Doing the Right Thing When No-one is Looking


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The session presents an opportunity for delegates to explore the contribution of professionalism and self‐regulation as a driver for quality and for person‐centred care.

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  • Expert knowledge & skills denoted power & demanded reward, status & visible trappings wigs uniforms etc As the professions proliferate, every group holding specialised knowledge will require an oath or code of ethics that obliges benevolent use of the power that knowledge bestows upon the practitioner. What can be democratised is access to specialised knowledge, or access to professionalism itself.
  • The focus on targets & money had caused confusion and frustration from staff who were motivated by public service, a personal quest, altruism or profession specific values and
  • Doing the Right Thing When No-one is Looking

    1. 1. Doing the right thing when no-one is looking Delivering the Quality Strategy Ros Moore Chief Nursing Officer for Scotland Douglas Murphy Senior Clinical Research Fellow, University of Dundee
    2. 2. Professionalism Workstream Delivering the Quality Strategy Why Professionalism is Important
    3. 3. Industrial Information Provider orientated User orientated Inputs orientated Outputs orientated Hierarchical clinical teams &departmental silos Collaborative/virtual teams with true partnership Power concentrated – in professions & managers Power sharing with staff patient & communities as partners Enforced compliance – PM policies, procedures & checks Bottom up standards setting & robust assurance Defensive conservative Open to review Open to change Self care infrequent Self care promoted Carers ignored Carers valued and supported Reactive single episode provider driven Preventative Anticipatory integrated H& S care models
    4. 4. Tertiary Secondary Primary Professional Care Professionals as authorities Professionals as true partners Professionals as facilitators Individual Self care Friends and family Self help networks Information age health care Industrial age medicine
    5. 5. Restore Public Confidence Reframe public perceptions & expectations of professionalism
    6. 6. Stated values versus behaviours Managers & staff Staff to staff Staff & patients
    7. 7. Student Who Created Face book Group Critical of Teacher Sues High School Over Suspension Captured on Face book, the food-fighting nurses at Stafford General hospital where 1,200 died By Andy Dolan
    8. 8. Restore Pride Identity & Purpose DH Workforce Survey 2007/8
    9. 9. Restore co Restore Confidence manage acceptable risk & challenge defensive accountability
    10. 10. Why Professionalism Gives continuity & helps us adapt to change Professionalism is not only a skills set in a given occupation; it is an ineffable something ... Larkin 2010
    11. 11. Professionalism Workstream Delivering the Quality Strategy <ul><li>Purpose of work </li></ul><ul><li>What does professionalism look like? </li></ul><ul><li>Communicating the message </li></ul><ul><li>Facilitating the message </li></ul><ul><li>Measuring the message </li></ul>
    12. 12. Purpose of Work Delivering the Quality Strategy <ul><li>Contribute to the Quality Strategy </li></ul><ul><li>Build on evidence of professionalism and promote Quality Improvement </li></ul><ul><li>Enhance person –centredness </li></ul><ul><li>Benefit service users and providers </li></ul><ul><li>Recommendations to Coordinating Council NHSS on communication/ facilitation/ measurement of professionalism </li></ul>
    13. 13. What Does Professionalism Look Like? Delivering the Quality Strategy <ul><li>Behaviours, attitudes, values </li></ul><ul><li>Relationships </li></ul><ul><li>Context </li></ul><ul><li>Unites </li></ul><ul><li>Builds </li></ul>
    14. 14. Communicating the Message Delivering the Quality Strategy <ul><li>Everyone </li></ul><ul><li>All healthcare staff </li></ul><ul><li>Patients </li></ul><ul><li>Public </li></ul>
    15. 15. Facilitating the Message Delivering the Quality Strategy <ul><li>Public </li></ul><ul><li>Personal </li></ul><ul><li>Cultural </li></ul><ul><li>Educational </li></ul><ul><li>Regulatory bodies </li></ul><ul><li>Employer </li></ul>
    16. 16. Delivering the Quality Strategy Cycle of Insightful Practice Insightful Practice Professional Support Development Needs Reflection on Credible Evidence from Practice Quality Feedback Quality Improvement Professionalism
    17. 17. Measuring the Message <ul><li>Understand the perceptions (experience) and agreement of how </li></ul><ul><li>well the attributes of professionalism are expected to be measured </li></ul><ul><li>by a range of possible feedback tools : </li></ul><ul><li>Individuals (staff, patients) </li></ul><ul><li>Teams </li></ul><ul><li>Different work-roles </li></ul>
    18. 18. Mapping Exercise
    19. 19. Existing tools used to measure aspects of professionalism in NMAHP <ul><li>Self Assessed Questionnaires </li></ul><ul><li>Records of incidents of unprofessionalism </li></ul><ul><li>Knowledge and Skills Framework </li></ul>
    20. 20. Some potential tools used to measure aspects of professionalism from contexts other than NMAHP <ul><li>Peer feedback </li></ul><ul><li>Conscientiousness Index (Feedback on Level of Conscientious-ness in behaviour) </li></ul><ul><li>External and Objective Feedback (based on patient care outcomes) </li></ul><ul><li>Personal Qualities Assessments (personality testing questionnaires) </li></ul><ul><li>Situational Judgement Tests (web scenario testing) </li></ul>
    21. 21. Some potential tools of team measurement (professionalism/ culture) <ul><li>Self-assessed questionnaires by team members of own healthcare team </li></ul><ul><li>Patient / Family assessed questionnaires of healthcare team </li></ul><ul><li>NHS Staff Survey </li></ul>
    22. 22. Mapping Exercise