastern

EpworthFreemasons

EpworthHawthorn

EpworthCliveden

EpworthGeelong

EpworthBrightonEpworthCamberwell

EpworthRichmond

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LargestEpworthsite

550beds

NewED,26bedICUandaddi=onal6theatrescommissionedFeb2016

28Theatrecomplexand4CathLabs4RecoveryareasTwoDayofSurgeryAdmissionArea(DOSA)areasCSSD400+staffCareforonaverage150pa=entsaday

EpworthRichmond-Periopera5veServices

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Epworthvalues

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MeasureofCultureandEngagement:2ways

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Data-BestPrac5ceAustralia(BPA)

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LevelofEngagement

Engaged Afeelingofbeingupbeat,posi=ve,op=mis=candengagedwithbeingatwork

Swinging Neitheroverlyposi=veornega=ve,canbeswayedeitherway

Disengaged Nega=ve,pessimis=c,blamingtraits

CultureClassifica5ons

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CultureofSuccess Morethan60%engagedVerycloseknit,focusedandcohesivePosi=veandcandomentality

CultureofAmbi=on 50–60%engagedAmbi=ousfornewandbe_erwaystodothingsAnythingispossiblementality

CultureofConsolida=on 40–50%engagedIntransi=on,areasofhighandlowendculture

CultureofReac=on 30–40%engagedAlotofworkpu`ngourfiresandworkontherun

CultureofBlame 20–30%engagementThemandusmentality,communica=onispoor

CultureofBlame+ Lessthan20%engagementMaybeahistoryofleadershipchurn

Measuresofculture….

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STAFF

Applyingforleadership

opportuni=es

Takingprideintheir

workplace

Interac=onwiththepa=ents

Lookingforsolu=onsto

issues

Holdingeachother

accountable

Smilingandhelpingeach

other

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DoctorfeedbackSickleavedataStaffturnoverrateStafflost=meinjuryrateStaffinterac=onwithotherdepartmentsinthehospital

Sowherewerewe.....

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StaffculturehadstagnatedataCultureofBlame

Themesthatcon,nuetoberaisedbystaffincludelackingaclimateoftrustandrespect;li:letrustinManagement/Exec,nothavingasenseofpurposeordirec,onandli:lerecogni,on,rewardorinvestmentinstaffdevelopment.

27%ofstafffelttherewasalackofhonesty,fairnessandnotgeFngbacktostaffonissuestheyhaveraised

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Feedbackontheirmanagerhasdroppedsignificantlylackofreviewoftheirperformance,seFngobjec,ves

andcoachingtoimprovetheirperformance.

October201330%staffwereengaged

30%staffweredisengaged40%were‘swinging’inthemiddle

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Whatdidwedo.....

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Wemade4changes

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ExternalReview

ManagementRestructure

Buildteamcapacity

Focusonvalueof

Community

ExternalreviewReviewoftheatrecomplex,lookingatprac5cesandprocessesaswellasiden5fyingimprovementsandsolu5onsOutcomesgroupedinto4areas:1.ManagementStructure2.Equipmentstorageandgeneralstoragesolu5ons3.Bookingsprocess4.Theatreperformanceintermsofefficiency

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ManagementstructureStructurechangewithaddi5onalsupportroles*SupportServicesManager*Pa5entFlow&U5lisa5onManager*BusinessManagerSeniorLeadershipTeam

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TheatreSeniorLeadershipTeam

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We,theTheatreSeniorLeadershipTeam,collabora6velystrivetochampionintegrity,trustandrespectinour

workplace,inthepursuitofclinicalexcellence.

Weendeavourtoachievethisthroughaunitedposi6veleadershipstyle,alignedwithEpworthvaluesand

behaviours,andconsistentlythroughperiodsofcertaintyandchange

Buildingyourmanagementteamcapacity

NUMlevel

Introduc=onofNUMProgram(commencedAugust2015)

ü  RedefineNUMperformanceexpecta=onsandrolepriori=es

ü  Commitmenttodevelopmentofbusinessandleadershipskills

ü  Opera=onalLeadersprogram(DiplomaofLeadershipandGENOS)

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AttheANUMlevel

Introduc=onofANUMProgram(commencedNovember2015)

ü  RedefineANUMperformanceexpecta=ons,KPIsandmeasures

ü  EnablesupportoftheNUM

ü  FrontlineLeadersprogram

ChangeStrategies–howdoyouimplement&embedbehaviour?

Phase1

Engagefirst

ü Consulta=onperiodwithnewPDü 360degreefeedbacksurveys

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Phase2

ü ADCS1:1withNUMs–developIndividualDevelopmentPlan(IDP)

ü Providethetoolsandframeworkforrepor=ng

ü Coach&development

Phase3

ü Provideclearandconsistentexpecta=onsü Ensureaccountability(monthlyEOMmee=ngs)

ü Rewardandrecogniseeffec=vebehaviourchange–ChangeChampions

ü Supportfromadistance

ANurseUnitManagersjourney

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How would you describe the culture of the department before you became a NUM

Whatmo5vatedyoutowanttotakeonaleadershiprole?

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Whatculturalchangeshaveyouobservedwithinyourteamoverthelastyear?

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EpworthRichmondOrthopaedicTeam

Epworth HealthCare

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Community

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•  Periopbakeoffs•  Chocolatecompe==ons•  CupcakeQueens•  PeriopServicesAwards•  Fundraisingforcolleagues•  Storiesandhumourincommunica=on

Focusonpeopleandengageinthevalueofcommunity

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Wherearewenow.....

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StaffEngagementLevel

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CultureofAmbi5on

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Othermeasures

CNSandENSapplica=onsconsistent

10Applica=onsforleadershipprogramsin2016,zero2yearsago

Agencyusagehasdroppedfrom11%to1%

Theatreinvolvementinallhospitalwideac=vi=esWai=nglistofstafftojointhedepartment

Pa=entrounding

Sustainingandmovingforward.....

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Strategies….

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•  Con=nuetobuildtheteam,partofwhichistoiden=fyandfosternewtalent

•  Con=nuetobevisibleleaders•  Keepcommunityideasfreshandnew•  Keepmeasuringandassessingboththedataandnondatadrivenmeasures•  Con=nuewithvaluebasedrecruitment•  Reward&Recogni=on•  Specificand=melyfeedback•  Con=nuetoprovideopportuni=esfordevelopmentthrough

formallearningprogramsandsecondments

Epworth–ANewDay

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Ques5ons

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