Time can pass you by if you’re not watching. As a nurse, revalidation is a triennial expedition through mountains of files and rivers of paper. Scrambling through the scraps of paper, one can get lost in the depths of despair trying to find that golden piece of feedback. And yet, as we go through life we receive feedback almost constantly. From the person behind you tutting for taking too long at the self-checkout, to the ‘nice outfit’ comment from a co-worker. Feedback is everywhere but how you use it is key.
Giving useful feedback to colleagues has never been something that we have been very good at in the NHS. Most feedback has been focused around critical reports, performance management or rag-rated tables with a big red mark through the middle. Such approaches to feedback mean that it makes it almost impossible for people to learn from these. Improvement is all about collaboration and learning to do things better for our patients. Unless we can learn to give open and honest feedback in a way that can engage people and also help them to grow, we will struggle to make sustainable improvements to services.
Feedback is a powerful tool and we must work in healthcare to give more valuable feedback that is appreciative and constructive.
The key to good feedback is summarised in Thanks for the Feedback and is broken into three key components. The first is appreciation and is area that we need to get better at in the NHS. We are always told when something isn’t going right but are too infrequently told when things are good. But there are groups of people out there that are trying to make things better. Programmes such as Learning from Excellence and The Academy of Fabulous Stuff are all about sharing the great work that people are doing on a regular basis. There are pockets of really outstanding and innovative services and it is key that this work is promoted and shared. If we are to maximise improvement capability within organisations, we must work to be kind and collaborative and celebrate this when we get it right.
The second is evaluation, something that is systemic across the NHS. We have Service Regulators, Professional Regulators, Commissioning Groups and Advisory Groups. There are 126 organisations with regulatory influence over the NHS all pushing and pulling services in a variety of different ways. Through this cloud of performance and financial targets, it can often be challenging for teams to clearly understand where to focus their energies. Whilst evaluation is important to ensure standards, we must be careful that this doesn’t become the basis of all feedback within the NHS. We must continue to evaluate improvements in order to share learning effectively but we must not lose that appreciation for people trying and pushing to bring change in the NHS.
Improvement is all about collaboration and learning to do things better for our patients. Unless we can learn to give open and honest feedback in a way that can engage people and also help them to grow, we will struggle to make sustainable improvements to services.
The final key component to effective feedback is the coaching element. If we want individuals and teams to grow we must provide them with the tools and support to improve. Coaching is about helping people to improve their performance and how to approach problems and come up with solutions. This form of feedback is about being supportive and listening, discussing ideas to enable individuals to grow and build improvement. The new offer of Hexitime is a modern community-based innovation that looks to build this sharing collaborative approach within the NHS. It is a time banking concept founded on the idea that you give an hour of your time in order to share tools and skills and in return you can claim an hour back to utilise another members strengths and experience. This is a concept that reflects the coaching methodology by providing an opportunity for a community to share expertise in order for individuals to grow and develop.
Feedback is a powerful tool and we must work in healthcare to give more valuable feedback that is appreciative and constructive. Too often we have relied on the red pen and we need to get better at understanding and listening to why things aren’t working. Whilst challenging, we can start to build this, by working collaboratively across services, professional groups and trusts to share feedback on what really works in the NHS and what things need fixing. We must understand what the data is telling us, learn to listen to our stakeholders and develop services together. Only by appreciating the difficult realities of the NHS can we begin to make meaningful change. So now it’s back to my pile of papers to dig out the smiley-faced sticker from my dentist as some good solid appreciative feedback.
To learn more about feedback and how to use it, I recommend Douglas Stone and Shelia Heen’s book on how to utilise feedback. It teaches the art of how to give constructive feedback but also how to receive it so that you can grow and develop.