Would you like to find out more about Civility Saves Lives? Just give us a shout as we love to chat all about the success of our partnership work with Tameside and Glossop Integrated Care NHS Foundation Trust.
Tameside and Glossop Integrated Care NHS Foundation Trust initially wanted their clinicians to reflect on their communication style, the impact of their behaviour (sometimes) on the multidisciplinary teams they worked with, and ultimately the potential impact that could have on patient outcomes. The Trust originally started a Civility Saves Lives awareness programme, inviting Chris Turner to discuss ‘why’ civility is so important in a medical setting, supported by the growing body of research on how incivility negatively impacts patient care (and an employee’s experience at work).
The Trust then asked Rambutan to partner with them on the ‘how’, to raise further awareness around Civility Saves Lives and in doing so drive a change in people’s behaviour and interactions with each other. There were a number of questions we needed to consider… How do we make a difference? How will we know it’s worked? How can we help people to become more self-aware of their impact on others? How will understanding the importance of civility shift people’s behaviours?
First up, we chatted with many medical leads and senior managers in the Trust to gain their perspectives. This provided us with fantastic insight into how the different areas of the Trust worked, the culture and how accepting people were of incivility, particularly coming out of Covid when, as one senior leader reflected, “The default communication style at the Trust has become very command and control”.
We built on this insight and partnered with a clinical psychologist to design our Civility Saves Lives programme. Initially, the plan was for the programme to be delivered only to clinicians, however, it was quickly extended to managers and then the rest of the workforce so that everyone in the Trust was given the opportunity to join the discussion about civility, and how each individual could positively impact the culture at the Trust.
We delivered online and face-to-face sessions to provide all the Trust’s employees with the knowledge, skills and emotional intelligence to drive positive interactions with colleagues, drive a more enriching, appreciative culture and ultimately improve patient outcomes.
To date, we’ve delivered our Civility Saves Lives programme to over 1,900 clinicians, managers and staff, with:
To assess how the learning was being embedded, we also surveyed participants six months after they’d attended a session and found they all continued to have a ‘Civility Saves Lives’ mindset every day at work and were still committed to implementing civility in their Trust. The majority of participants also agreed that the programme continued to have a positive impact on their working environment.
Qualitative feedback from the Civility Saves Lives workshops has also been overwhelmingly positive, indicating how valuable participants found the discussions. As an example, here’s just a few comments from participants:
We also wanted to measure the longer-term difference the programme had made by tracking the wider impact across the organisation. We did this by agreeing, in partnership with the Trust, three specific questions in the NHS staff survey that we would track over time. And, when the survey came out in the following years, the results against the agreed statements below had all improved:
The Civility Saves Lives programme is part of a wider cultural change programme which aims to identify and reduce unprofessional/unproductive behaviour across the NHS. The campaign has highlighted that disrespect and rudeness affect the quality of work, people’s likelihood to help each other and increase errors.
Incivility in the NHS ranges from behaviours such as disrespect, rudeness and if not addressed can lead to more severely detrimental behaviours such as bullying and harassment. These behaviours can impact someone’s state of mind so severely that it costs the organisation in financial terms (due to absence or unproductivity). In the most severe cases, incivility can impair someone’s ability to do their job which could result in poor patient outcomes, including loss of life. This unprofessional/unproductive behaviour has been found to be widespread across NHS organisations. Put simply, the standard of patient care can be negatively affected by incivility between colleagues.
Our research found that:
Our Civility Saves Lives programme delivery started from the position that everyone comes to work to do the best job they can each day (and in the care profession this may be their vocational drive), but factors and pressure during the day can stop people being at their best.
Using Daniel Goleman’s five components of the emotional intelligence model, we focused on providing people with the skills of:
We also included Kim Scott’s Radical Candor approach to give people the skills and confidence to challenge each other’s behaviour.
We developed a tool to help people understand their triggers and how to ‘proceed with wisdom’. The basis of this is that once a trigger is identified, you can then notice the sensations this generates in you, acknowledge your emotions, analyse your thoughts, and then consider much more helpful thoughts at three stages: before the moment, in the moment and after the moment. All to help individuals stop a situation from descending into a negative behavioural spiral or culture.
Our clinician sessions were slightly more focused on their own individual impact; whereas the managers focused more on feedback and culture i.e., for you to affect a change, how are you challenging people when you observe them behaving in a way that’s incivil or that’s having a negative impact on others?
“With support from Rambutan we wanted to bring to life true cultural change with our Civility Saves Lives programme. Rambutan has been instrumental in developing and delivering online and face-to-face sessions on Civility Saves Lives interventions for clinicians, managers and all other staff. These interventions have truly effected a change in behaviour among our people, who now fully recognise their role in improving civility and culture at The Trust and how this can, and has, positively impacted patient outcomes.”