Frampton Anne, Fox Fiona, Hollowood Andrew, Northstone Kate, Margelyte Ruta, Smith-Clarke Stephanie, Redwood Sabi
University Hospital Bristol NHS Foundation Trust, UK.
BMJ Qual Improv Rep. 2017 Apr 28;6(1). doi: 10.1136/bmjquality.u220946.w7041. eCollection 2017.
Improving staff engagement has become a priority for NHS leaders, although efforts in this area vary between organisations. University Hospital Bristol NHS Foundation Trust (UH Bristol) is a tertiary teaching hospital where concerns about staff satisfaction and communication were reflected in the 2014 staff survey. To improve staff engagement, a real-time feedback mechanism to capture staff experience and to facilitate feedback from local leaders, was developed and piloted using the Model for Improvement. Initially piloted in two areas in January 2015, the Staff Participation Engagement and Communication application (SPEaC-app) was gradually rolled out to 23 areas within the trust by November 2016. The 2015 staff survey revealed significant improvements in staff motivation, satisfaction with level of responsibility and involvement, and perceived support from managers. These improvements cannot be attributed to this new mechanism in their entirety, but local surveys indicated satisfaction with SPEaC-app, the majority reporting that giving feedback about their shift was valuable while fewer staff had noticed changes in their work area as a result of the comments made via SPEaC-app. Between March 2015 and November 2016, 9259 entries were recorded, with an average of 15 entries per day across all areas. Of the entries, 45.7% were positive and nearly 40% were negative, and 'team working' was the most frequent theme. The project has identified the key factors associated with usability of the SPEaC-app, including, access, location, reliability and perceived privacy of the SPEaC-app. The SPEaC-app is valued and used most by staff in areas where feedback from local leaders is regular, rapid and comprehensive, and where staff comments are acted upon, leading to tangible change. This suggests that strong, consistent local management is required in order to embed it in new areas. SPEaC-app has the potential to support local engagement between managers and their service delivery teams, stimulate tangible improvements in service delivery and support the process of change. Longer term data are needed to determine whether SPEaC-app can influence other factors including staff turnover, recruitment and retention.
提高员工敬业度已成为英国国家医疗服务体系（NHS）领导者的首要任务，尽管各组织在这方面的努力不尽相同。布里斯托尔大学医院国民保健服务信托基金（UH Bristol）是一家三级教学医院，2014年员工调查反映出对员工满意度和沟通方面的担忧。为提高员工敬业度，开发并试用了一种实时反馈机制，以获取员工体验并促进地方领导的反馈，该机制采用了改进模型。员工参与、敬业度和沟通应用程序（SPEaC-app）于2015年1月在两个领域首次试用，到2016年11月已逐步推广至该信托基金内的23个领域。2015年员工调查显示，员工积极性、对责任和参与程度的满意度以及对管理者支持的感知都有显著提高。这些改进不能完全归因于这一新机制，但地方调查表明对SPEaC-app感到满意，大多数人报告说对轮班情况给出反馈很有价值，而较少有员工注意到工作区域因通过SPEaC-app提出的意见而发生变化。2015年3月至2016年11月期间，共记录了9259条意见，所有领域平均每天有15条意见。在这些意见中，45.7%是积极的，近40%是消极的，“团队合作”是最常见的主题。该项目确定了与SPEaC-app可用性相关的关键因素，包括SPEaC-app的访问、位置、可靠性和感知隐私。在地方领导的反馈及时、迅速且全面，并且员工意见得到落实从而带来切实改变的领域，员工对SPEaC-app的评价最高且使用最多。这表明需要强有力、始终如一的地方管理才能将其推广到新领域。SPEaC-app有潜力支持管理者与其服务提供团队之间的地方互动，推动服务提供的切实改进，并支持变革进程。需要长期数据来确定SPEaC-app是否能影响包括员工流动率、招聘和留用等其他因素。
