Plum designed and delivered an appreciative inquiry across the community nursing service of this inner city Trust, to improve standards and patient satisfaction
Guy’s & St Thomas: Appreciate Inquiry across Community Nursing
The community nursing service covered seven localities in a large inner city area. There had been concerns over capacity and the quality of patient care delivered across some of the localities and issues such as running with a consistently high vacancy rate; putting undue pressure on already stretched community staff
What we did:
We set up an appreciative inquiry approach, to explore the diagnosis of the issue, to ensure that there was not further cultural decline and/or inappropriate blame. We shadowed community nursing teams in their day-to-day patient care delivery, exploring challenges and generating solutions. We facilitated several leadership summits, involving senior leaders across the Trust, within the localities and across the nursing teams. This helped generate immediate developmental solutions to pressing, as well as setting out longer term solutions. A development plan was co created with all involved across the localities and including stakeholders. We then supported the project management arrangements and methodology to oversee the plan, coaching and supporting leaders and project leads formally and informally to achieve objectives and longer term sustainability.
What we achieved:
- A clear and accepted diagnosis of the root cause of the problems, engaging those on the front line and their leads;
- A celebration of previous achievements, which had been lost in the focus on corrective action;
- An approach to problem solving that the community nursing team continued;
- Increased nurse recruitment to the community teams;
- An action plan to stabilise organisational cultural issues across the different localities and to develop more consistency and outcomes in the future;
- Connection to enabling strategies (ICT, estate, leadership and talent management);
- More confident leaders.
Plum was part of a multi-disciplinary team, delivering a global lean leadership programme, to support a range of organisational and behavioural changes across the business, to shape a new culture and leadership ‘mindset’.
A review of largest area of business for HEE London & South East, developing the interrelationships with other areas of the business. This was followed by a functional review for the other 3 Regional Areas of HEE, to develop consistency.