Listen up: five ways to embrace frontline feedback

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While the COVID-19 pandemic has obviously been disruptive for many businesses, it has also fuelled innovation, allowing rapid bottom-up change across industries – perhaps most visibly so in the healthcare sector. As we start embarking on the journey to “normality”, there is value in reflecting on the lessons learnt during the pandemic and applying this hard-won knowledge to sustain this level of innovation and democratic change in a post-COVID-19 world. What have we really learnt? How can we continue to embrace frontline feedback?

1. Make learning simple (facilitating methods of rapid learning from front-line workers)

An article published by the Industrial and Labor Relations School at Cornell University in 2012, still resonates with the current challenges healthcare faces in embracing innovation. The study highlights the value of understanding the perception of employees regarding a novel solution before implementing that solution, to ensure that it is solving a problem rather than imposing additional challenges. The article also talks about the importance of frontline staff involvement in the uptake of a new technology. Successful adoption and implementation of a new technology requires employee readiness to the deployment, as well as a stable workforce that is engaged in a two-way feedback between staff on the ground and management.

A more recent article by McKinsey, provides a framework to “unleash sustainable speed” for workplaces that want to successfully embrace rapid learning and change. The framework relies on three main actions: rethinking ways of working, reimagining structure and reshaping talent.

2. Embrace failures and don’t stop trying (ditching the culture of blame once and for all)

As well as healthcare systems being in the limelight, science and biomedical research have also come under close scrutiny, and there is an urge for healthcare workers to take a page from scientists’ playbook to accept failures. An article published on the Canadian Journal of Public Health says:

“Focussing on simple tactics… allows multiple iterations of testing to fail fast and fail often, and understand what elements work best; innovation is a learning process.”

This article echoed what Dr Mike Ryan, the Executive Director for WHO Health Emergencies Programme, had said a few months before, when asked about learnings from previous efforts of fighting an epidemic:

“Perfection is the enemy of the good when it comes to emergency management. Speed trumps perfection. And the problem in society we have at the moment is everyone is afraid of making a mistake. Everyone is afraid of the consequence of error, but the greatest error is not to move, the greatest error is to be paralysed by the fear of failure.”

3. Listen to your staff, and do it now (frontline voice/real-time feedback)

The value of frontline worker engagement and feedback in driving rapid learning has been put in the spotlight under the pressures of the COVID-19 pandemic.  “NHS reset” – a campaign by the NHS Confederation to shape health and care in the aftermath of the COVID-19 pandemic – highlights in one of their articles that the transformation we’re witnessing within the health and care system was “led by frontline staff and empowered by a changed leadership culture… at both local and national level”. It is now incontrovertible that the insights coming from the challenges that frontline workers face every day should be at the very heart of innovation and change in the workplace (Palanica and Fossat, 2020). However, these opportunities for transformation will only continue to persist and benefit from the momentum that has built up in the past year (Marlow et al, 2020) if  leaders are willing to streamline decision-making by reducing central control, embrace a flatter hierarchy in their organisations, and empower local leadership.

4. Take advantage of quality improvement (QI) tools that can help make the transformation sustainable, faster, better (use of QI techniques to make good decisions when designing and implementing new patterns of work)

A recent study published on the International Journal for Quality in Health Care (Fitzsimons, 2020) highlights the importance of using validated approaches and processes for any improvement initiative, even in a crisis situation. This allows for structural adaptation to new situations and prioritisation of certain tasks across all improvement work, even if the standard of quality cannot be maintained at the same level under certain pressures. Additionally, the study emphasises the importance of clarity and transparent team communication through regular huddles that encourage participation from everyone involved, and the value of documenting and comparing expectations with the actual results of an action as an opportunity to learn for the whole organisation. An article by the Health Foundation (Lewis et al., 2020), encourages the use of available resources and tools, especially digital software and technology that can support learning, collaboration and improvement.

5. Dismantle the old structures and ditch the micro-management (and let people be good at what they’re good at)

In South Africa, the virus hit hard and early. In the Western Cape they used virtual communications to collaborate across sites and organisations. Together, they discovered that there had to be a new way of responding to frontline feedback, and to do that effectively, some old restrictions needed to go. Staff were redeployed to meet new needs and initiatives were trialled to monitor staff morale. “At New Somerset Hospital, a secondary hospital, an anaesthetist used a simple measurement – asking staff to deposit marbles into a ‘good day’ or ‘bad day’ bottle – to gauge work‐day experiences, staff morale and impact of interventions.” Prototyping manual methods of sentiment tracking is an excellent way to discover what questions that will drive the most useful feedback – and these learnings can then be transferred to a digital solution such as ImproveWell. They also found the “a tiered system of rapid learning” helped to energise the system. Generally, an openness to try something new and let go of the reigns a little was vital to meeting the challenge.

Circumstances have pushed us all to the limit and proved that necessity really is the mother of invention. The changes forged in the white heat of the pandemic would have taken decades to have manifested in normal times – or may not have transpired at all. We now know what we’re capable of and how that could be achieved. It’s just a case of learning those vital lessons.

Engage to Improve with ImproveWell

ImproveWell is a digital solution that helps healthcare organisations in the NHS and beyond achieve their improvement and staff engagement goals. With it’s smartphone app and intelligent data dashboard, ImproveWell empowers teams to:

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