Making Change Happen

My experience of being in a strategic leadership position, is that as a team, you have an idea which needs to be implemented but then gets stuck in roll out and fails to embed. The Ockenden review and many national reviews all show that there is a failure to change practice despite an overwhelming reason to do things differently.

I feel that rather than speeding through our action plan, which is the expected approach when recommendations are requested to be implemented.

These often build on a library of recommendations, audit action plans, continuous improvement projects: https://www.hssib.org.uk/patient-safety-investigations/recommendations-but-no-action-improving-the-effectiveness-of-quality-and-safety-recommendations-in-healthcare/report/#:~:text=The%20Recommendations%20to%20Impact%20Collaborative%20Group%20(referred%20to%20in%20this,recommendations%20made%20by%20other%20organisations.

How do we alter this – we need to step back and empower others to find their own path to creating solutions.

As part of Nurture Health and Care Ltd and our new investigation strategy, we have introduced the concept of Safety Bridging Statements.

Traditional investigation recommendations often aim to be decisive and reassuring. But in complex health and justice systems, they can unintentionally oversimplify problems that are anything but simple.

A single recommendation can imply there is a single fix. In reality, safety failures usually emerge from interacting pressures: workload, environment, policy, culture, technology, and human judgement, all evolving over time.

Safety Bridging Statements are our response to this complexity.

Rather than prescribing a fixed solution, a Safety Bridging Statement:

• Names the system risk clearly
• Explains why it matters for safety
• Creates a bridge between learning and action
• Invites discussion, design, and local ownership

In other words, it shifts the question from
“Have you implemented the recommendation?”
to
“How will this risk be understood, addressed, and monitored in your context?”

This approach recognises that:

• Different organisations face different constraints and capabilities
• Sustainable safety improvements are co-designed, not imposed
• Learning is strongest when professionals are engaged, not instructed

This is how investigations move from closing cases to opening conversations and from compliance to learning.

As projects grows in complexity and size, there will need to be more oversight but by creating insight in our teams, we will enable achievement of real change.

Project Management, Leadership and Followship

Even with improved project success rates and more technologically advanced tools project management tools including the introduction of artificial intelligence, organisations face many complex challenges in setting and achieving their strategic goals.

Management is all about creating stability and embedding systems and processes.

Leadership is about achieving change.

We rarely remember the critical elements of inclusion and followship in creating sustainable change.

I am interested in the concept of followership as a positive asset alongside leadership skills and project management. This should be inclusive and representative for the whole team and the community they serve.

Psychological Safety and Insight

Improving the teams ‘productivity’ and ‘efficiency’ is a difficult task to achieve.

Is this the correct language to use when we are looking at improvement in a humanistic service.

Teams are made up of human beings, people often with diverse personal culture, different skills, strengths, weaknesses, and different personalities so creating safe spaces to discuss and plan is the skill that we want to expand.

Participating in teams, both as a leader and a follower requires an open mind, the ability to listen and being open to challenge.

Providing a safe space where each individual can thrive creates a happier team who can be more creative and ensures a supportive environment which enables insight.

Psychological safety and the different models all enable people to feel included, to enable participation and challenge.

If we create fear, which is often where the culture is grounded in criticism; this is where we get stuck, fearing the outcomes of change which prevents us from fully participating in the solutions.

When our teams feel comfortable asking for help, sharing suggestions informally, or challenging the status quo without fear of negative social consequences, we are more likely to innovate quickly, unlock the benefits of diversity, and adapt well to change.

Leaders build psychological safety by creating the right climate, mindsets, and behaviours within their teams. People should be able to be honest, authentic and trust is created through a consistent, predictable and safe space.

By empowering your team to be the best they can be and enabling them the freedom to define their own journey to a shared vision, we can create new ways of working and embed the insight from all.