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Transcript from #EdgeTalks November 2017: Connecting People for Innovation and Collaboration

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Transcript from #EdgeTalks 3rd November 2017: Connecting People for Innovation and Collaboration

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Transcript from #EdgeTalks November 2017: Connecting People for Innovation and Collaboration

  1. 1. Edge talk webinar (UKEDGE0311A) Page 1 of 10 Downloaded on: 03 Nov 2017 3:11 PM JANET WILDMAN: Hi everyone, it is 9:31 and welcome to Edge Talks on November 3. This session we are going to be looking at FabTeams Week – Connecting People for Innovation and Collaboration. Thank you so much for joining us today. We are really excited to introduce a subject that everyone has an opinion about, and it affects all our working lives – how to create FabTeams at the Edge. We think it is about connecting people through innovation and collaboration. So we want to hear your views on what works, any methods and approaches that you've used, and what is the evidence behind some of this. Before I go on, there is a couple of announcements I would like to make. If you would like to join our Edge Talk community and receive regular updates, contact me, Janet.Wildman@nhs.net, or let me know who you are by registering your interest in the chat room. The next of the talks will be on December 1 when we look at the role of music in supporting patient care. That will be a fantastic way to end the year for Edge Talks. We hope you will be able to join us then. Paul, could you move my slide along? My name is Janet Wildman and I will be chairing the session today. I'm joined by the Edge Talk Team, Leigh Kendall, who is going to be monitoring the Twitter activity and feeding back during the session and also Rosie Redstone who will be the monitor for us. And we have Paul Woodley, who will be looking at the chat room but also providing technical support for us throughout the session. If you are joining in today and beyond, please use the chat box to contribute continuously during the web seminar. And also please tweet. We want to bring in as many other people, who are not necessarily registered, to attend, but if you are on Twitter, we would like you to use the hashtag #Edgetalks and @horizonsNHS So, I'm going to hand over to Claire Haigh, who is going to introduce herself, as well as the other three speakers that we have today, and we will take it from there. Over to you, Claire. CLAIRE HAIGH: Thank you, Janet. It is great to be with everybody this morning for the Edge Talk. I am absolutely delighted to see the stories that we're already starting to collate around this topic, which is a great topic and something that is so important f or all of us working at the edges and working to collaborate and innovate. Today we have three amazing presenters with three great stories to share. Let me tell you about them before I go on to talk a bit about the work I have done. Today we're going to hear from three amazing people who are pushing the boundary on what we mean by teams. We are going to hear from Cath Doman and they are going to talk about the work I have been doing. Then Boena Zeneli will talk about high-intensity use a work and how they are looking at borderless teams. And Andrew Messina from Stockport Together and the work they are doing their on assisted discharge. Do you want to say hello to everybody? ANDREW MESSINA: Hi, everybody. CLAIRE HAIGH: We will go on to their stories in a minute. I wanted to give you an opportunity to hear some of the themes that have emerged around this. You don't know who has already managed to have a look at the crowdsourcing tool we have sent out ahead of the Edge Talk, that we have been tweeting lots about. We wanted to crowd source ideas around how to develop teams at the edges, and what developing teams meant. This is a bit of a summary of some of the themes. Janet, I think we can get people to point at the things they think are really important to them, in terms of these themes that are emerging? Some of the themes we found here are really important. JANET WILDMAN: Paul, I wonder if you can help us, to encourage our audience to use the Anecdote to point to the key areas that resonate for them? PAUL WOODLEY:
  2. 2. Edge talk webinar (UKEDGE0311A) Page 2 of 10 Downloaded on: 03 Nov 2017 3:11 PM Everybody has the ability to do annotation now. If you click on the pen symbol in the top left of your screen, you will get the choices of tools. If you click on the arrow and then click on the screen, you can indicate... People are starting to do it. CLAIRE HAIGH: Connectedness, how people are stronger together. We have somebody else talking about how to challenge and disagree stop arrows all over the place! Being able to speak up and share, quite a few votes for that. You know what is really interesting, we have votes all over the place. That tells me that generally the themes that are emerging are overall a really nice picture and fitting with the crowd thinking on this, really. I don't know if we can save the slide, Janet and Paul, so we can keep it as a snapshot of what people are saying? Janet, can you put the (inaudible) in the chat room as well so people can add suggestions to that throughout the conversation? JANET WILDMAN: Yes, and we will keep these slides because they show what are the most important factors when it comes to teams. CLAIRE HAIGH: This is just my summary of the data, so it is just one point of view, one of the words that came up time and time again was listening. If you are not listening to different voices, that really stood out to me when I was seeing the different views people had. We want to keep on this conversation and keep knowing what you think makes a fab team, because we know teams are changing and are not standing still, and they work in a very different space. Leigh, can I bring you in here to talk through the 10 things FabTeams do sketch, which is amazing and gives us an overview of some of the ideas that the Horizons team have crowdsourced around teams and what makes a difference? LEIGH KENDALL: I created this sketch. Back in August we did some crowdsourcing on Twitter, asking people to give suggestions about what makes a fab team. We were inundated with responses, which is fantastic, and we had an expert panel of colleagues which got together and looked at the themes which came up. From that, I created the sketch note. The idea of the sketch note is to create an accessible way of understanding the concepts. It is not intended to be a chapter and verse summary of everything that FabTeams do, but the conversation started. Some of the effective things the teams do and many teams have printed this out and have it up in their workspace, and they can refer to it to see what they are doing well and where they can improve. Please do continue sharing it, and if you have anything you think we could add, we could do a new one. CLAIRE HAIGH: Thank you, Leigh. That is a really powerful way of starting to think about that. And we want people to be able to add and iterate this all the time, because we know that new thinking and new ideas into the conversation will add to it. Before I share some of the learning I have done with Collaborate Out Loud, the social enterprise I founded last year, I wanted to get you all to do a poll. I think I'm seeing a shift in how people are working on teams. I'm interested in the people we have on the webinar today, to understand a bit about your experiences of team working right now. We will do a poll, and Paul will help me with it. I will read out the questions are the four options, and Paul will enable the poll. Where do you currently do most of your team working? Is it in a traditional team reporting to one line manager? Is it mainly in project teams? Is it in collaborative teams across organisations and systems, or is it in teams that span formal structures and social networks? Paul, can you enable the poll so that people can start to answer that? PAUL WOODLEY: Thank you, Claire. I have just started the poll now. You should see in the bottom right of the screen, the poll questions and the optional answers. Please put in the answer you think is most appropriate. 17 people have completed it so far. CLAIRE HAIGH:
  3. 3. Edge talk webinar (UKEDGE0311A) Page 3 of 10 Downloaded on: 03 Nov 2017 3:11 PM How how long is remaining? OK, 20 seconds to do that and then we will share the p oll outcomes. It is really interesting, obviously people work in all kinds of spaces in their roles. Are we ready to share? PAUL WOODLEY: You should now see it on the bottom of your screen. CLAIRE HAIGH: C. 8/18 people saying they work in collaborative teams across systems. And only two of the people spend their time working on what we would traditionally see as a team. And five people are talking about how they spent the majority of their time working across formal structures and social networks, which I think is a move we're moving towards. Paul, can we save those results? PAUL WOODLEY: Yes, they will be saved at the end of the session. CLAIRE HAIGH: That was a snapshot to see what the people are doing and where they are. It was a good context in terms of today's chat and session. I just wanted to share with you some of the work we have done, and some of the learning I've had through some of the Collaborate out Loud work that I do. I want to explain quickly what it is. We work in the D space, the space between formal structures and social networks. What we have created is a series of communities that come together, and this is our community manifesto, to give you an idea of how we work. A series of communities that come together to focus and take action and innovate around complex public service challenges. Through doing that, we have learned an awful lot around teams. And not teams in a traditional sense, but in terms of C and D. And also, B, to an extent, as there are projects going on here. And can I just take some questions before we start hearing about that. So this is some of the learning about that that we had. This slide here is what we are seeing in terms of how views are changing. Please contribute during the chat on this. I will ask Janet to summarise the chat into questions. What we see, trying to work here is actually there is a lot more short-term project-based teams which fits with what you said in the poll, a lot less borders, borderless teams, which fits what you just said. Complexity of the issue, far more collaborations - so this is about more collaborative work rather than formal partnership working. A lot more virtual teams, geographically spread. Multilayered, where an individual will often work across multiple teams. Agile, and ability to adapt to the more responsive. Democratised, they are able to access people, ideas and skills in ways we couldn't before. That is interesting and important. The technologically enabled, and the last two things are socially powered and self-organising, so really not necessarily have formal power, but social power and they need to self-organise more and that allows people to bring their whole self to that. Janet, do we have any comments from people? JANET WILDMAN: People are finding that really interesting. What the poll found, that the fact that teams are changing means it's resonating with people. Generally speaking, this is a complex area, a changing area and the leadership models haven't caught up, as well as organisational development. How to deal with teams at the edge and how they are changing in significant ways and how can we make that all work to really achieve the purpose of teams? Leanne is saying, "Love self-organising and using new power." If you do, is to make in the chat rooms please do so. we will put it to the presenter as a go through. That's all from us here. CLAIRE HAIGH: What we're learning in terms of what makes it effective ... What's really nice in terms of what Leah develop and the crowdsourcing exercise, actually there is loads of residents, and what I would like to say is that this is a collective effort, not my thinking. I helped curate, but this is a collective wisdom and that is important in terms of where this comes from. I will go through this briefly and then offer a chance to question and we will spend the rest of the time concentrating on the stories of Cath, Boena and Andrew. We found that effective communities at the edges and in the spaces between the formal and informal embrace the energy of difference and use that and the crowd. (Reads) So rather than trying to work in one person space or the other persons,
  4. 4. Edge talk webinar (UKEDGE0311A) Page 4 of 10 Downloaded on: 03 Nov 2017 3:11 PM apparently they create a shared space and start to build trust and relationships. So they do spend time building trust and shared intent. (Reads) There is so much that resonates back to what Leigh sketched for us. The work on the real and often, challenges that we face in the public services. They borrow learnings anywhere and everywhere. The need to look at. They co-create novel solutions and ideas... (Reads) So they are really action oriented and that fits with the research. They are able to test their ideas and learn together from this. They work out loud which is something, I looked up the concept of working out loud, it gets somewhere faster. They are really generous and careful at making sure they are saying where ideas come from. Actually, this is a shared wisdom and we wouldn't have got that if this hasn't happened. And they spread their ideas. So they are some of the top things we found work really nicely into teams and what you will hear through the stories that are coming up next is that this is what they are doing in practice that the three presenters will talk about. Janet, any questions? JANET WILDMAN: No questions at this stage. CLAIRE HAIGH: Cath, welcome. So, Cath is the program director at Harrogate Vanguard and she will share her story about how she has been pushing the boundaries about working in teams and how to do differently. CATH DOMAN: I'm going to share with you the story and the journey we've been on. It is actually a journey that started really (inaudible) and we found waste through that and we found better ways of developing the team working. Am I in control of my own slides? Excellent. It's good to be in control of your destiny. Sam Jones was the original leader of the Vanguard program. (Reads) We've really tried to pay that forward and practice what we preach. So right at the beginning, we got, we became Vanguard back in March 2015. It was exciting and everyone was giddy and thought it was going to be a really easy path and we would come out at the end and everybody would be glowing and shining and fabulous. Of course, it has been a long journey, a long, bumpy road. We made a lot of mis takes, particularly with teams. What we started with… - my animations are not working. I just have some words against the Good, the Bad and the Ugly there. PAUL WOODLEY: Bear with me. CATH DOMAN: Our ambition in common with many of the Vanguard sites was to develop teams that kept people out of hospital, work closely with GPs, develop social care and try to develop the idea of sharing skills and blurring boundaries between different roles. Our ambition at the beginning was to dissolve the boundaries between the different organisations and then everyone working happily together. That was going to be easy, of course, wasn’t it? We didn't get it right. We set an initial pilot. That went fairly well and then we tried to spread it across the rest of the district. But I think constantly we were saying, do something different, innovate, integrate. And people sat there going how, what do you mean? Just do something different, it will be fine. We really didn't put enough support, mentoring and leadership into that to help them explore how they could do something differently and delivering services differently. We had all kinds of practical issues around things like Wi-Fi, and we were trying to get people (inaudible), stuff coming into…. Who were the host. T hey couldn't access their systems, all kinds of things. It was really tricky. We didn't provide, or give enough attention to, organisational development and the support to help people understand what it means to create a different way of working and to work in joined-up teams. We simply didn't give enough leadership and change-management support around that. And there was lots of pressure coming down from the national teams, to deliver this quickly, get on with it, do it fast. And no attention to the kind of detail that sits underneath that.
  5. 5. Edge talk webinar (UKEDGE0311A) Page 5 of 10 Downloaded on: 03 Nov 2017 3:11 PM I have another thing that should come up here, Paul. CLAIRE HAIGH: Is that in the next slide? Paul, anything you can do on that front? CATH DOMAN: The 'plain ugly' bits were just some really tricky behaviour going on across the teams, and I think that was just a consequence of just not supporting them well enough. We have an example when someone came into play locate with the district nurses, they were not given space, they were put in put in what was collectively known as incontinence corner, so we were giving bad messages to staff. And that is the story that underpins the new culture you are trying to create. You have staff being made to feel that they are not welcome, being shoved in a corner where the incontinence supplies are kept and that is not going to get anyone off to a good start. So just a quick overview of our journey. March ‘15, very excited, we are going. And it took the best part of one year to get up and running. By March ‘16, we had a massive reduction in our traditional funding. But all of our plans were predicated on this additional funding and it dropped by 78%. We had to stop, regroup, rethink and come up with a new plan. And in July ‘16, we came up with a plan. But that was still fundamentally flawed. And going back to what I was saying about hasty rollouts and the pressure to move quickly, we rolled out across the district and by March '17, so, earlier this year, the whole thing came to a catastrophic point. The senior management board decided this isn't affordable, not sustainable. We've created something that isn't going to work into the future, we need to stop and rethink how to do it differently. By March ‘17 it was feeling a bit like this. We stopped, we thought, how are we going to do this? And took a different approach. The transformation board said we are behind this but we need to test it in a different way. We give you permission to do something radically different to what we've seen before. They pushed us towards creating what we call a pop-up organisation, like a pop-up shop. Something that felt very different, something that felt unique, and gave people that were getting involved in this a clear (inaudible) to go around that wasn't their existing organisation, it was something neutral and in the middle that didn't feel like social or mental health. Focus on preventing avoidable admissions. We scaled it right back to the three practices. It is about a third of our population, which meant we could really get into the details and get it right in detail around three practices before we started going out beyond. The focus was around true integration, and again, support and permission to do this. They said, if you are getting blocked, come back to us. For the first time, they put one of the chief executives in, and the senior responsible officer. We had them there to do the unblocking. The magic ingredients, that I think have made it work this time... I hope the animation is going to work this time. Paul, you're going to have to help me here. The animation is not working. JANET WILDMAN: I'm not sure what is happening, do you mind moving on, given we have a limited amount of time? CATH DOMAN: I can, but this is the key slide. CLAIRE HAIGH: Do you just want to run through and say what they are about? CATH DOMAN: I can't actually see the slide at the moment, though... It's too small. Have we lost Paul? CLAIRE HAIGH: Shouldn't have done. CATH DOMAN: I will have to go onto my own desktop, apologies. The first thing, our magic ingredients were around permission. This was permission from the Chief Executive, the second key thing was ground up design. So we involved the staff right from the beginning and spent a week locked away in a room to design what this team was going to look like. Everything from the team name through to the (inaudible), through to how they were going to run their business and what their values and behaviours were going to be.
  6. 6. Edge talk webinar (UKEDGE0311A) Page 6 of 10 Downloaded on: 03 Nov 2017 3:11 PM Right through to on the Monday morning, following up how we were go ing to start running this team. Another key magic ingredient was around: co-location, what I call sharing the milk. It is interesting on the poll earlier around virtual teams, but to really get teams working together, they need to be in the same room, the same building, sharing the milk and a biscuit tin and having conversations getting to know them. The team had access to problem-solving on a daily basis, so if there was a problem, it could get solves there and then. They had a system of daily huddles, 12:30 every day, when the GP comes in, they work through their cases in the last 24 hours, and everyone knows what the plan is for each of the people, and it enables them to really progress what they are doing. There is never any wait or downtime. Access to each of their systems. We haven't got everybody working off the same system, mental health is on one and GPs on another, but if they all sit in the same room with their laptops open, during that huddle, they can see what's going on in each organisation. Very parochial things like parking. We are about to move our team into the social care space in the middle of Harrogate with no parking. We have just said we will pay for some parking for the time being stop and finally, the management tools in the team's name. It is a shame the animation didn't work... CLAIRE HAIGH: Cath, is there anything else key you wanted to say in the next 30 seconds before we have some questions? CATH DOMAN: Yes, the next slide – one of the things that has really underpinned this is the quality improvement system. You can see hopefully on the slide, there are six components to that. I won't go through them all, but the key thing is I think it made a big difference our access to the leadership team – leaders from across the organisation that do the unblocking and give the permission will stop daily huddles, as I mentioned, and also visual control. And we have a screenshot which you probably can't see very clearly, but this is in the team room and it shows at a glance what is going on. How many referrals, where they have come from, when they are going to be discharged. Practical stuff, issues to escalate, which team we have available when, and that kind of thing. And finally, this is some of the team. That is not all of them. There is the GPs and the pharmacists and the social workers and so on. CLAIRE HAIGH: Thank you very much, Cath. It is great to hear what you've done and how honest you've been about the stuff that didn't work and how you got over some of that and kept looking at what you are doing and were able to hone down to what would make a difference. I heard you talk about that you eliminated some practical niggling things like parking so they don't get in the way, which is an interesting approach to that. Janet, do you have any questions from the chat or the WebEx for Before we move on to Boena? JANET WILDMAN: Can I bring in Leigh and Rosie to say what is happening on Twitter? LEIGH KENDALL: On Twitter, people have been enjoying some of the slides that I flipped. The feedback from the Tricider crowdsourcing, they are going to use it for their own teams, so that is perfect about sharing knowledge. So please continue the conversation at @Horizons #Edgetalks. JANET WILDMAN: Anything on your side, Rosie? In the chat room, there have been a couple of suggestions, around leadership being really important to this, as well as sometimes there is a false sense of urgency and the need to step back and think about what is really important. Another thing that really resonates with me is around the social energy. The small things really matter, like being able to have conversations to connect with people. Some also talked about technology being imported for connecting people together around teamwork. Any response to that would be really helpful. CATH DOMAN: One thing I would like to emphasise is the disproportionate amount of leadership that has had to invest in this. When the team and the new way of working is up and running, you won't expect anything like the level of leadership supporting it, as it will become more self-sustaining, but I think often organisational systems underestimate how much leadership and
  7. 7. Edge talk webinar (UKEDGE0311A) Page 7 of 10 Downloaded on: 03 Nov 2017 3:11 PM people rolling up their sleeves and supporting and making an impact on problems that this takes, to just support the teams when things are tough. For them to know that people have got their back and are looking after their interests. If people are going to take a step into the great blue yonder, they need to feel safe, and I think feeling a strong presence of leadership around them is important. CLAIRE HAIGH: Thank you, Kath. It has been great to hear that. People can connect with you on Twitter at @CathDoman and you will be carrying on the conversation via #Edgetalks. And they can see the animations on your slides that didn't work. I am really conscious of time, and I want to make sure we have time to hear from Boena and Andrew. I'm suggesting maybe we take both of the presentations for five minutes each and have a discussion about the two together, if everyone is happy with that. If I can introduce Boena Zeneli, who works at Northeast Essex. Boena, can you say hello? BOENA ZENELI: Good morning, everybody. CLAIRE HAIGH: You've got four or five minutes to tell your story. If I could hand over to you. BOENA ZENELI: As we are a bit pressed for time, I suppose I wouldn't go through all the slides. Maybe I would just try and summarise how we worked together as a team. I want to start by saying that this project has been quite successful and it has the (inaudible) financial savings and all of that, but we want to look at it from the point of view of how did we work together and correspondence, because the work involves a lot of teams. And we have worked to a (inaudible) meeting, and even if that is clinical and involves ambulance, mental health, acute services, and sometimes also GPs. We also work with social services and fire services. So it is a lot of people to get in contact with and bring together to serve our patients. At the same time, the way I have gone about it is to make sure, the aim, the goal, the vision, it was very clear to everybody. So every time the members come to the EMT meeting, we make sure that we explain to them what we are trying to do here, and try and make them well-informed. And also we try to make sure that we understand everybody is here to gain something. It is not just about making sure we are doing our best for the patients, but also making sure that we make the working experience for our team members are more enjoyable one. By working together, they have really seen the benefits. But it hasn't been that easy. Bringing people from different organisations, with very different cultures, making them understand that this is important work, but as Cath was talking about, nobody has the time for this. These meetings happen every 4-6 weeks and people do this on top of their work. It has been very challenging in terms of also, sometimes there were issues with the technology, information governance, but also with communicating and having people committed to the project. Another thing that I have to mention quickly is that regardless of how much you've got understanding, and you know the theories about bringing together and working with teams, we have to be open-minded and be flexible. Assess the situation and what is happening and then try to analyse and readjust things. One of the things, when we were talking about the challenges, one thing I need to mention is that when it comes to engaging, most of the organisation has been quite willing and actually worked well together. But there was one organisation that was very hard to engage. I asked, what do you want us to do? How can we help, because we need you to engage because it is also good for you. They knew it was good but they didn't have time. So we have gone to their premises. The EMT meetings happen in their premises, so they can't escape when we are there. So pretty much we have come to a point where we have engaged all the organisations that we wanted to. However, with this last organisation, there is a lot more work to be done, which we will come to in the slide about the future. I think I have to mention just briefly that sometimes keeping myself motivated has been a bit of a challenge, because there does come a point where it is like obstacle after obstacle.
  8. 8. Edge talk webinar (UKEDGE0311A) Page 8 of 10 Downloaded on: 03 Nov 2017 3:11 PM I think you just have to be resilient and just believe that what you're doing is the right thing, and once you have built the trust of the people, you have people on board and good support from your managers, I have to say that, it makes life easier for the project manager but also the people involved in the collaboration So, establishing meaningful connections results in great success. Basically, it was that. Keeping everybody supported, keeping everybody engaged. I communicated, to make sure everybody was engaged, I treat them equally, but I also, to understand their roles, I spend one day with the ambulance crews in their van or whatever it is called. I spent a day with the community matron. I spent half a day in the GP surgery, and I have spent time with most of the members so I know what they do on a day-to-day basis. And then I know what we need to do different to make life easier for them and also their patients. Just to say that I have asked team members as to what they thought about the project, and I'm not going to go through this, there were some very good comments. Basically, I believe this project has proved very important to collaborate, to work across boundaries, especially when we think about future SEP's and having less and less boundaries, I think this is the first step in the right direction. For the future, we're going to continue with our work at make sure even better processes are in place. Engage more organisations and just try to share our knowledge, but also try and find other organisations that have done the same thing and share it with them. The last thought, just to summarise and I think it summarises me and what I have done until now. That is (inaudible). I don't know if we will take any questions. CLAIRE HAIGH: Thank you. What you told me yesterday about the example you gave when you hold the meetings, constantly thinking about how we can do small things and by doing that the trust between the teams. BOENA ZENELI: Exactly, to me that felt maybe the rest of the team felt maybe we are less important to you, why are we going to us. They saw something important in it and we are all happy to actually move as long as we get engagement from the salary organisation. CLAIRE HAIGH: What I will do is let Andrew talk through his slide. ANDREW MESSINA: Can you hear me? Just go into my slide. I will be very brief. Like Harrogate, we're also another Vanguard site and provide a lot more out-of-hospital, and getting people out of hospital to get them back into the community, because we strongly believe that people do better at home and they only need to be in hospital when they need to. We didn't like the language of discharge and assess. What we're really doing is transferring to another part of our system. As it was, before we do the project, there could be up to 70 people on a day in our hospital who medically didn't need to be there. People with complex needs that need ongoing care either in their own home or in a community bed. The way the system was designed was that professionals would go into the hospital and assess that person's needs, meanwhile the person is deteriorating in hospital and ultimately goes on, stays on in hospital. And that has an impact on our system and on our floor. We turn that on its head and instead of what we call a push system, we thought of pulling people out, the community reaches in and pulls them out. We identify them early who are eligible to go home and the door, heads of assessment of that individual back in their own environment. And the challenge with the objective was that it really cut across all of the different services and organisations, it is hospital, our community nursing services, social work, primary care and also the voluntary sector. As a pathway, it cuts across all of those different organisations which - So what we did to overcome that, we had as part of the project a big room, a shared space where that non-traditional team comes together. The nurse, the therapist the district nurse, the GP, social worker, et cetera. We come together and it was a real problem solving room where we are learning and reflecting and problem-solving to make improvements to the process and implementing it. I am a strong believer that the people working the process are actually the experts. To break down the traditional top - down management. It was really about empowering people to problem solve. What we did, first of all, around testing and piloting, we did the new process which first of all, they designed it, and we got together with the group and we tested it. We did the new process with one patient only. And it was about learning, so we
  9. 9. Edge talk webinar (UKEDGE0311A) Page 9 of 10 Downloaded on: 03 Nov 2017 3:11 PM followed the PDSA cycle, we tested it with the one patient and reflected. And we asked what went well and what didn't, what did we learn from that and what will we take to the next cycle? And we repeated that cycle. It was a real philosophy that was picked up by some of the presenters, we failed fast but we learnt quickly. It's not about a project, a beginning and an end, once we're implement a change, as well as that were also trying to create a culture of improvement and learning and to problem solve. In doing that we also engaged an improvement partner, AQuA in the north-west, to give staff the skills to transfer those to adopt that in the learning. We did create quite a social movement in that group. We've gone through that forming, storming, norming and performing in a non-traditional team. In those power structures, everybody's view is equal in that room. It is not about lame. Initially there was a lack of trust at times, and that is because of history and tradition and protecting oneself. We always took it back to our goals. And that patient. It is not about individual services but about learning and empowering people to make changes. CLAIRE HAIGH: 30 seconds left. ANDREW MESSINA: We have had some tangible improvements, within the hospital, but I think in some ways, it is power for the patients, some of the softer benefits, relationships are greatly improved and there is a greater level of trust. We are still on that journey but I think there are pockets and green shoots of that integrated teamwork. CLAIRE HAIGH: I think that is the theme, teamwork and trust, that has gone through all the presen tations today. Can we just go to the chat room. JANET WILDMAN: I'm just going to head over to Leigh and Rosie. LEIGH KENDALL: There are some good conversations going on on Twitter. Leeanne made the good point about protected time and how we could use that to enhance collaboration. CLAIRE HAIGH: Rosie, anything from you? OK. Really quickly. I have a question for Boena and Andrew, if you had one top tip? Andrew? ANDREW MESSINA: I think it's, keep it simple. I see in the chart that PDSA, it's really simple. Empowering people, because people are experts in their field and it is about letting go of the traditional power structures and letting it, don't over plan things, just let it take its shape. CLAIRE HAIGH: So emergence, new power. Boena, what would your top tip be? BOENA ZENELI: Building trust. Just making sure that you are honest about it, I am often too direct. Just be honest and make people understand that at the end of the day it is for the benefit of everybody. And your honesty and your willingness I think people will come on board. CLAIRE HAIGH: That is excellent, thank you. We have one minute remaining and I would just like people to have a think about the question that is on the screen now. And just vote in the poll. What we're asking you is how energised are you to try something, some of the approaches and tools you've heard today? I'd really like people to just take part in the poll to end and then we will just thank our presenters and let you get on with your day. PAUL WOODLEY: The poll is now running and you will see it in the bottom right corner as before. CLAIRE HAIGH: People are doing it. While we're voting, I'd just like to thank Cath who had to leave. Also Boena and Andrew. Janet, do you have any final remarks? JANET WILDMAN: I'd like to thank everybody who is joined the course today. This is brought up some fascinating issues on how to make an effective fab team. I have do hope you will join up to Edge Talks on 1 December.
  10. 10. Edge talk webinar (UKEDGE0311A) Page 10 of 10 Downloaded on: 03 Nov 2017 3:11 PM CLAIRE HAIGH: And we will keep the Tricider going so people can cure to what they are saying about this. I am really pleased that I let out with this 16 people that completed, 11 are very motivated, and five are motivated. A good result. Have a brilliant day, thank you everyone. SPEAKER: (Multiple speakers) Thank you.

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