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Thursday, September 27, 2018, Issue 170

WHY Fronts

Onion head

Layers

AUTHOR: CHRIS WOODGATE

In Synergy News this month (if my publishing deadlines are correct) I talk about ‘peeling the onion’ to look at what is behind the external symptom revealing the root cause. As leaders I am sure you are well aware of root cause analysis and the trial and tribulation it can be.

What I would like to challenge you with is how the layers were built in the first place and why we feel the need to be safeguarded by those layers.

A quote from Jean Luc Picard of Star Trek fame may help us to look at this; “Every choice we make allows us to manipulate the future”. Quite profound I think, what about you? What does this bring to mind when you think of it in context of your working environment and the responsibilities you have to your patients? When I think back over my career as a team lead, manager and director I know I put in layers to ensure that governance was met, that quality was considered and that patient safety was maintained; as well as layers that looked at performance and budget I think my onion grew very big from time to time. Those choices I made in what I put into those layers had an impact into how service/services met their remit and how my direct reports were able to innovate and change things for the better. Sometimes the layers were good, sometimes not so good down to the outright awful, which restricted the future to my vision rather than an inclusive approach where improvement and innovation could flourish.

I read an interesting snippet of a study on parental responsibility which may help to understand our use of layers, good and bad. In a poll of parents, many of the frustrations that come with having children were not placed at the door of society or the children, the parents tended to blame themselves. They felt overwhelmed and were losing the confidence in their ability to do the job, resulting in the task becoming burdensome and laden with guilt. Does that ring any bells around management in the NHS today? The facts were that most of the parents within the study were doing a credible job but they never received the all-important pat on the back for their level of commitment and sacrifice. The key to restoring some equilibrium for those parents was often just the words “hang in there, you’re more skilled than you think you are," rather than increasing discipline and restricting behaviour in their children.

When you look at the staffing areas of the Imaging Standard, often all we need to say to our team leads or teams we work with is “you are better than you think you are”. When you perform an appraisal for a direct report instead of layering, why not just congratulate for getting through another year on the frontline? When you do a team brief instead of layering, tell the team about the successes no matter how small they are. When there is a need for communication around patient safety issues make sure the layer you build is for the patient and not just your peace of mind.

When you are faced with your own crises in confidence and frustrations, instead of layering allow yourself to recall all the good/great things you have achieved; I can guarantee you will find some. Only when you have your equilibrium back can you build layers which having meaning to everyone and the understanding why the layer is necessary.

In certain Zulu areas of South Africa, people greet each other with a phrase that means “I see you”. Do you really ‘see’ the staff in your teams, are they individuals or problems/workhorses? Do you really ‘see’ yourself?

The Leadership & Management LM1C10 (look it up) talks about reducing stress; when we are ‘seen’ and appreciated stress is reduced, the job appears worthwhile and the need for protective layers is reduced as we trust in one another. This allows staff to flourish, innovate, improve and build together.

http://www.sor.org/imagine-services-accreditation-scheme

https://www.rcr.ac.uk/clinical-radiology/service-delivery/imaging-services-accreditation-scheme-isas

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