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

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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

Discover

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:
The pressures of increasing workload, staff shortages and limited NHS funding, together with the necessary drive to report and investigate critical incidents, can have an overall negative effect on staff morale. 
 
We set out to assess the extent of this problem in Maternity by performing an electronic staff morale survey.  We received a total of 160 responses representative of all members of the intrapartum multidisciplinary team.  Strikingly, only 42% of respondents felt appreciated by their team ‘often’ or ‘always’.  Whilst only 39% of respondents had heard of Excellence Reporting, 78% thought that there were equal learning opportunities to be gained from when things go well, as there are from when things go badly.
 
The interest in learning from excellence identified in this survey supported the validity of introducing a system of Excellence Reporting with the aim to improve team morale, patient safety and provide a system for positive learning.  We launched our online Excellence Reporting system in March 2018. We have thus far had a tremendous response with over 75 members of staff having benefitted from receiving a structured piece of positive feedback.
 
Less than a year in, this project remains in its infancy; future goals are to continue to expand the awareness and utilisation of our reporting system to establish it as part of normal practice.  The database of excellence reports will facilitate adoption of appreciative inquiry to further spread positive learning. We also hope to collaborate with other groups  to establish a Trust wide Excellence Reporting system.
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