Give staff the tools to lead service transformation

We know that staff are most engaged in their roles when they have a degree of authority and control over their work and environment, as well as the opportunity to stretch themselves and to develop. Conversely, the least engaged staff are often hourly workers with little authority or influence over their work.

The most successful health care providers – just like cutting-edge organisations in manufacturing, transport and other sectors – are giving their staff the tools and resources to lead transformation from the front line. Rather than calling in external experts to redesign services, they are using these resources to help frontline staff master modern methods of quality improvement.

By investing in and empowering their staff, these organisations are unleashing their employees’ enthusiasm and creativity to improve how they do their work, creating a constituency of leaders of change, rather than stubborn opponents to change. In doing so, they are creating ‘learning organisations’ where staff at all levels participate in continuous, daily improvements in care – rather than one-off flurries of activity when an organisation or service hits the buffers.

There are many ways of going about this. Like Virginia Mason, the Mayo Clinic and other international leaders, Salford Royal NHS Foundation Trust has established a Performance Improvement Directorate to support staff in developing and testing service improvements. Others, such as University Hospitals of Leicester NHS Trust, are using Listening into Action or similar methodologies to deliver staff-led service improvement. At Leicester, frontline staff are leading a range of improvement projects, for example to improve anaesthetic checks, introduce floor-control visits in orthopaedic theatres and simplify recruitment processes. While there are differences in the approaches used, the focus is on developing rather than disempowering frontline staff, building a foundation of technical knowledge in the organisation and creating a culture that promotes innovation.

Board members should ask the following questions

  • Do we have a strategy to support continuous learning, innovation and improvement?
  • Have we invested resources in building the capacity needed to help staff innovate and improve services?
  • How much senior leadership time is dedicated to supporting frontline staff in trialling innovations and delivering improvements?

Next: establish a culture based on integrity and trust