Using QI to improve joy in work

The phrase joy in work is used by the IHI to describe a methodology they developed to improve each individual’s ability to enjoy their work. Using a QI framework, it identifies the necessary components of joy in work and provides detailed guidance on how to make them part of the daily work culture.

Part of my interest in this area came from the emerging body of literature that points to the impact of high levels of stress and fatigue in the work place. In one study, it was found that high levels of stress are associated with errors that can harm patient care. Another noted that work stress can lead to anxiety, anger, unethical behaviour, poor decision making and chronic exhaustion and burnout.

It has also been found that those most at risk of compassion fatigue are those in the medical and mental health sector who are caring for patients day after day.

My motivation for setting up the Joy in Work Special Interest Group (SIG) was to look at what QI tools, research materials and learning were available to reduce fatigue and stress in the work place.

Myself and my colleagues John Rouse, Mel Newton, Rachel Volland, Ronan McBride and Beccy Percival wanted to create a comprehensive and engaging programme to learn all about joy in work so that we could then share this knowledge among the QI community.

Our aim with this was to offer individuals, teams and organisations options and resources for using a QI approach to increase happiness at work.

One of the things we reinforced as part of the Joy in Work SIG was the importance of making a commitment to the project. At the same time, given the level of work pressures in health and social care, it was clear that it was important to allow people to give what they thought they could.

To strike the right balance between these two elements, all those in the programme were encouraged to set their own levels of commitment for themselves.

Adopting a flexible, balanced approach was key to each participant being encouraged to give what they could, and when they could, on their terms.

We found that this led to a highly engaged and enthusiastic group of individuals who turned up with something unique to contribute.

In short, this approach improved joy in the joy in work programme.

Over a four-month period from November 2022 to February 2023, we ran fortnightly 90-minute Joy in Work sessions, with each one building on learning from the previous.

In keeping with our open, flexible approach, we adopted a collective objective to explore the tools of joy in work and learn how they could be applied to various work place settings.

Guest speakers from a range of organisations including the East London Foundation Trust, South Tees Hospitals NHS Trust, Southern Health and Social Care Trust, Hexitime, and Health and Social Care Quality Improvement Northern Ireland all shared insights and case studies. Having this breadth of organisational engagement enriched the learning experience for all of us.

We drew inspiration from the IHI’s white paper on joy in work, which includes nine components for creating a workforce that can improve joy in work.

This framework provides practical tools for health care organisations at any stage of their journey toward improving joy in work. It includes a self-assessment tool for organisations, ways to test different approaches, measure outcomes, and examples of where the tools have been applied.

Along with the IHI framework, we looked at the ​“15 seconds 30 minutes” method (15s30m for short), an approach that Professor Rachel Pilling and Dan Wadsworth of Bradford Teaching Hospital NHS Foundation Trust developed. 

As its name suggests, 15s30m involves identifying opportunities for spending a few extra seconds on a task now that will save someone else 30 minutes later.

Designed to reduce frustration and increase joy across organisations and systems, the beauty of 15s30m is its simplicity. It doesn’t require any training or understanding of QI, it can be done by anyone at any level in an organisation, and it doesn’t require large-scale change at system level.

In fact, 15s30m is designed for small changes that make a big difference.

From the questionnaire our participants filled out at the start of the programme, we knew that most of our participants had limited understanding of joy in work before the programme began. At the end of this programme, 75% of respondents involved felt confident or extremely confident in their ability to implement a joy in work approach in their teams.

Aside from the learning outcomes, participants shared how being part of the programme gave them a sense of wellbeing, belonging and the opportunity to grow and learn.

Here are a few of their comments:

The Joy in Work programme was made up of a highly diverse group of professionals from all levels with different backgrounds and lived experience. It included managers, leaders, academics and clinicians from across the care sector, including charities and third sector organisations. This diversity emerged as one of the programme’s key strengths.

In our sessions, we found that individuals worked together to cultivate a psychologically safe approach that focused on collaboration and was largely free of hierarchy. In practice, this meant every participant enjoyed an equal voice, and we did not pay much attention to job titles.

A participant at one of our sessions used the phrase ​‘I have found my tribe’ to describe the sense that they had discovered a likeminded professional culture.