Mersey Care's strategy to pursue 'perfect care' clearly articulates unprecedented, audacious goals for clinical practice in our field, and an ambition to become a best provider and a best employer.
The transformation required is significant and requires a cultural shift that is dependent on a paradigm shift in mind-set, behaviour and practice. The successful delivery of our strategy is primarily dependant on the engagement and alignment of our workforce. Redesigning work in relation to the purpose, strategy and espoused values i.e. work imagined as opposed to work done. Congruence between the two precedes alignment.
COVID-19 has further exposed the fragility of the care system and reinforced the need for strong relationships with local partners. Technical solutions alone are not transformative, nor do they satisfactorily mitigate risk. Now more than ever, solutions must be socially constructed, collectively owned and collaboratively delivered. Our strategy therefore places people at its core, recognising the sector as a human system, creating congruence between culture, structure and process in order to achieve the organisational health required to deliver organisational performance. The two are intrinsically linked and support the ability to manage complexity whilst sustaining quality.
Now more than ever, solutions must be socially constructed, collectively owned and collaboratively delivered.
Chief Executive
It is well documented that the healthcare system is one of the most difficult places in which to work, and one of the most difficult to manage. It is a complex environment that is inherent with risk and potential for 'things not going as they are planned'. We know from much and deep engagement with Mersey Care staff that they are fearful of the associated consequences and punitive action.
As a result, our plans place greater emphasis on psychological safety for continuous learning and improvement and include solutions to address the well documented impact of legacy infrastructure and organisational design. By positioning culture, safety, improvement and organisational design as interdependencies truly enables us to optimise and upscale quality and improvement.
Our ambition to create a restorative, just and learning culture (RJC) and apply organisational health concepts addresses risk to safety and are proven to improve outcomes for patients, lower levels of turnover and increase levels of wellbeing and commitment within the workforce. In essence RJC/P aims to foster a sense of community, establish relationships that enable us to prevent harm, whilst simultaneously building capacity for trust, reconciliation and restoration should harm occur. This culture is underpinned by embedding practices that enable people to voice concerns, share ideas, debrief and reflect safely, with respect and due care, continually shifting the narrative from what has traditionally been framed as failure into an opportunity for growth. Psychological safety is at the heart of a RJC. The board need honest, objective feedback and critique. RJC is underpinned by a comprehensive programme of engagement that facilitates a continuous process of listening and dialogue that challenges our thinking, provides the reality check, informs our strategic priorities and reinforces our shared accountability for quality and organisational culture. This gift of honesty is imperative for the board to continuously check and balance how the 'work imagined' compares to the reality of the 'work done' and our people's experience of the trust.
In essence RJC/P aims to foster a sense of community, establish relationships that enable us to prevent harm, whilst simultaneously building capacity for trust, reconciliation and restoration should harm occur.
Chief Executive
We have developed a suite of evidence based programmes and interventions that underpin organisational health, clinical excellence and patient safety II, which are effectively operationalised for all leaders, teams and the wider workforce. The plans and interventions are designed to create a culture of enthusiastic cooperation, team working and support within and across organisations, taking responsibility for improving quality, learning and developing better ways of doing things.
Our chosen methodology deliberately aims to embed inclusion and antiracism into every micro part of the operating model and employee lifecycle. We have introduced systems that identify aspects of work that impairs safety and efficiency, that ultimately erode staff resilience and engagement. We recognise that our ability to deliver best care is also dependant on the capability of our workforce and believe that investing in developing capability today is proactively creating the capacity to deliver services tomorrow.
Our interventions are designed to ensure they become systematised, embedded and sustainable to truly underpin continuous improvement in organisational performance. These programmes are well established and evaluation demonstrates triangulation to improvement in quality and reduction in costs.
Psychological safety has been continuously created through open and honest dialogue; creating a sense of inclusion and belonging in team based working plans, safety in speaking up and out, mutual respect, civility, cooperation and accountability through our leaders and teams. Through this approach we create a line of sight to RJC providing a golden thread through our people, systems and processes, providing a compassionate environment that supports 'perfect care' and high quality, safe services.
Joe Rafferty will be speaking about 'healing after harm; how leadership affects learning from adverse events' at our Governance and Quality conference this year, taking place on 17-20 May. Book your free member ticket here.
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