Meet the team: Kingston Maternity - Together is Better
Kingston Hospital NHS Foundation Trust
- England - London (South)
- Kingston Hospital: Susana Pereira (Consultant), Alexandra Ridout (Registrar), Jonathan Grellier (Head of Improvement)
- Sierra Leone: Welbodie Partnership
What is the challenge or opportunity you are focusing on?
If burnout in healthcare were described in public health terms, it would be labelled an epidemic. A 2015 study found over 50% of physicians report symptoms of burnout, and an alarming 6.4% had contemplated suicide in the preceding year.
Clinicians tell us they are exhausted, frustrated, and experiencing overwhelming stress. People are feeling overburdened and overregulated. They spend more time looking at computers than their patients’ faces. With increasing demands on time, resources and energy, it’s not surprising that this has become a property of the system we work in. It affects quality, safety and healthcare system performance.
Aaron Antonovsky said that health is more than the absence of disease. To quote the institute of health improvement, “joy in work is more than the absence of burnout.”
“In healthcare, joy is not just humane, it’s instrumental…You cannot give what you do not have…The gifts of hope, confidence, and safety that health care should offer patients and families can only come from a workforce that feels hopeful, confident and safe. Joy in work is an essential resource for the enterprise of healing”.
How can we motivate and create “Joy in work”? We believe that leaders have an obligation to help demoralized staff members reconnect with their original sense of purpose, compassion, and caring. To recapture why we went into medicine in the first place. To see that we are making a difference in the lives of the people we serve. To promote camaraderie and teamwork.
We believe joy is a resource for excellence.
Our aim is to form a link between Kingston Maternity Unit and the Welbodi Partnership (a UK registered charity: 112517), to support Maternity Care in Freetown, Sierra Leone. We believe this Health Partnership would build the capacity of individuals, institutions and systems to improve health outcomes for mothers and babies in Sierra Leone as well as revitalising a sense of purpose and encourage “joy at work” for the staff of Kingston Hospital.
We hope to embed an enhanced system of training and mentorship alongside local partners at the Princess Christian Maternity Hospital (PCMH), located in Freetown, Sierra Leone. The single tertiary facility providing specialist maternity and gynaecology care for the country, this partnership will catalyse improvements in healthcare delivery both home and abroad. This partnership will be built on a quality improvement model, as well as training though the PROMPT model of multi-disciplinary practical obstetric emergency training. Our aim is to identify avenues for growth and development between and across these two health systems.
This partnership would be undertaken with the support of Welbodi Partnership in Sierra Leone. Since 2008 they have worked in partnership with hospital management, health facility staff and the Ministry of Health and Sanitation (MoHS) in the host country. Their participatory, stakeholder-driven approach, fostering local ownership and innovative solutions within a resource-constrained environment is aligned with our own, and will be essential to the long-term success of this project.
The benefit we hope top achieve
We expect to drive positive change in the health and wellbeing of UK staff. There is a wealth of literature identifying the benefits of overseas experience for NHS staff. Alongside developing leadership and problem-solving skills, we have witnessed first-hand team members returning to their work place with renewed motivation and vigour in their roles at home, as a direct result of their experiences in Sierra Leone.
Sierra Leone has one of the most fragile health systems in the world, reporting the worst maternal mortality rates globally. Estimated at 1165 per 100,000 (six times the global average), death during pregnancy and childbirth account for a third of all deaths in women of reproductive age. Maternal death reviews and surveillance reports indicated that the majority of these women die in a health facility (82%). 50% of all deaths are attributable to causes that are easy to identify through basic surveillance, and readily treatable. Low-skills amongst health workers was identified as a key factor contributing to hospital deaths (Sierra Leone Reproductive, Maternal, Newborn, Child and Adolescent Health Strategy (2017 to 2021 MoHS).
This opportunity for shared learning has potential for significant impact on morbidity and mortality figures, as well as personal development within the UK workforce. This project supports our belief that joy and generosity come together. Actively nurturing the compassion and dedication of healthcare staff will lead to more effective and empathetic care, both home and abroad.
Benefits for the Q Community
The methods of aim setting, tests of change, and measurement that are used for clinical and operational process improvement will now be applied to a new setting (low-income) and with a new, additional goal (shared joy at work). This work will help develop the small body of international literature around quality improvement in developing nations. We will disseminate both our clinical and individual learning stories through a variety of mediums, including social media, story telling and through PROMPT teaching at the Institutional, National and International level. Our learning will be shared far beyond the individuals that benefitted from the opportunity to attend.