Demonstrating High Reliability at the Royal Free London NHS Foundation Trust

The Royal Free London NHS Foundation Trust engaged clinical and non-clinical staff at the beginning of the COVID-19 pandemic to take a pulse on the value of the support services and communication efforts. The Trust utilized staff feedback and data analyzed by goShadow from the 2020 COVID-19 debrief to prepare for the inevitable second surge of COVID-19. Through data analysis and goShadow support, key learnings are integrated into new ways of providing patient care and staff support--psychologically, emotionally, and operationally. The goShadow team partnered with The Royal Free London NHS Foundation Trust again at the beginning of 2021 to learn from both teams and individuals after the second surge.

Senior leadership engaged employees to understand the successes and barriers through their eyes. Demographic information was collected in both surveys to examine which bands, roles, and departments were represented. The demographic data from the first COVID-19 debrief was instrumental in developing a more robust outreach plan to obtain feedback from all roles in the Trust.

Consistent emotional support, teamwork, and visibility of leadership were identified as successes in the 2020 COVID-19 debrief. Recruitment, management of staff, standardized redeployment training periods, and addressing the psychological and emotional toll of the COVID-19 pandemic were identified by staff as opportunities for improvement. Senior leadership utilized this feedback to maintain and improve existing programs while also creating new support opportunities for the second surge of the pandemic. 

Developing High Reliability principles within your organization builds a foundation that makes bracing long term challenges like Covid-19 more manageable. Here are some tips on how to do so, some of which the Royal Free London NHS Foundation Trust adopted during the partnership with goShadow. Increasing transparency through regular staff meetings, leadership rounding, honesty, and reliability builds a foundation of trust and clear communication. Accountability is built by setting clear expectations, having opportunities for team building and leadership development, and to align values and strategy. It is important to communicate clearly by asking patients and staff “What Matters To You?”, having a two-way dialogue, and to provide both public and private spaces. One of the next most important things is to develop a community with a growth mindset. This means fostering a culture of co-design and creating opportunities for continuous learning through dedicated time for active learning and opportunities that push staff out of their comfort zones while offering necessary support. Lastly, never settle for the status quo, and keep pursuing improvement. Ways to do this include regular pulse surveys, shadowing, QI Initiatives, and acting on feedback. 

Employees identified increased distribution and guidance regarding PPE, strong teamwork, flexible work accommodations, and policies and procedures from the first wave of COVID-19 preparing staff for the second surge as success stories in the 2021 Individual COVID-19 debrief. Adequate IT support, proper equipment (ventilators, pumps, consumables), and adequate staffing were identified as areas for improvement. Overall employees felt that the Trust was significantly more prepared during the second surge of COVID-19. The 2021 team and individual surveys were focused on the key learnings and 

next steps senior leadership can take away. The Royal Free London NHS Foundation Trust intentionally sought to hear the voice’s of all community members by asking “What Matters to You” these four words shifted the mindset of the COVID-19 experience from a tragedy to an opportunity to reflect, grow, and become stronger individually and as an organization. 

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Posted on

December 17, 2021