From children and young people
We have been thinking about how we are leaders of engagement within the RCPCH Engagement Committee, which includes young people, parent/carers and paediatricians. Our experiences of supporting others to do something different about involving children, young people and families in service shaping can be used as examples to help others in their leadership of different topics.
We thought about three areas.
1. Why it matters to different people. We took time to think about why engagement matters to us, what has inspired us, our hopes, how to build a movement and how to think about what we want to achieve, like help for patients - and doctors, too.
Our hopes are that we are heard and understood properly and not pushed to the side, to not feel insecure and judged in hospital. By building an engagement movement it allows care to be tailored to individuals and groups to ensure the best possible experience.
Use short videos to explain things, create easy to follow information that is accessible to everyone and think about how to create an action they can join in on. We’ve done a video about our engagement story, we’re creating a one page poster for RCPCH staff and we’re asking people to be an engagement ambassador and volunteer with us.
We can build an engagement movement by continued, high profile visibility that celebrates and shares success
Finally, one volunteer offers four tips:
Finding your own leadership style
Being a good leader is about showing up and saying "we can do this"
Leadership doesn't look the same in everybody. Dr Tessa Davis talks through what leadership means to her and how she found her own style.
Managing conflict - case study
Training level: All levels
Setting: Neonatal department
What prompted the change? The paediatric registrar is called by the neonatal junior doctor requesting the review of a term baby admitted to the unit. The junior sounds upset and mentions it’s been a challenging night with the nursing team. The nurses have challenged the need for admission and the junior has been short in their response. It becomes apparent that the relationship between the junior doctor and nurse overnight has become fraught, both feeling disrespected and distressed.
What happened? The patient safety was paramount. Individuals of the team had a coffee with the registrar to sound out their concerns. The registrar acknowledged the stressful situation for each of them and facilitated mediation focusing on shared goals. Informing the consultant of events, the team planned to safely work together escalating overnight if any opposing views in care.
The incivil incident led to a ‘cup of coffee’ intervention. Apparent patterns within the team were further investigated and the department entered an awareness intervention programme. Focusing on Civility Saves Lives; the impact on performance, wellbeing and patient safety.
How did this support training and trainees? Recognising the impact of incivility on the individual, the team and the patients is paramount. Learning how to take action when witnessing unprofessional behaviour is a key leadership skill and has a wide-reaching impact.
Any practical tips? Deescalating challenging behaviours can be testing. Using an approach to understand the information and move forward with a plan can be incredibly helpful.
Dr Anna Baverstock explains more in her presentation:
You can find out more on the Civility Saves Lives website, and from this TED talk on rudness in teams.
Balancing training with service needs - case study
Training level: All levels
Setting: All settings
What prompted the change? A senior house officer working on the general paediatric wards through winter was unable to attend clinic, missed many teaching sessions and had multiple ‘supporting professional activity’ (SPA) days cancelled due to pressures and staff shortages.
What happened? The junior team worked closely with senior colleagues to ensure adequate cover and highlighted the impact on training, lack of SPA time and clinic exposure. They were encouraged to use exception reports in order to provide clear evidence of workload and provide data to support a business case for a clinical fellow post.
How did this support training and trainees? Trainees were able to recognise the impact of staff shortages on their training and development. The acknowledgment of workload and collaboration with senior team enabled the juniors to attend protected teaching. The addition of a clinical fellow eased the daily pressures ensuring those working felt supported and able to get home on time.
Any practical tips? Use of exception reporting (or hours monitoring) can offer practical support on managing educational delivery and addressing time pressures within the NHS. Working closely with senior colleagues to support their use and provide useful data is key. See our webinar on sustainable working practices for more information.
Acting on what you see - case study
Training level: All levels
Setting: Neonates, Ward and A&E
What prompted the change? Patient safety concerns were raised in relation to the long wait times in A&E to be seen for neonates prior to management plans being started.
What happened? Neonates attending ED were regularly waited in A&E for significant lengths of time before full assessments could occur and or management plans were formulated and actioned.
Upset by one particular case, when a patient was found to need urgent treatment after a lengthy wait in A&E, a trainee explored the extent of this issue. They found that other similar occurrences had happened previously and identified points along the patient journey where potential obstacles occur which may delay treatment.
The trainee engaged key stakeholders (nursing, medical and managerial workers) who had input/would be active along different parts of the patient journey to discuss the issue and their perspectives. They led a team to formulate different change ideas and constructed several plan-do-study-act (PDSA) cycles until a sustained significant reduction in waiting time occurred and sick patients were clearly identified, and management started at presentation for those most in need.
How did this support training and trainees? Leadership skills were developed by the trainees involved by learning to collaborate between different departments, Advocate for change, share the vision for change and engage stakeholders from different departments to drive departmental improvement. They also learned to construct a business case to obtain funding for needed equipment to help address the issue.
Any practical tips? Find day-to-day topics which ignite an emotion in you and use that passion to garner support and engagement in other key stakeholders to try to make change. Be willing to use different modes of communication to share the vision (presentations, posters, verbal conversations, data figures).
A training presentation
Dr Sarah Arthur and Dr Segn Nedd have created a presentation you can use to get thinking about how to develop your leadership style - see the downloads section for these tools.
Sarah is an ST7 at Musgrove Park Hospital with a special interest in Neonates and is a regional rep for Severn on the RCPCH Trainee Network. Segn is ST7 and PEM Trainee at Queen's Medical Centre. Segn is also a representative on the Trainees Committee and on the Equality, Diversity and Inclusion Member Reference Group.