1. Welcome Cultivating Compassion Main title slide page
Co-brand logo here
Welcome
Cultivating Compassion
Vicky Romback & Dr Lindsay Aikman

2. What a Difference a Year Makes…
‘People First’ 3000 Improvers
QI project work in teams
‘15s 30m’
‘Kata’ Continuous Improvement
Team behaviours

3. Who are we? The Glenbourne Unit Acute Mental Health Unit in Plymouth
One male and one female ward 19 beds each
Place of Safety Suite
Proactive in embracing QI ethos and methodology for some time

4. Welcome Why Cultivating Compassion?
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“a healthcare organisation’s culture is a critical factor in the development of its patient safety climate and in the successful implementation of quality improvement initiatives.”
Organisational culture: variation across hospitals and connection to patient safety climate
(Speroff et al. 2010: 592)

5. Welcome A Framework for Safe, Reliable, and Effective Care
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A Framework for Safe, Reliable, and Effective Care
IHI White Paper

6. “We did nothing ‘wrong’”
Learning from deaths
Welcome
“We did nothing ‘wrong’”
“Allow us to grieve”

7. Supporting people we care for
AIM PRIMARY DRIVERS
To increase the overall outcome measures by 50% (aggregate)
by April 2019
Self-compassion
Supporting the team
Supporting people we care for
Systems and Processes
Self-care / self-awareness
Building resilience / role modelling / giving permission
Tuning in to distress / responding to distress
Embedding / training / communication

8. Supporting people we care for
AIM PRIMARY DRIVERS
To increase the overall outcome measures by 50% (aggregate)
by April 2019
Self-compassion
Supporting the team
Supporting people we care for
Systems and Processes
Self-care / self-awareness
Building resilience / role modelling / giving permission
Tuning in to distress / responding to distress
Embedding / training / communication

9. Measurement Baseline measures Data collection on change ideas
Compassion focused measures
Compassion for others (Pommier)
Self-compassion (Neff)
Professional quality of life
Warwick-Edinburgh wellbeing scale
The Future Scale (Snyder et al.)
Data collection on change ideas
Mindfulness for staff
Incident huddles
The SCORE survey

10. Who was involved in the project?
Welcome
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All staff invited to complete measures (130 pax)
43% response rate compassion measures
76% response rate SCORE survey
Monthly working party – rotating membership
Minutes shared back to team via brief video
On going work in smaller pockets of people (connects to multiple other projects)

11. PDSA Testing ramps: Incident huddle
DATA FEEDBACK TO FRONTLINE STAFF
Cycle 1E: Sharing feedback more widely
Practice supervision
Cycle 1D: Planning attendance in advance
Cycle 1C: Input from various staff roles
Cycle 1B: Preparation
Cycle 1A: Logistics: Suitability for ward & facilitator availability

12. Example… Wider system Issue Actions Smoking in garden
Planned garden sweep for buried lighters
Co-ordinate between wards
Patient who swallows
solid items as a coping mechanism
- only in hospital environment
Formulation session to help staff feel less stuck
Liaise with recovery unit re high likelihood of swallowing behaviour continuing there
Other re-ablement options making a return to the community possible?
Person-specific

13. Qualitative feedback on the incident huddle
Feels like you’re problem solving as a team
It empowers us more to feel like we’re making a difference
Good to chew it over and realise that we’ve done everything we can
Qualitative feedback on the incident huddle
I’m more mindful of what’s happening on the other ward and them us
Whatever we’ve implemented has helped us better manage future similar incidents

14. PDSA Testing ramps: Staff mindfulness
DATA FEEDBACK TO FRONTLINE STAFF
Cycle1E: Staff being more comfortable to use on wards for selves and patients
Cycle 1D: Make own videos to meet unit’s needs
Cycle 1C: Planning ahead for most helpful videos
Cycle 1B: Getting a bespoke tablet and speaker, build in to work day
Cycle 1A: Informing staff about apps

15. Qualitative feedback on using mindfulness in the workplace
When everything is spiralling, it helps to ground you.
Job role can include lots of heavy emotive topics and can be draining, so can be important to have some space from that.
A nice cleanse.
Qualitative feedback on using mindfulness in the workplace
If it’s too prescriptive it doesn’t work.
Work isn’t the right place to do it, it makes me feel emotional and tearful and I try not to open that side of myself whilst at work.
When your head is full and you have just received a lot of information it can be nice to
just stop.

16. Wheel of Awareness, Siegel 2018

17. Challenges & Barriers Acute clinical environment
Change ‘below the water level’
is slow
Staff struggling to prioritise themselves
Shifts and rotas

18. Discovered the power/flexibility of video
Unintended consequences
Welcome
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The compassion-measures are an intervention in and of themselves
Discovered the power/flexibility of video
Enforced mindfulness!!

19. Simultaneously going fast and going slow
Learning
Simultaneously going fast and going slow

20. Welcome What next? Extend the project Keep up the good work!
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