01.04.13
APPRECIATE people management to improve patient care
Source: National Health Executive Mar/Apr 2013
Kevin Croft, president of the Healthcare People Management Association (HPMA) and director of people & organisational development at Epsom & St Helier University Hospitals NHS Trust, outlines how good people management is vital in the NHS.
The need to APPRECIATE
The case that good people management improves organisational performance has been made – Professor Michael West and others have even shown how good people management, staff engagement and team working improves patient care. Despite this, the recent staff survey shows the basics of good people management are not happening consistently across the service. The Francis report also reminded us what can happen when the people issues are not prioritised. In response to these findings we need to redouble our efforts to improve the quality of people management and the Healthcare People Management Association, an association for HR and OD professionals working in healthcare, are launching an APPRECIATE campaign to improve people management practice.
Room for improvement
Whilst improving in many areas, the 2012 staff survey results present a mixed picture and highlighted significant room for improving basic people management and therefore patient care.
There are some clear positives from the staff survey, including:
• 89% feel their role makes a difference
• 88% believe the trust provides equal opportunities for career progression or promotion
• 83% of staff appraised in the last 12 months
• 81% received job relevant training, learning or development
• 78% satisfi ed with quality of work and patient care they give
There are areas where it is a relief, given the Francis Report, that results are not worse, but where there is a significant improvement opportunity – for staff and patients. For example:
• 74% feel they are able to make suggestions about improvement
• 68% able to contribute towards improvements
• 63% happy with the standard of care for a friend or relative
• 62% believe care of patients and service users is their organisation’s top priority
• 55% would recommend their organisation as a place to work
• 55% have adequate materials, supplies and equipment to do their work*
• 54% get clear feedback on their work from immediate manager* However, there are also clearly areas where people management practice is falling short or where the survey highlights the difficult working environment for staff.
For example:
• 47% satisfied with the recognition for good work*
• 40% feeling the trust values their work
• 37% suffering work-related stress
• 36% having a well-structured appraisal
• 35% saying communication between senior managers and staff is effective
• 30% experiencing bullying, harassment and abuse from patients, relatives or the public
• 29% feeling pressure in last three months to attend work when feeling unwell
• 27% say senior managers try to involve staff in important decisions
• 26% reporting senior managers act on feedback from staff
• 24% experiencing bullying, harassment and abuse from staff
• 15% experiencing physical violence from patients, relatives or the public
Getting line managers to APPRECIATE
The basics of good people management can be forgotten or not prioritised in busy operational environments. The HPMA are therefore launching an APPRECIATE campaign to help promote the basics of good people management. The APPRECIATE campaign aims to promote appreciation as a key management behaviour and use the letters of APPRECIATE to create a 10-point people management checklist for use by managers at all levels:
1. Aims, objectives and priorities – are your team clear about what they are trying to achieve, what’s expected of them and what’s most important?
2. Performance management – are you giving your team regular feedback on performance, know whether they are doing a good job and advised about what needs to change? Do staff have a good quality appraisal?
3. Personal and professional development – are development needs identified and staff supported to improve?
4. Recognition – are staff recognised for a job well done?
5. Empowerment – are staff able to make and enact decisions to improve the service they provide?
6. Communication, communication, communication – there can never be too much use of this most basic management tool, but are you doing enough and is it two-way?
7. Involvement – are you involving staff in decision-making? This can only be effective if you are doing enough of number six (communication) and is the foundation for achieving number five (empowerment).
8. Accountability – are you following up team members on delivery what it has been agreed they would do? Are there conversations and consequences if things are not done, or done to an acceptable level of quality?
9. Teamworking – are your staff working effectively as a team?
10. Environment and equipment for the job – is there a work climate that supports staff do a good job and protects them from potential safety issues or harm (e.g. harassment, bullying, violence, aggression, errors, near misses, incidents)? Do your staff have the equipment and resources to do a good job?
Getting organisations to APPRECIATE
We need to make the case for good people management across organisations. In response to this senior leaders, non-executive as well as executive, need to commit to improving people management practice and be good role models. Clarifying expectations of good people management is important, even for those who have extensive training and experience. In our busy operational environment even the most fundamental practices can be side-lined. We hope you will find the APPRECIATE tool useful here.
Tracking how staff are being managed is useful to help inform the need for development and interventions and incorporated ‘people’ into the organisation’s performance management arrangements will make sure the importance of people management issues are not lost. Mangers may say they haven’t got time for the people issues because of more immediate operational pressures. The truth is likely to be they have so many operational pressures because they are not making the best use of their people.
Not emphasising people management in the recruitment process and job descriptions of managers is a real missed opportunity. Once they’re in the organisation recognising and developing good people managers is another core activity that is often lost as managers are so busy dealing with operational issues. The HR team has a clear role to make sure policies and procedures support good people management and the advice given to managers does the same. Finally, the staff survey, which is fundamentally about the quality of your people management, provides a great opportunity to assess your progress and guide future plans, although you also may want to use other tools to assess progress in the interim.
Getting the system to APPRECIATE
We also need to think about how we are promoting and improving people management across the system. HR leaders have a key role to play and this is why the Healthcare People Management Association is launching its’ APPRECIATE Campaign.
Launching in central London on April 24, the campaign will include:
1. Launching the APPRECIATE People Manager Checklist (as outlined above). Those who have responsibility for people management will be able to use this very simple checklist to track if they are doing some of the basics of good people management.
2. Creating an accessible case for good people management that HR & OD professionals and senior leaders can use to help make the case for improving people management and gain senior leaders support.
3. Collecting and promoting examples of how organisations are improving the patient experience by improving the people management experience.
4. Introducing a good people management award as part of the HPMA’s annual awards ceremony to showcase examples of best practice and celebrate the contribution of good people management to patient care.
5. Encouraging organisations to recognise good people managers and good people management practice.
6. Encouraging organisations to ensure people management performance and people-related issues are included in manager appraisals.
7. Promoting the use of performance management tools to ensure people performance is considered as significantly as other performance domains.
8. Promoting mechanisms to monitor and respond to feedback about the people management experience similar to the way we monitor and respond to feedback about the patient experience.
9. Signing-up key partners to support the campaign for appreciating the contribution good people management makes to improving patient care.
10. Promoting training and development opportunities for improving people management practice. *national average for acute trusts using Quality Health
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