It began with an email from the Health Issues Centre, where I’ve attended many workshops and forums as a consumer representative. The sender was Safer Care Victoria, an organisation I imagine few Victorians outside the health circle know much about unless they listen regularly to Radio National’s Life Matters.
You are invited to attend a day of kindness – bringing together a wide group of influences and change agents from across the health service sector, to focus on activating engagement at the local organisational level. The theme of the event is: “Continuing the Conversation” – kindness between everyone in healthcare.
Re-imagine a healthcare system that has kindness, trust and respect as core components. This is based on the evidence that there is a direct relationship between staff well-being and patient well-being. An interactive day, featuring inspirational local and international experts such as:
• Dr Lorraine Dickey; Neonatologist The Narrative Initiative
• Dr Catherine Crock AM; Chair and Founder of The Hush Foundation
• Assoc. Professor Michael Greco; CEO Patient Opinion Australia talks
• Mike Farrar; former Chief Executive of the NHS Confederation
• HUSH Kindness Play “What Matters” facilitated by Dr Catherine Crock AM
• Internationally renowned performers, the Grigorian Brothers
• Dumbo Feather – a platform for storytelling
Friday marked day five of a successful Gathering of Kindness Week. A day, full of thought-provoking conversations and activities, designed for a better way forward for healthcare.
I lost no time in registering because not surprisingly they had a waitlist of people who wished to attend this complimentary event which included catering, entertainment and thought-provoking conversation.
A bonus was the venue at the Docklands, a part of Melbourne I don’t visit very often. There was also the opportunity to catch up with health professionals and consumer reps I’ve met at other events.
Consumer Voices Important
In recent years, I’ve had more experience with the health system than I’d like, which motivated me to become involved and do what I can to improve the quality of care.
It is important to applaud what is working and the good outcomes achieved as well as criticise failures.
There was so much packed into the day at Docklands, it’s difficult to know where to start so I’ll share the highlights that appealed to both my hats – the writer as well as health consumer representative.
Time and again speakers emphasised the power of individual stories to change procedures, attitudes and perceptions. The forum was about patient experience and there is a variety of ways the stories can be told.
Being in hospital is like being in a play you haven’t read. There’s bewilderment, you’re on stage and don’t know the outcome.
The opening segment, a film of Clarke & Dawe used humour to start the conversation about the different perspectives of a hospital experience for staff, administrators and patients. The two satirists are renowned for their great play on words and they didn’t disappoint:
gown, discharge, night register, waterworks, running at low cost…
Take a few moments to ponder the different interpretations and uses of these words…
A fitting introduction to begin a conversation about the perceptions of all the players in a health system and the need for empathy and kindness.
Everyone has a role to play: kindness starts within all of us.
One of the key people behind the Gathering of Kindness Week is Dr Catherine Crock AM, Founder of the Hush Foundation. A medical pioneer, she is a longtime advocate for culture change in hospital care and has put into practice what she preaches!
I bought these CDs years ago when coping with caring for my dying husband – they work!
Working with patients, families and healthcare professionals, Hush transforms the culture of healthcare by harnessing the power of the Arts to educate, inspire and create change for better outcomes for everyone.
She developed a music collection to reduce stress and anxiety felt by both patients and their families in hospitals, transforming the environment through the use of carefully curated music from some of Australia’s foremost musicians and talents.
Working at the Royal Children’s Hospital, Dr Crock said repeated surveys showed parents valued kindness and care. The atmosphere improved when the creative arts (musicians, composers, actors) were harnessed to improve the well-being of families, patients and staff.
The Gathering of Kindness aimed to build, nurture and instil a culture of kindness throughout the health care system. The key theme being “The Power of Kindness”/”Continuing the Conversation” to better understand how to improve the healthcare environment for all stakeholders, including staff and consumers.
Three CEOs discussed and shared stories of why and how they initiated change in their organisations:
Dr Sue Mathews, The Royal Women’s Hospital, Frank Evans, Central Gippsland Health and Adj Professor David Plunkett, Eastern Health.
Remodelling is required to meet today’s patients’ needs
Dr Sue Mathews told a story that was a turning point for her to rethink her attitude to hospital administration and rules.
Like many working on hospital wards, she said, her favourite announcement was “all visitors go home” until one evening a man sitting by his wife’s bed explained they had just lost their baby after trying for seven years and spending $35,000 on IVF treatment.
“I can’t grieve with her?” he asked.
Sue has introduced leadership walks around the hospital asking patients in real time how their experience is to learn how to design a toolkit to draw out information from patients and improve the system.
For example, she discovered that for one woman who works full-time when the hospital calls regarding appointments within working hours she will always be busy to take the calls or miss them, and vice versa if traditional business hours are adhered to as far as women contacting the hospital when they may be available to speak.
Health is a policy-driven sector and many policies are 25 years old or more – hospital culture had to change.
The Women’s Hospital employed a Chief Experience Officer who has guided more than 600 staff through a course that uses videos, workshops and discussions to remind them why they are in healthcare.
By watching or listening to patients about their experience the staff go through what they ask female patients to do. They then list what needs to change whether it be policies, visiting hours, outdated and stupid rules preventing good patient experience or rules that create staff problems.
They discuss what rules are broken or need to be.
The Women’s Hospital is bringing kindness into everyday practice and Dr Mathews works hard to be a good role model. For example, it is important to remember people’s names so people feel valued.
She uses the model way – show how kindness can be and help staff and patients to see and behave in a positive and kind manner to improve everyone’s wellbeing.
“Begin challenging your own assumptions. Your assumptions are your windows on the world. Scrub them off every once in a while or the light won’t come in.”
Unpack Your Assumptions
Over lunch, I experienced one of the exercises the Women’s Hospital has used to change their culture: Unpack Your Assumptions.
It was a working lunch – we had a few minutes to digest our food and then down to work!
We teamed with a partner and I was with Ruben, a young man from the Department of Health whom I’d never met.
Choices, Choices Choices.
The exercise designed to challenge our own beliefs and choices and the assumptions we make about others solely on appearance:
Are they like us? If different, how and why do we think so?
PART 1 – instructions to be read and carried out in silence
The situation: You are an expert camper. You love camping and have camped every summer for as long as you can remember. You are packing for a week solo camping trip at a site with no electricity. You will be able to park your car at the site so the weight of what you pack is not an issue however, you will not be allowed to use your car to go and get anything for the entire week. As you finish packing the car you realise that you have room for 5 more items.
The task: select 5 items from a list of ‘extras’ that you would choose to bring with you. (There was a list of 13 items including mobile phone, book, e-reader, alcohol, extra clothes and food, batteries, matches…)
PART 2 – The situation is the same but this time it is your partner who is going on the trip. You are not going together. They are also going alone.
The task: Maintaining the same assumptions you select 5 ‘extra’ items for your partner to take on their trip. (From the same list of 13 items)
PART 3 – without speaking to your partner, consider the following questions:
- Is what you chose to bring for yourself exactly the same as what you chose for your partner? (a) If yes, why? (b) If no, why not?
- What was it like to make choices for your partner without consulting with them or knowing their story?
- How did it feel to consider yourself an expert?
PART 4 –
- Compare lists with your partner
- If there are differences between what they chose either for themselves or you – justify your choices to each other
- Discuss the questions in Part 3.
The facilitator, Sherri Huckstep, the Women’s Hospital Experience Officer, led an interesting discussion encouraging people to share their choices and reasons.
Ruben picked 3 out of 5 correct for me and I picked 4 out of 5 for him. (Maybe writing all those character profiles helps?)
- We both agreed we did not pick the same items for the other person as we chose for ourselves because we considered gender and age differences. (He is younger so I chose more tech-based items, he said he considered my gender and age and added more warm clothes!)
- We both found it difficult to choose extra items for the other person while not knowing anything about them. I felt unskilled and nervous.
- We both felt uncomfortable setting ourselves up as experts and making decisions in the dark with limited knowledge.
Sherri then read aloud the poem The Cookie Thief, from Chicken Soup For The Soul, edited by Jack Canfield.
Assumptions can be wrong and are the source of much of the conflict we experience in our lives. We may all have assumptions we need to question!
The lady in the poem attributed the cookie thief’s behaviour to rudeness never considering he may have had a good reason to take the cookies. She never gave him the benefit of the doubt or considered she may have been wrong. He never stopped her helping herself.
How they both reacted to the situation speaks volumes about attitude and how to deal with certain events and people.
It pays to keep an open mind! Do what you can to discover all the facts.
People want to be called patients, not clients.
The CEO of Eastern Health, Adj Prof David Plunkett said that time and time again patient surveys said courtesy and kindness was what really mattered. They focused on improving communication and customer service but still, patients said courtesy and kindness: “If I’d just been treated with kindness” a common response.
Eastern Health has 5 million pieces of data to say that kindness must be an organisational value – they don’t need any more surveys to measure!
Accountability and humility core values.
He asked the 10,500 staff and volunteers how they could support each other and how to create a safe working environment.
They got prompt cards “I will smile”.
When the staff discussed how they treated each other and made a commitment to kindness, respect and excellence, it led to kindness with patients.
All in it together!
Prof Plunkett suggests questioning the data – it’s qualitative information about what is going wrong but when you go past the data argument and use stories from patients’ experience and effect change, it works.
They collated 400 stories; they didn’t resonate with all staff but the good and bad feedback worked to motivate and accept kindness as an organisational value.
Leading with Care
Frank Evans from Sale explained that in 1997-1998 there was a conflict that divided the community, families and staff at the hospital. One afternoon there was a knock on his door. A man had a petition to get rid of the hospital CEO. He asked Frank to sign, completely unaware that Frank was the CEO.
Frank invited the man in for a cup of tea and they had an interesting chat. (I’d like to have been a fly on the wall!)
Another turning point for Frank was the sad, powerful, personal story of “Claire” who wrote a book Dying For A Chance. He bought a copy for all staff, and also had Claire address staff. His philosophy is to engage with people and try and understand them, accepting there are difficulties providing quality care.
They now have a new model for their integrated health service and are trying to build a culture of caring and kindness. There is more conflict this year with the push for change.
- All staff are involved in writing a Communications Charter.
- There is a new leadership framework – “Leading with Care” and they are preparing a leadership matrix.
Aas a consumer, it was heartening to hear from CEOs who are listening to the patients and their workforce before implementing changes and actively trying to alter the culture of decisions from being only financially or resource driven.
It was an ideal time to watch the Hush Kindness Play – What Matters, written by well-known writer and actor Alan Hopgood.
Alan and his team of actors aimed to make kindness matter to staff and patients and through this Hush Project after the play is performed, they have talked to 9000 people about the particular issues it raises.
There have been over 140 performances of health-oriented plays raising issues such as
- the devastation of a medication error
- different aspects and challenges of aged care
- and this latest one – focusing on small acts of kindness that make a difference, or what happens when kindness and empathy is lacking
Ironically, the role I remember Alan Hopgood for was the small town doctor in Bellbird, an ABC 70s soapie my mother wouldn’t miss!
I recognised him straight away when he appeared on stage, especially his deep but softly reassuring voice.
He has wanted to make a difference in the area of men’s health with his writing and has written several plays and a book in 1996, Surviving Prostate Cancer – One Man’s Journey. He often gives talks using his wonderful sense of humour to tell his story and encourages others.
Alan and the players thanked the audience restating the strong message of What Matters that kindness is not elective, not a weakness but a choice we make.
And it doesn’t stop in the confines of a medical setting.
The value of and sharing stories of kindness often doesn’t rate because positive news stories don’t get traction.
Fiction writers know this too well – we are taught from day one that it is conflict that sells, and it doesn’t have to be resolved to make a book a best seller!
However, when you are ill, perhaps fighting for your life, perspectives can change. Or when you are a health professional burnt out or traumatised. (Read a transcript or listen to the podcast about compassion fatigue and mental health.)
Even the smallest act of kindness makes a difference.
A doctor stepping outside boundaries with “Mother Theresa” actions or advice should not be accused of ‘being too kind’ and ‘unprofessional’.
Patients taking the time to write a ‘thank you card’ or leave flowers or chocolates for staff: doctors, nurses, administrators, cleaners, volunteers – all the people who have a part in making our health system function – are sadly rare, but do make a difference.
The Power Of Story To Engender Kindness Within Organisations
The impact of kindness should never be underestimated and discovering how many people and organisations are promoting positive changes in behaviour, attitude, and workplace culture is an uplifting experience in itself.
Associate Professor Michael Greco who worked with Father Brosnan to bring kindness into Pentridge Prison interviewed two CEOs from the UK with experience of improving patient experience of the NHS.
He quoted the definition of civilisation as being a slow process of society learning to be kind.
Perhaps he offered the best quote of the day –
“Kindfulness is fundamental to human growth.”
A more civil society is society being kind and unfortunately, we have too many examples in the wider community where our political leaders and the general population are not being kind or civil.
How we treat asylum seekers and refugees only one example that has been in the news recently!
Participants at the forum expressed again and again, through fantastic examples from their workplaces or life experience how powerful the gift of stories can be.
The importance of listening and recording stories whether positive or negative to learn from them.
These stories from staff or patients when aided by the creative arts – whether by poetry, plays, film, memoir or short story – can hurry along the all-important change towards ‘kindfulness’.
- The Narrative Kindness Project my next blog!