Appreciating what goes well in Milton Keynes

Celebrating and learning from the good things that happen is becoming part of life at Milton Keynes University Hospital Foundation Trust.

From a formalised system that rewards staff for doing a particularly good job to an “appreciative inquiry” process which aims to work out why something is going well, the trust’s culture is one where positive practice is actively sought out, learned from, then shared.

“It’s human nature to dwell on things that don’t go well,” says Jyothi Srinivas, consultant paediatrician, one of the leads on the trust’s scheme for rewarding excellence. “It takes a lot of effort for ourselves to say ‘you know, actually I did a good job with that patient today’. But it’s easier for a colleague to say ‘I watched you, you were so good with that patient’.”

The trust began with a simple app where anyone can report when a colleague has done something particularly good. These reports go to the Dr Srinivas and colleagues, who check to make sure there is no identifiable patient information, and who categorise them under headings, including leadership, teamwork, and compassion. A certificate signed by the chief executive is then posted out to the staff in question.

Staff welcome the certificate, says Dr Srinivas. “They say they feel acknowledged, they feel that someone has noticed when they do something really well. Many times, staff who received it will say they weren’t doing anything extraordinary that day – it’s not like they’ve come into work and said ‘I’m going to be really good today’. Many are surprised, but they feel appreciated, and it helps staff morale.”

There are around 60 champions across the trust who encourage people in different departments to use the system to acknowledge their colleagues. They also meet every few weeks to get feedback on how their departments are doing, and to discuss any themes emerging from the reports.

As well as acknowledging positive practice, the trust is now trying to learn from it, introducing an “appreciative inquiry” process. “This is about looking at what went well, why did it go so well, how can we do this more often?” says Dr Srivinas. Generally, they will look at a department which has lots of examples of positive practice coming through, then sit down with the teams and ask them what they feel is working particularly well – is it the leadership, for example. This information is then displayed to that department and to others as a learning tool.

The trust has also “flipped” the exit interview process, asking those who aren’t leaving why they choose to stay, and learning from the answers.

“I think in our trust that we understand that if we look after the staff better, then they will look after the patient. For staff, knowing that they did a good job makes such a big difference.”