An interview with forensic psychiatrist Dr Amar Shah – Chief Quality Officer at East London NHS Foundation Trust and National Improvement Lead, Royal College of Psychiatrists.
While others were struggling to cope with the pressures of the pandemic, teams using ImproveWell to support the improvement of joy in work were bucking the trend in a national Quality Improvement collaborative.
Having run a number of large, national Quality Improvement collaboratives, Amar and his colleagues at the Royal College of Psychiatrists were considering what to tackle next against the background of the pandemic.
“There was pretty unanimous decision that putting focus on staff and staff wellbeing in order to tackle burnout was probably going to be one of the most critical things that teams and organisations wanted to work on,” says Amar. Designed to build on the Institute for Healthcare Improvement’s Framework for Improving Joy in Work – which sets out the theory of what it takes to create a really joyful, thriving workforce – the collaborative wanted to find out how to bring more meaning and purpose into work and how to remove the things that get in the way of that. The team invited anyone across the country to take part in the programme and were thrilled with the take-up across different settings and organisations.
Where did ImproveWell come in?
“Probably one of the most challenging bits of this type of work is the measurement,” Amar reveals. “We have to know whether the changes we’re making actually lead to improvement and the only way to do that is through data.” But finding a way to capture how people are feeling at work in real time and make that available for analysis isn’t easy. “ImproveWell offered a digital platform that allowed us to ask a set of questions on a weekly basis. That meant all of the actual administrative work of collating the data could be taken away from the team and all they had to do was contribute their data – so they could spend more time thinking about the actual change ideas that they wanted to introduce.”
Improvements across the board
The programme recruited 38 teams from 16 different organisations across England and Wales. Every team collected data through the ImproveWell platform on the same three questions every week, which meant the central team at the Royal College of Psychiatrists could aggregate the data over the course of the year.
“Overall we saw improvement on our three outcome measures, which is really impressive. This was in the second year of the pandemic – there were all sorts of things going on in society and at work – so this was a really unusual finding. Most people were talking about an increase in burnout in the workplace but we saw that these teams were able to reduce burnout. There was a 50% improvement in the percentage of people who say that they enjoyed being at work frequently, a 41% increase in those who said they had no symptoms of burnout and a 38% improvement on the percentage of people who would recommend their place of work. Those are pretty impressive figures.”
Amar is keen to spread the word on a programme which, as he says, could be replicated by any team in the NHS. “If you go to the Royal College of Psychiatrists website, you’ll find all our resources for anyone to access anywhere in the world. We’re writing it up to make sure there’s a peer-reviewed publication that demonstrates the learning from this initiative. And then we’re trying to work with national organisations in England to see how we can scale this up. What can we do to deliver this work on a bigger scale because we know it delivers results?”
What were the things that health workers were concerned about? “Common themes included paying more attention to wellbeing, how we work together (the switch to large-scale virtual working hasn’t always improved wellbeing), getting back to being there in person and building relationships, really thinking differently about leadership and how we involve people in making decisions, plus the simple act of recognising and rewarding people. Affirmation and appreciation are really powerful.”
In conclusion, Amar sums up the benefits. “ImproveWell is a simple digital platform that allows people to share how they feel at work and also things that they spot at work that could be improved, and what they would do about it. Everyone owns the improvement effort and contributes to it. It’s very democratic, very transparent and it makes measurement much easier. It’s an opportunity to simplify measurement. And you can see your own data, which is really powerful – it allows you to reflect on what you might do differently in your own routine.”
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