Why every Datix is a GREATix

Why every Datix is a GREATix

Here at the Datix HQ in Wimbledon, we’ve been learning about and discussing recent initiatives to report and learn from ‘excellence incidents’. There are a number of compelling reasons why reporting and learning from examples of good practice and excellence in healthcare are valuable. By sharing examples of outstanding care or improvement initiatives that have been shown to result in tangible benefits, this learning can be shared and emulated by others. The very act of recognising examples of excellence is also something that can greatly improve moral and help foster a supportive and positive culture.

There is also real value in looking in detail at specific incidents of excellence. A recent paper describes a process where such reports are given detailed consideration at an ‘IRIS’ (Improving Resilience, Inspiring Success) or reverse SIRI (Serious Incident Report Investigation). The paper describes the positive benefits derived from the process, including empowering front line staff to share ideas and innovation.

It is encouraging to learn that some organisations are starting to use Datix as a means of reporting ‘excellent incidents’ and we’ve even seen the term “GREATix” coined to describe such reports. We are currently working to see how we might be able to support such initiatives.

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The Leadership Report Card – How well am I doing?

For a good part of my career, I was a front-line stakeholder, providing healthcare to patients and collaborating with them to achieve best outcomes. So in this sense, I was a follower, not a leader, and therefore in a particularly good position to judge the quality of the leaders of the institutions where I worked.

My viewpoint has always been that although some leaders may view those on the front-lines as individuals who work for the leaders, the truth is somewhat different.
The key responsibility of leaders is to enable those carrying out the day-to-day work of health care to be successful, to take pride in their work and to experience joy and meaning, which is so significant to professional success and a personal sense of well being. So, who best to judge the quality of leaders than those whom the leader serves?

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Leadership and Management – It’s all about clarity

Leadership often is viewed as something emanating from the top and filtering downward. However, effective leadership is more about colleagues working together, buy-in and bottom-up implementation than anything else. For a leader to be effective, a culture of collegial buy-in must be present, and there must be reasons for followers to follow, to sustain a safety culture and to align their daily work efforts and patterns with clearly stated goals of the institution. Themes, goals and mission statements may emanate from the top, but their achievement depends on the efforts of subordinate levels of leadership and, ultimately, to those on the front-line.

In “closed” systems where members of staff are salaried employees, it may be easier to implement and sustain a culture of safety and to develop strategies to achieve institutional goals. In more “open” systems, where some doctors and nurses are employees and others are self-employed or working under contracts, especially agency staff, it may be more difficult for leadership to be effective. If leaders and front-line stakeholders are not aligned and working together to achieve the same outcomes, then safety and highest quality cannot be assured.

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Leadership and the Just Culture – Holding the Keys to Safety, Joy and Meaning

Leaders are responsible for establishing and sustaining the culture of an institution. They are accountable for monitoring the institution’s cultural rhythm. With strong leadership, that rhythm should vacillate only slightly, rather like the variations on a barometer as compared to those on a thermometer. The rhythm must be stable or else turbulence sets in, with associated disruptions and hazards. Safety degrades under such circumstances and patients and staff can be harmed.

A key strategy for success is for leaders to recognize vulnerabilities that may affect staff performance and to address them specifically. This is accomplished by sustaining a culture where just treatment, e.g., the Just Culture, is the norm. The Just Culture consists of two dimensions, related but also unique in character.

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Building an Organisation with a Memory on Just Culture? Part Two

Sixteen years after an Organisation with a Memory was published, Jonathan Hazan Director at Datix considers how people and processes are at the heart of a Just Culture in healthcare.

Reflecting on the last sixteen years since the publication of Sir Liam Donaldson’s report “An organisation with a memory” it becomes apparent that the slow progress of the NHS to modernise its approach to learning from failure could well be the result of the lack of a supportive culture, where staff can report and openly discuss errors. This is often referred to as a Just Culture. To create an organisation with a memory an environment needs to be nurtured where incidents are reported for the purpose of learning. A culture where people feel they will not be unfairly blamed and have the right tools and technology available to report and analyse near misses, incidents and serious events when they happen.

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