Involving staff with quality improvement initiatives

NHS Employers has published Staff involvement, quality improvement and staff engagement:  the missing links.

This briefing aims to help managers and leaders understand more about how involving staff with quality improvement initiatives can have a significant impact on staff engagement levels.

Involving staff in quality improvement decision-making, planning and delivery has always been a good idea. However, at a time of unprecedented pressures and financial challenges it is an issue of the highest importance.

This new briefing explores the benefits, approaches and working examples of how organisations are involving staff with their quality improvement activities.

Read more about staff engagement initiatives across the NHS here.

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People with dementia benefit from goal-oriented therapy

Personalised cognitive rehabilitation therapy can help people with early stage dementia significantly improve their ability to engage in important everyday activities and tasks. | via ScienceDaily

A large-scale trial has found that cognitive rehabilitation leads to people seeing satisfying progress in areas that enable them to maintain their functioning and independence.

Cognitive rehabilitation involves a therapist working with the person with dementia and a family carer to identify issues where they would like to see improvements. Together, they set up to three goals, and the therapist helps to develop strategies to achieve these goals.

The goals participants chose were varied, as dementia affects people in a wide range of ways. Some participants wanted to find ways of staying independent, for example by learning or re-learning how to use household appliances or mobile phones. Some wanted to manage daily tasks better, and worked with therapists on developing strategies to prevent them burning their food when cooking meals. Others wanted to stay socially connected, and focussed on being able to remember details like the names of relatives or neighbours, or improving their ability to engage in conversation. Sometimes staying safe was important, so strategies focused on things like remembering to lock the door at home or withdrawing money safely from a cashpoint.

The Goal-oriented Cognitive Rehabilitation in Early-stage Alzheimer’s and Related Dementias: Multi-centre Single-blind Randomised Controlled Trial (GREAT) trial involved 475 people across eight sites in England and Wales. Half of them received ten cognitive rehabilitation sessions over three months, and the other half did not. The group receiving the therapy then took part in four “top-up” sessions over six months.

The researchers found that those who took part in the therapy showed significant improvement in the areas they had identified, after both the ten week and “top-up” sessions. Family carers agreed that their performance had improved. Both participants and carers were happier with the participants’ abilities in the areas identified.

Full story: University of Exeter. “People with dementia benefit from goal-oriented therapy: Personalized cognitive rehabilitation therapy can help people with early stage dementia significantly improve their ability to engage in important everyday activities and tasks.” ScienceDaily. | 18 July 2017.

The realities of partnership in person-centred care

Although conceptual definitions of person-centred care (PCC) vary, most models value the involvement of patients through patient-professional partnerships | BMJ Open

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Objective: While this may increase patients’ sense of responsibility and control, research is needed to further understand how this partnership is created and perceived. This study aims to explore the realities of partnership as perceived by patients and health professionals in everyday PCC practice.

Conclusions: In our study, patients appear to value a process of human connectedness above and beyond formalised aspects of documenting agreed goals and care planning. PCC increases patients’ confidence in professionals who are competent and able to make them feel safe and secure. Informal elements of partnership provide the conditions for communication and cooperation on which formal relations of partnership can be constructed.

Full reference: Wolf, A. et al. (2017) The realities of partnership in person-centred care: a qualitative interview study with patients and professionals. BMJ Open. 7:e016491

Using kaizen (continuous improvement) to improve employee well-being

Participatory intervention approaches that are embedded in existing organizational structures may improve the efficiency and effectiveness of organizational interventions, but concrete tools are lacking | Human Relations

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In the present article, we use a realist evaluation approach to explore the role of kaizen, a lean tool for participatory continuous improvement, in improving employee well-being in two cluster-randomized, controlled participatory intervention studies. Case 1 is from the Danish Postal Service, where kaizen boards were used to implement action plans. The results of multi-group structural equation modeling showed that kaizen served as a mechanism that increased the level of awareness of and capacity to manage psychosocial issues, which, in turn, predicted increased job satisfaction and mental health. Case 2 is from a regional hospital in Sweden that integrated occupational health processes with a pre-existing kaizen system. Multi-group structural equation modeling revealed that, in the intervention group, kaizen work predicted better integration of organizational and employee objectives after 12 months, which, in turn, predicted increased job satisfaction and decreased discomfort at 24 months. The findings suggest that participatory and structured problem-solving approaches that are familiar and visual to employees can facilitate organizational interventions.

Full reference: von Thiele Schwarz, U. et al. (2017) Using kaizen to improve employee well-being: Results from two organizational intervention studies. Human Relations. Vol. 70 (no.08)