I would like to acknowledge the support and generous scholarship that the Florence Nightingale Foundation made to my leadership development and the direction provided by my mentor Sue Machell and Liz Robb, Chief Executive. I would also like to thank The FNF LNNM / Dame Christine Beasley Leadership Scholarship for the sponsorship.
I would also like to acknowledge the support from my employer, Barts Health, my Chief Nurse Kay Riley and Deputy Chief Nurse Yvonne Blucher, and St Georges University Hospitals NHS Foundation Trust and my Chief Nurse Jennie Hall, in terms of study leave to undertake my leadership programme.
I was awarded the Florence Nightingale Scholarship in December 2013. Over the next eighteen months I undertook a number of development opportunities, which were funded by the scholarship in the areas of personal leadership, career leadership and the improvement of patient care.
Patient Care Improvement Project
The overarching vision for Barts Health is “changing lives” in East London and beyond. As part of the strategic vision the Board signed up to the ambition to achieve 95% harm free care for its patients by 2016. An improvement strategy was agreed which would focus on delivering standardised care based on evidence based practice, evidencing excellent clinical outcomes and improving the safety culture of the organisation.
As part of this strategy I led the project entitled “Barts Health Quality Improvement Collaborative”, with the aim was to improve patient safety by reducing rates of grade 2-4 pressure ulcers, falls resulting in harm and deterioration leading to cardiac arrests. I was successful in securing £550K from LETB to recruit Improvement Leads and provide education to the next cohort of wards in the collaborative. Key partners in the improvement journey are colleagues who lead on aspects of quality in our principle clinical commissioning groups, NHS England and UCL Partners the academic health science network and centre of which Barts Health are a founder member.
Over the course of the year the project supported sixteen wards. The approach was underpinned by Improvement collaborative’s consist of multidisciplinary teams coming together to collaborate, share ideas and learn from each other. A structured improvement methodology was used: rapid cycles of change (PDSA cycles), and run charts to demonstrate improvement.
After three months, the Board reviewed the achievements, and commented that although improvement was beginning to happen, it wasn’t happening fast enough. The initial three months had focused on being front line driven, building knowledge and skills in the ward alongside delivering clinical practice. However, the proposed approach was proving difficult to deliver due to the financial constraints in the organisation meaning that teams were not able to be released to attend training, action learning sets or events to share best practice.
The approach was adapted in August 2014, and due to the financial and poor performance throughout the Trust a different emphasis was placed on the programme. The approach changed to a rapid improvement project, less about using the traditional collaboration model, but more about setting standards and holding people to account for delivery.
The project did not substantially reduce the number of pressure ulcers in the year it ran. However, at the end of the year, and as part of the Sign up to Safety the approach and the evidence of what was achieved was submitted as part of a bid for funding to continue the project. In March 2015 I was advised that I had secured 2.2. million for Barts Health to drive forward the programme, and the model that had been used for the first 18 months was recognised by the DOH as a model that would lead to long lasting process and cultural change.
Personal Leadership
To understand how to be a more effective leader able to inspire others, and better able to negotiate from a corporate perspective, raise the standards for professional nursing, staff experience and improved patient experience.
Career Leadership Objectives
My aspiration at the beginning of the scholarship was to become a Deputy or Director of Nursing. During the 18 months I undertook several programmes to assist in my leadership development. I attended the Leading Change and Organizational Renewal (LCOR) Programme, The Florence Nightingale Conference in London, Aspiring Nurse Director Programme and the NTL Organisational Development Programme focusing on individual, group, organisational and global development.