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Harley
Street Clinic
The
Harley Street Clinic approached HQS to carry out a consultancy
project on internal communications, after the completion
of its accreditation survey in 2002. The hospital achieved
overall high compliance against the HQS standards and within
five months of the survey was successful in being re-accredited
for three years. However, the HQS team - and the hospital's
Chief Executive Officer - identified some concerns regarding
communications.
The
HQS team found that staff were enthusiastic about their work
but tended to identify with their department or speciality,
rather than with the hospital as a whole. One surveyor said
that it felt like surveying different organisations - not
one hospital.
The
Harley Street Clinic is one of the largest non-NHS centres
for oncology including radiotherapy. It also specialises in
adult and paediatric cardiac surgery. The CEO was aware that
individual staff members identified with their service area
and there was a strong sense of teamwork and expertise in
the departments but that the internal communications across
the hospital as a whole needed to be strengthened.
Internal communication audit
HQS was asked to work with the hospital to develop tools to
measure staff perceptions about the effectiveness of communication
systems. This involved a questionnaire for staff, one-to-one
interviews with managers and a series of focus group discussions.
The questionnaire was distributed to all 399 staff and achieved
a response rate of 39% (157 returned). In addition, 52 staff
took part in more in-depth discussion through focus groups
and 26 managers had interviews. The questionnaire response
rate and coverage of the different staff groups through discussions
were sufficient to draw some robust conclusions.
One
of the main findings was that, as in many organisations, there
was a perception among staff that internal communications
at The Harley Street Clinic were not as good as they could
be. As originally identified, communication within department
was reported as being better than the systems for communication
on hospital-wide issues. Staff also recognised that each individual
has a responsibility for communication and two-thirds of respondents
admitted their own communication with colleagues could be
better.
The
use of e-mail was identified as being less effective than
it could be due to inappropriate use, such as unnecessary
mass circulation of information, and lack of access for some
staff. In general, departmental meetings were felt to work
well, as do hospital-wide issue groups, such as health and
safety and clinical governance and inter-departmental meetings,
where these had been set up.
With
regard to communication with patients and the impact of this
on the patient's overall experience, it was recognised that
there was room for improvement. There were good examples of
patient information but these needed to be made universal
across clinical areas.
To
address these findings, HQS put forward various recommendations.
These were:
·
The results of the survey to be communicated to all members
of staff and form the basis for resolution of problem areas.
· An internal communication strategy to be developed
with a detailed focus on hospital-wide issues to complement
the current structure for external communication.
· A review of communication systems to be undertaken,
including a mechanism for feedback at all levels.
· Communication training to be developed and adapted
for all levels of staff and then rolled out in a structured
training programme.
· A programme of training to address cultural awareness
and attitudes to cultural differences to be rolled out across
the hospital.
· Terms of reference to be reviewed or developed for
all committees and fora within the hospital.
Implementing
change
A working group, facilitated by HQS and chaired by the hospital's
Communications Manager, was set up to look at the recommendations.
The group met three times within four weeks to ensure there
was a rapid response to the survey and focus group findings.
The group members were enthusiastic and keen to implement
steps that would bring about change. The group agreed to take
forward action in a number of areas, particularly looking
at some of the basic communication systems that could improve
the patient's journey and ensuring that patients are more
aware of what to expect.
A
team brief system has been introduced to formalise the messages
from the fortnightly management meetings and provide a routine
system for upward communication. Cultural awareness training
has been implemented, using the skills and experience of a
member of staff to set up and roll out a training programme.
A
patient information group is being set up, with representation
across specialities, to ensure consistency and replication
of good practice. A new booking form is being introduced which
will ensure more information is given to the hospital before
the patient is admitted so that patient care packages can
be planned in advance.
Quality
Working Groups are being set up to encourage staff from different
areas to work together to resolve specific problems and bring
about service developments.
The
internal communications strategy is in place and action has
already been taken. It now requires maintenance and vigilance
to ensure that the new systems are adhered to and that they
are modified if they are not working properly. The hospital
is committed to continuing to ask staff for their opinions
and perceptions and to monitor the actions and improvements
that are taking place.
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