Leading with compassion€¦ · ways of promoting and supporting attentive kindness in everyday practice are brought to bear on the daily lives of staff.” Ballatt, J., & Campling,

Achieving change together

Edward Parkes 09 March 2015

Leading with compassion: Practical actions to awaken, inspire and challenge

Compassionate Leadership Webinar | 09 March 2015 Copyright © 1992-2015 Finnamore Ltd

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Purpose, objectives, outcomes

Purpose: To consider what ‘leading with compassion’ looks like - practically and tangibly

Objectives:

Participants will consider their own leadership practices,

in light of the dilemmas and trade-offs they face,

being deliberate about operating at different levels:

the self, manager/leader, team, and the organisation

to enable an environment in which compassion can thrive

Outcomes:

• Attendees feel comfortable in starting the conversation in their own organisations and

own teams, in terms of ‘what does compassionate leadership mean for us’

• Greater awareness of strategies to enable resilience and balance in terms of managing self, others and teams


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“You can inspire, and awaken. There is something about the passion and the fire within. They may have an ember and my job is to make a roaring fire and keep it alight.”

“I know I lead compassionately. Am I a soft touch? No. You mustn’t give the impression you are a push-over, and it’s all fluffy clouds. There is a hard edge.”


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How can we account for the headlines?

This couldn’t happen here… This just isn’t relevant to me, my role, my organisation


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Why did I come in to healthcare?

What is it that crowds out your ability to follow your vocation?

What are the pressures you are under that mean that the care of human beings gets pushed down your list of priorities?


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Under pressure

• Not enough staff and/or resources

• Not enough time… space to think is a luxury

• KPIs and meeting performance targets

• Financial sustainability

• Adherence to policy and meeting statutory responsibilities

• Operational fire-fighting

• Relationships across boundaries

• Who ultimately is accountable?

• Tired… me, my team, my colleagues, my partners


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How can a whole organisation become wilfully ignorant?

“I am very interested in how and why people lose their compassion, as in

my experience this happens to some

people but not to others, at varying

lengths of time after joining the NHS.

Is it due to pressures on individuals,

vulnerability, poor leadership and

support, poor alignment of the

individual's purpose with that of the organisation, personal traits, or

combinations of many factors?”

http://www.maniacworld.com/peer-pressure-on-the-elevator.html












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It’s about creating environments where compassion can thrive

Overall Engagement • Advocacy, intrinsic

engagement,

involvement • Sense of pride +

attachment to the organisation

• Discretionary effort; willing to get the extra mile

The Environment

• Meaningful feedback

• Feeling valued by and ‘safe’ with colleagues

• Supervisors’ support • Team working • Work pressure • Interesting job • Involvement

Hospital Performance

• Fewer errors • Lower infection

• Lower mortality rates • Quality of services • Financial performance • Pt sat and experiences

Employee Reactions

• Health and well-being • motivation/morale • stress/absenteeism

Source: Dr Michael West, Leadership and engagement for improvement in the NHS: Together we can. The King’s Fund 2012


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Lots of tub-thumping, but why is action so difficult?

• Compassion is a result, not an input:

It is the culmination of all the things we do

• It is a ‘wicked’ problem that demands ‘clumsy solutions’: There is no silver bullet

• Engagement paves the way for compassion:

Prescribed solutions short-circuit the opportunity for change from within


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Whose business is it to create environments where compassion can thrive?

• Nurses?

• Doctors... just the consultants, or everyone, inclusive of trainees?

• Wider team?

• Managers and directors?

• Commissioners?

• Arms-length-bodies?

• Patients and carers?


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Compassionate leadership… it’s everyone’s business


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The Self


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What keeps you sane, resilient, and emotionally connected to your work? How do you remain vigilant and present to respond to the needs for others, when there are lots of competing demands?

“I see people in periods of duress resort to bad behaviours. They shout louder, and control more as

they feel threatened.

I said to myself: ‘I’m not going to let this organisation turn me into someone I don’t like.’”


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Self mastery

What are people already doing?

• Building a network of optimistic,

affirming and appreciatively challenging

people, and offering mentoring to others

• Making time and space to listen without

agenda to staff and patient experiences

• Remaining actively involved in delivering

care, or contact with patients

• Committing to personal development,

whether internal/external courses

• Personal practice: coaching, meditation,

mindfulness

• Consciously being present.

What can you do?

• What are your triggers? When does

your ‘inner critic’ surface?

• What ways or practices could help you

process your emotions, sustainably and

healthily?

• When does your work feel most

meaningful, and most futile? How can

you stay connected with your core

purpose?


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Manager/leader


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“Heroic leadership just won’t work here. It’s not sustainable.” Skills of the compassionate leader:

The shepherds of clumsy solutions and collective intelligence

• Be as skilled at finding the right questions as developing the ‘right’ solutions.

• Challenge the status quo, whilst being part of that system.

• Span boundaries, organisational and professional.

• See failure as a necessary consequence of trying something new. The role of the manager/leader is not to prevent risks, but to make it safe to take them, and to create learning from the failure

Ask the question and always follow through:

“I’m amazed at how creative staff are

… but you only have a small window to capitalise on it. If you don’t action it fast enough you lose the energy.”


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“Rules and regulations and inspection are

ways we reassure ourselves, and I see those

things as enablers, but we need to keep

connecting with our core purpose.

The discussion does not begin with ‘do we

have procedures in place?’, but ‘why are we

doing this?’.”


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Manager/Leader: the field guide for engaging and developing people


• Practical skills development of new commissioning leaders, to advocate

effectively for patients

• Welcome new members of the team, establish the standard, systematically invite feedback from ‘fresh eyes’

• “It’s about building a network of leaders and encouraging them to build their teams.”

What can you do?

• How can you keep the focus on quality

and service alive, when there are many

other drivers and pressures?

• What processes or practices can you

adopt which help you step back from

your default means of problem solving,

to open up new ways of seeing and

acting?

• How can you keep attuned and aware

of your team’s needs?

• What demonstrations of thanks are

you able to perform that encourages

behaviours aligned to values?


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The Team


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“If my team had a difficult day, I’d make sure we had time to reflect

and consider what would we do differently, as well as what worked and thank you’s. It’s not punitive.

And I encourage my managers to do the same with their teams.”

“Securing diversity in the NHS will be a sign of a compassionate leader. It is more than employment rights. If we have a diverse community, unless there is a diverse workforce who knows it and understands its different needs, it will be much harder to show compassion to those being cared for.”


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Attentive team work


• Recognising that when operational issues hit, team stress points become critical. Help is needed to rebalance.

• Bringing patients back following feedback and change, to reinforce commitment and accountability

• Changing the physical and social

environment.

• Being brave enough to recognise when there is an issue, name it, and bring in trusted facilitators if needed.

• In transformation work, “agreeing what we need to deliver together, how we will decide collectively, and how to support those managing losses.”

What can you do?

• What practices could help ‘reflexivity’,

safely and honestly and routinely, e.g.

after action reviews?

• What opportunities exist to build on the

power of the positive – what already

works well, and how it could be even

better?

• How can you, and the team, reward

collective action as well as recognising

individual effort?

• What means or methods could you

introduce that provides a safe way to

flag personal needs, or notice them in

others?


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The Organisation


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“It is good to see works like compassion appearing in recent health policy. In the current climate, however, there is a danger of the development of yet more standards, specifications and procedures to promote such behaviour.

This process is unlikely to reap the benefits hoped for unless ways of promoting and supporting attentive kindness in everyday practice are brought to bear on the daily lives of staff.”

Ballatt, J., & Campling, P. (2011). Intelligent kindness: reforming the culture of healthcare. RCPsych publications.

“It’s not good enough to meet targets if our staff end up on Prozac.”


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How will your vision, strategy and values get put into practice throughout the organisation, or system?

1. Listen

2. Engage the leadership body

3. Define, revisit or re-affirm the organisational values

4. Embed the values and behaviours and incorporate into organisational life

5. Connect the organisational strategy with individual goals and objectives

6. Assess individuals on performance

and values

7. Conduct a leadership and talent review

“I had performance meetings yesterday, but you don’t need to do it by bringing people to their knees.”


25 SaSH Plus: Accelerating Success

• Acknowledged role models

• Vehicles and catalysts for change

• Create focus, energy, enthusiasm

• Help make stuff happen

• Shape the journey of getting everyone living the values

• Go from words on walls to part of our DNA where everyone models it

• It’s how we do things around here

And where do you come in?

“Culture eats strategy for

breakfast.”

- Peter Drucker


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Full report

http://www.england.nhs.uk/wp-content/uploads/2014/12/london-nursing-accessible.pdf

Field guide

http://www.england.nhs.uk/wp-content/uploads/2014/12/london-nursing-field-guide-accessible.pdf





















Achieving change together

Documents

Leading with compassion€¦ · ways of promoting and supporting attentive kindness in everyday practice are brought to bear on the daily lives of staff.” Ballatt, J., & Campling,