Introducing a Learning from Excellence pilot scheme in a busy Radiotherapy Department (#2456)

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Idea Description
Overview of Innovation:
We had a run of incidents requiring a detailed report and feeding back to staff in the department. Whilst we did need to learn from these incidents it seemed like a good time to introduce a more positive way of learning and as a way to increase morale.
We had heard about Learning from Excellence from Birmingham and used their website for help.
We set up a reporting system and " sold " it to the staff using a recent example of when we felt there had been excellent practice.
We then launched the scheme, calling it RT Thumbs up with key members of staff from different jobs.
We have managed to deliver some learning sessions from reports that have been submitted. We have had mixed feedback, some staff are not keen whilst others really like it. We plan to do a questionnaire at the 1 year mark to get feedback.
We have managed to deliver 2 learning sessions from the incidents reported. We code the incidents as LFE and Good Practice. Only the LFE's are suitable as learning events. We also dig for further ideas at the sessions to improve quality.
Our dream is to keep this ingrained within our department but also toexpand on this within the Radiotherapy community. We also wish to write an article of our findings to get published in our professional journal.
We also wish to see a RT thumbs up event that will change practice.
Attached is the Certificate that staff members get sent .
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Overview of Innovation:
Define
Learning from Excellence in Salford Royal Critical Care

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Critical Care at Salford Royal is a 24-bedded unit admitting over 1000 patients/year.  It serves as one of the country’s busiest neurosciences units and is a centre for major trauma.
Inspired by the Learning from Excellence team, we decided to implement LfE for two main reasons;
• To improve care for patients by recognising, examining and amplifying good practice.
• To enhance staff morale and build a culture of rewarding excellence.

Our project utilised a simple paper based reporting tool, staff are encouraged to report any excellent practice. An electronic excellence report is then sent to the reporter and the person whose excellence is being appreciated. Reports are analysed for reporters, reportees and themes. Bimonthly summaries are distributed to all staff, allowing learning to be shared and excellence celebrated with the whole team.
Since the project launched in December 2016, 252 excellence reports have been received. Staff from all groups including nurses,consultants and other medical staff and admin staff have submitted excellence reports.  At present nursing staff are the most frequent reporters; Band five nurses, the largest professional group, are most frequently reported.  Common themes include teamwork, communication and excellent clinical practice.
A staff satisfaction survey demonstrated that a large majority of staff agreed or strongly agreed that LfE was useful for learning, had positive effects on staff morale and has potential to improve patient care.  It was commented that LfE allowed staff to ‘highlight other people’s strengths’ and ‘encourages positive culture’.

Dream
We intend to build on our experiences by carrying out in depth analysis of excellence reports using Appreciative Inquiry methodology.

Design
Having recently undertaken training in Appreciative Inquiry with Learning from Excellence for Quality Improvement, we are planning our first Appreciative Analysis of Excellence. We plan to present our work to the Greater Manchester Critical Care Network  and will continue to support the expansion of LfE within Salford Royal and the North West Region.  We will continue to actively engage all members of the multiprofessional team.

Destiny
We will continue to share our bimonthly reports locally and plan to present our learning to the Executive Team of our hospital at the Leaders Forum.  We look forward to sharing our learning and learning from others at the LfE Community Event.
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Overview of Innovation:
The Learning from Excellence Patient Experience
Learning from Excellence (LfE) originally started in our hospital as a positive reporting system to allow staff to provide appreciative feedback with the primary aims of improving morale, resilience and learning from good practice.

However, it has become increasingly clear that it is not only work colleagues but also patients who have a need or want to say thank you for their care.

At the time of writing this abstract, there have been over 300 LfE nominations from patients and relatives who have been treated in our hospital. Some of these nominations are from recent admissions and some from admissions months or even years previously.

In our poster, we will present our experience in connecting patients with the LfE initiative. We will look at the practical aspects, our successes and the difficulties which we have encountered. We will explore our findings on: What do patients think as episodes of excellence? What do patients believe we should learn and replicate?  How this compares with nominations from staff? And look at ideas for the future.
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Overview of Innovation:

HEFT provides maternity services across 3 sites and has a birth rate of approx 10500 births per year. Following the Care Quality Commission’s inspection of HEFT in 2014 the Head of Midwifery commissioned an Internal Quality Review, reviewers identified that there was an issue with low staff morale and motivation, it was also noted that retention of staff and high sickness levels were adding to the low staff morale. Following the reported success of LfE at Birmingham Children’s hospital a team of senior midwives at HEFT decided to implement LfE within Maternity.
The ‘quick start up guide to LfE was adopted and with buy-in from the senior midwifery leadership team and the trust safety and governance lead an implementation date was set.
The LfE project lead met with staff from other departments who had already implemented LfE to share resources and to discuss any barriers encountered.
The team opted to use a quick, simple and easy to use paper reporting system.
The launch was well advertised in and around the maternity unit. Each ward area was assigned an LfE notice board and LfE was launched officially.
LfE updates are regularly presented at a variety of forums within maternity. Information, trends and themes are fed back to all staff.
The LfE initiative has been very well received in maternity, staff appear genuinely grateful to have a system of reporting when things go well in addition to reporting clinical incidents. There appears to be a shift in the culture of the organisation and how safety is managed. LfE cannot take all the credit for this however as the maternity governance system has recently been restructured and risk is now owned by the clinical leads in each area and not by an overarching maternity governance team. It is felt that the arrival of LfE has complimented these changes within the service.
Hopes for the future:
Governance and risk to take the project forward and expand across all areas of the trust
Implementation of an online reporting system that can generate emails to the reporters automatically and notify the team when a report is submitted.
Clinical area's to have a named member of staff as LfE lead, which will be trained in Appreciative Inquiry and will hold regular AI conversations to discuss the reports submitted.
For key learning from LfE reports to be identified and implemented in a timely and efficient manner.
For an improvement in the quality of information submitted on reports, with greater detail about what was specifically excellent.
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