'Clinical governance for people': set your staff up for 2021 success - and meet your CG requirements - all in one.

Big year, 2020. When I look back on my comms over the year, whether it be video, written or podcast, a theme runs through it. In the end, whatever we achieve - in technology, implementation, innovation, care - comes back to people. So let’s finish the year where we started: reminding ourselves that without the people who get out of bed every day and do what they do across aged, community, acute and mental health, our organisations are nothing.

That's why clinical governance requires us to ensure systems are in place to support staff to do good work and create great care. But all too often this is played out as a series of tasks: training, position descriptions, credentialing etc. We tick off the tasks but miss the intent: are these clinical governance systems helping staff to do good work in a challenging environment? If we look at the ‘people’ part of clinical governance through this lens, we can both fulfil our requirements and set staff up for creating greatness at point of care. But we have to change our thinking a little – so here are five points to creating a 'clinical governance for people’ mindset.

1. We’re people who serve people. You can have world-class plans, standards, policies, technology, systems and documents – but they’re not much use without people to bring them to life (until it’s robot time, anyway.) This seems rather obvious, does it not? Yet sometimes I think that an alien observing us might wonder what it is that we do think is important in our organisations. So much time around boardroom tables is dedicated to finances, real estate, strategy, the next technology purchase, sector politics and positioning. We agonise over policies, procedures and standards. And then we wonder why care quality is inconsistent or mediocre or harmful. Why our ‘culture’ isn’t positive and high performing. Why change and improvement are so hard. In people serving people sectors, the ‘people’ bit sometimes seems to be missing.

2. Staff can only rise to the level of the tide we provide for them. Sometimes I think we forget this. Of course, some staff will choose to sink or bail, whatever the tide. That’s life. But most staff want to rise on your tide; to do well, to be good at their job, to go home knowing they’ve made someone’s day better, to be acknowledged for their contribution. Mastery, Meaning, Appreciation – this is the tripod that supports job satisfaction. And higher satisfaction makes for happier staff – which makes for happier clients, residents and patients.

3. Staff success is built on executive foundations. Success in any facet of your organisation takes management effort. Staff must be super clear about their role and responsibilities when it comes to creating great care and experiences – and deliberately supported and equipped to enact that role. Skilled guidance is required to make progress, improve and to course-correct if things go off the rails. ‘Not so easy’, I hear you say – and at times it most certainly is far from easy. But I see so many staff without even these basic supports in place, and their managers wondering why they’re not performing.

4. Hard work and good intentions are not enough. In our research into quality systems a couple of years ago, Professor Sandy Leggat and I noticed a consistent phenomenon: boards and executives with a reliance on - or you could even say an expectation that - staff would be the gatekeepers and drivers of high-quality care. In fact, many hospital leaders seemed to think that their reliance on staff being ‘good’ was a reasonable key strategy to ensure patient safety. So far, so good. Of course, staff are the major players, as I’ve noted above.

However, the kicker here is that these leaders didn’t know much about the abilities and behaviours of the frontline staff in whom they placed this trust. And they didn’t have a specific plan for supporting staff to do their good work. Trusting people without equipping them to fulfil expectations is a wobbly platform, and shows a lack of understanding of how the complexity of the environment can thwart even the most well-intentioned, hardest working staff. 

It appeared that this belief let these boards and executives off the hook in terms of implementing specific strategies to equip staff to create high-quality care; until something went wrong and that trust was perceived to be broken. Disappointment and blame follow, and we’ve seen some of this played out in the media this year. Poor care and services are suddenly thrust onto the shoulders of middle managers and staff, who were not set up to succeed in the first place.

5. Think like a coach. The sporting field is not so different from the working world. Sport is a complex system. Everyone plays by the same objectives and rules. After that, it’s up to each team to craft their approach and get the best results they can. Coaches don’t just ‘trust’ that players will do the right things and perform well. Even at the elite level they’re trained, guided, shaped and supported to do well. Yes, you still have stars that shine and middle of the road players grinding it out. But if well managed, the whole team rises.

If you want things to go well at point of care, craft your approach. Support your staff to achieve great results within a challenging environment by implementing clinical governance systems with that intention.  Develop meaning, mastery and appreciation in their work. Look after them as you hope the coach of your favourite sports team looks after the players. And we’ll see you in the great care finals in 2021.

DO THIS!

1. Next time you discuss clinical governance requirements at your quality committee, enrich the discussion with some feedback from staff on how well those systems support them to provide high-quality care and services. 

If you're ready to sharpen up your skills on leading people through the improvement cycle so that 'people power' propels, rather than constrains, your success, sign up for the free LEEDIT short course here Or if you prefer a book, interview or tool on supporting people for great care, click on the link below.

BUILD YOUR QUALITY LEADERSHIP MASTERY!

10 years ago this month I started building a suite of resources designed to help human service organisations to create great care (10 years!)  It started with a newsletter (an early version of QNews) and one book - 'The Strategic Quality Manager Handbook' - which I wrote when researching what we could do differently to get more improvement traction and success. From there I developed and began testing the Strategic Quality System Model. Since then, as I've developed my knowledge, I've evolved a package of tools and information, based on evidence and experience, that supports organisations to build a simple, engaging and strategic approach to creating greatness. Find them all here.

• Four books: The Strategic Quality Manager Handbook; Create a Great Quality System Blueprint; The Point of Care; Three Essential Strengths for Quality Leaders
• Three online courses: Lead Improvement with LEEDIT; Quality System Roadmap; Strategic Clinical Governance for Boards and Executives
• Workshops with thousands of participants; collaboration with over 50 organisations to implement the strategic quality and clinical governance framework; and board and executive coaching
• Numerous short training videos, tools and other resources including QualityNews and the No Harm Done podcast.
• And lots of laughs along the way!