Transformation in healthcare – how to influence and lead from the frontline

Have you ever wondered how to put forward an idea or suggest ways to align processes and procedures across your organisation? Perhaps you’ve found a solution to streamline budgets and funding, but aren’t sure how to present it properly? Knowing where to start and how to clearly communicate ideas that can drive positive change can be challenging. However, knowing the steps to take to craft a compelling pitch can help you achieve your goals, and create positive change for the future.

Get comfortable with your purpose

First and foremost, you need to know the reason why. Ask yourself ‘what’s the reason I’m doing this? Why is there a need for this now?’. This could be providing quality care for patients, delivering accessible care for all, or creating a safe and accessible space for patients to share their experiences. Consider wider organisational goals, see how your purpose aligns and use this to create your vision statement.

Know your aims and objectives

You’ve decided the why, now it’s time to carve out what you want to achieve. There’s likely an underlying problem that you’re trying to solve or an improvement you’re trying to make. Let’s say your purpose is to provide quality care for patients, but you’ve identified that there’s a way to improve. Your aim and objective would be that you want to increase patient satisfaction by 10% over the next 12 months. This gives you a direction to take your purpose, a strong foundation for being able to evidence what you want to achieve, and a key measurement to aim for.

Mapping your service

Here you need to think about the shape of any proposed service change, and how that will impact on future workforce requirements. Start by mapping where you currently are, so you can see how to get to where you want to be. Blend things (what you do) and feelings (why you do it). The VSAOO framework, designed by our Principal Client Director, Matt Girdlestone, provides a robust template for this. It’s possible to start mapping your service on your own, but we recommend doing it in groups for maximum impact.

The five “whys”

Getting to the root cause of the problem can be accomplished by following the five whys practice. It’s used to explore the cause-and-effect relationship of an underlying problem, and when paired with data and insights, can be incredibly powerful. Sometimes we jump to an assumed caused, instead of delving further. This is where the five whys come into play. It challenges our assumptions and gets us to dig deeper to uncover the root cause, instead of the assumed cause. All you need to do is ask why five times to get to the crux of the issue. Let’s use an illustrative example.

Problem: a patient was delayed in being discharged by 12 hours from a ward.

Why: The discharge paperwork wasn’t completed on time.

Why: The doctor responsible for signing the paperwork wasn’t available.

Why: Doctor was in Urgent and Emergency Care (UEC) to deal with the increase in patients and limited bed capacity.

Why: UEC had exceeded bed capacity due to blockages in discharges processes.

Why: There were equal discharge challenges across another department.

In this scenario, the assumed cause was that the paperwork wasn’t completed on time, yet the root cause is that the doctor was in UEC, helping resolve challenges in this department with bed capacity.

Develop your insights

Data and insights play an important role in being able to effectively pitch your proposal. You’ll need to strike a balance between qualitative and quantitative, as both have a range of benefits and limitations. Quantitative data will give numerical data that can be counted or measured. Quantitative data on the other hand is subjective. It can offer deeper insights into behaviour and feelings. Both serve important purposes and when combined, allowing you to paint a full picture of the problem you’re trying to solve, and why.

Plan, Do, Study, Act (PDSA)

Originating from Walter Shewhart and Edward Deming, this iterative process allows you to trial new processes in a controlled environment. It’s worth having this in your back pocket if you’re challenged on how you expect to roll out said changes or ideas and can be effectively used to reduce risks. Using the previous example of a patient was delayed in being discharged by 12 hours, let’s apply the PDSA approach.

Plan: Develop a checklist for discharge tasks.

Do: Introduce checklist to a select number of nurses, provide training on how to use it and test its use over four weeks.

Study: After four weeks, collect data to determine if there has been a reduction in discharge delays.

Act: If the changes resulted in a significant reduction in discharge delays, standardise the new process across the department or hospital.

How can I take this forward?

Crafting a compelling pitch in the healthcare sector is essential for driving meaningful change. By grounding your proposal in a clear understanding of your purpose, setting specific aims and objectives, and using frameworks like VSAOO and PDSA, you can effectively communicate your ideas and demonstrate their potential impact. Employing techniques such as the five whys will help you uncover the root causes of challenges, allowing you to address issues at their core.

Remember that the integration of both qualitative and quantitative insights will provide a well-rounded perspective, making your pitch not only persuasive but also data driven. With a structured approach and a clear vision, you can confidently present your ideas, garner support from stakeholders, and contribute to a culture of continuous improvement. Your commitment to enhancing processes and delivering quality care will ultimately lead to better outcomes for patients and a more efficient healthcare system.