Wednesday, 22 May 2013

Teamworking in General Practice

Keep it simple

Sir Matt Busby is said to have been quite simple in his instructions to his European cup winning Manchester United team. 'Just get the ball and give it to George (Best).

It's a challenging time in General Practice and easy to lose focus on the patients and their well-being. So many letters, emails and phone calls. So many requirements in terms of prescribing, referrals, and protocols. So much data collection, and soon a new computer software system, to all intents and purposes ,'forced' upon us. And much more beside. But what often gets forgotten, or rather ever considered, is the GP as an employer. In other words, do we look after our staff?

It's fresh on my mind since we spent 3 hours this afternoon as a practice team, looking at our surgery and brainstorming where we might do better. We didn't have an expensive facilitator, nor did we meet in a swanky hotel. It was a simple format and it 'worked'. We basically just talked and listened to each other!

We were divided into six groups of four, each having either a GP or the practice manager in it.

1. We began with a brief team building game where people were divided into pairs and asked to have a conversation beginning  with one person choosing a holiday destination, eg, 'I'd like to go to Australia..' The partner then had to reply with a, 'yes, but....' answer. To and fro the conversation then went for a few minutes, each responding with, 'Yes, but..'. The next task was to have a similar conversation but this time with the response, 'yes, and...' Seeking to fill out the other's reply, 'yes and...we can go to New Zealand on the same holiday etc'. It's a simple game but enables people to see how much more supportive a 'yes and' approach is, especially before a brainstorming session when we are all quick to shoot down others ideas.

2. In our groups of four we were then challenged with the question, 'If money were no object, what would you do to improved this surgery and the service it offers?'  The catch? The answer had to be drawn with no speaking! It lead to some creative thinking about the building which interstingly, were perhaps better highlighted by engaging a more creative part of the brain than from straight discussion.

3. In our groups we then debated what would be the main thing we would like to change  to improve the working of the surgery. Having asked for one thing, I then allowed 3 or 4 which were fed back to the whole group, in reverse order of priority. It lead to some very helpful discussions. From all of the groups, the top three came out as:~
*improve communications (predominantly internal)
*increase nurse availability
*increase doctor availability

And after a vote, it was nurse availability which just came out as the top request, beating improved communications.

4. We then discussed what would be the one thing which would improve our individual job satisfaction.  This again was very helpful, not least in hearing others verbalise what mattered to them. And this was so helpful for doctors who may cocoon themselves in their consulting room, oblivious to the stresses and strains which the staff are under.

5. Then we discussed, 'what is the most common positive thing you hear said about the surgery?' It was really great to hear lots of encouraging things, and made many feel proud to be a part of our surgery.

6. Finally with the clock ticking  we asked, 'what is the most common negative comment you hear about the surgery? Parking, the need for confidentiality at the reception desk,  and availability of appointments, featured mostly.  There were certainly areas to work on.

Three hours really well spent. Quiet receptionists speaking up during the feedback time. The opportunity for all to be heard and taken seriously. We'll be doing it again in 6 months.
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