Dimensions and subdimensions example quotes—CEO Self Reports
| First order dimension | Subdimension | Example quotes |
|---|---|---|
| 1 Resource provision | 1.1 Securing funding | “we would probably take a paper to our Trust executive group shortly after that [the end of IHI involvement in the programme] with a decision…whether to continue on the current method [SPI approach], if so, are we going to internally fund it” (Interviewee 6) “We did make a decision to put aside a £200000 patient safety reserve, a SPI reserve if you like, to fund the consequences of any initiatives that might come out or any requirements that might come out.” (Interviewee 7) |
| 1.2 Resource allocation | “we resourced the central office, if you want to call it that, and tried to ensure that people had time, and energy, and the desire to do the right thing there.” (Interviewee 16) “You have to do it and do it well and do it properly and fully and resource it properly. And I guess the NHS as a whole and to some extent us as well have a history of getting in to projects, not resourcing them properly, and then doing them half heartedly. And then they never work and you wonder why, and the answer's bloody obvious actually. But they won't let you do that with SPI.”(Interviewee 12) | |
| 2 Staff motivation and engagement | 2.1 Motivation and empowerment of staff | “I think we created the appetite. Nobody was knocking on our door saying they wanted to do patient safety so we created the appetite. So I guess that was top down.” (Interviewee 9) “we've slowly over time ..[delegated work].. to try and increase level of autonomy..So I suppose it was part of me trying to free up people's thinking actually..my first couple of meetings saying, well what [is] 8 of those at 300 quid? Well do it you know and they just found that really liberating because that meant they made some really big strides in the middle of the project.” (Interviewee 14) |
| 2.2 Shared dialogue | “what I see it [my role] as doing is setting an example that's about having the right dialogue.. And once you've got that engagement, and you've got that dialogue, these issues become central to the debate.” (Interviewee 16) “talking to the staff actually and more importantly listening to the staff about what's going on. You always learn such a lot..When did you last have an incident? What was, what caused it? What did you do about it?.. How many opportunities do you get to raise these sorts of issues?” (Interviewee 13) “They [walk rounds] help the visibility mantra which everybody says about executive teams don't they? They have been an interesting cross check about the things that you think are going on in the organisation” (Inteviewee 17) | |
| 2.3 Reinforcement of staff involvement | “clearly if they've [clinical staff] not been following our policies in terms of hand washing and so on, they'll be disciplined. Simple as that..I've got nurses ringing me up saying I've told a doctor off, he hasn't changed his behaviour and we're now following that up..They've been talked to..some of that is about saying, excuse me, but you are doing this actually.” (Interviewee 3) “what I then used..saying right where are all the surgical CDs [Clinical Directors] who are looking at their shoes, why aren't you doing it? And next time we meet to talk about this I want to know your experiences on how you do it, so you sort of try and create a purpose to it” (Interviewee 14) “initially it was more around initial conversation with [director name] and getting him on Board” (Interviewee 16) | |
| 3 Commitment and support | 3.1 Display of visible commitment | “If they don't see you believe in it [SPI], why the hell should they struggle?” (Interviewee 2) “I think the most important role is to be seen to be committed to it [SPI].. It's all very well being a figurehead, but this doesn't allow you to get away with just turning up for the celebratory glass of wine or whatever it is. You've actually got to be in there and do it”(Interviewee 12) “we've puffed our chests up and said we are serious about this and then we have to follow through. But what's interesting now that we are following through, people believe it and there is a visible, noticeable difference in the last two or three weeks out there on the wards in terms of consultants, they're taking their ties off, they're rolling their shirts up, they're washing their hands and people are challenging.” (Interviewee 3) |
| 3.2 Creating the right environment/climate | “What a Chief Executive has to do is to build a coalition of support to a broad framework within which people work.” (Interviewee 15) “And it's about creating the right climate..in some respects I created a climate of restraint” (Interviewee 14) | |
| 3.3 Directing staff and stating purpose | “one of the things I was keen that we did was to make this something that the whole Board was interested in and not just the acute hospital because some of the learning will run across other parts of our service out in the community. So from day one we put together a very broad communication.” (Interviewee 9) “we have a five year vision that actually can be brought down to one sheet of paper. Eventually it will be in several vehicles, it will be a glossy document that will be presented to all new staff, that will be brought out at the start of any project meeting...on the one page one, the work SPI appears..So a Chief Executive has to do some top down things, about setting a tone, setting a direction...The first one [task], [is] to adopt it [SPI], to take advice, to accept advice. The second one, then, is to learn enough about it that you can speak authoratively. Chief Executives have to be able to speak about everything for 90 seconds..so a Chief Executive needs to have a 90 second elevator speech..that you can turn to a group of doctors, in the right situation, and say SPI is really the thing because, and then you list whatever” (Interviewee 15) | |
| 4 Monitoring progress | 4.1 Reviewing SPI measures | “we are seeing well populated Run Charts, we're being able to use and understand the data more effectively, both at a senior level and within the teams.” (Interviewee 9) “I'm regularly looking at the information that is produced from it [SPI], I wouldn't say I'm looking at the data itself...It's normally a presentation, or patient story, or something like that..so that's changed the Board [agenda] in that you're not straight into finance..But whether we're hugely different to where we were 18 months ago, I don't know really.”(Interviewee 10) “at the breakfast meetings..we go through all the [SPI] measures” (Interviewee 7) |
| 4.2 Performance management | “we've got a different design for our performance management.. data points that will be demonstrated for assurance purposes at the Board.” (Interviewee 3) “I think it's [SPI is] in our operational plan, it's a performance measure in there, so therefore, when we meet the divisions on a monthly basis, one of the things we'll be asking them for is their SPI measures.” (Interviewee 10) | |
| 5 Embedding programme elements | 5.1 Strategy and agenda change | “for me, it's, it'll [SPI will] be a way of doing things, integrated into where we are, and it has to be key item on every agenda, the things that's shaping the debate.” (Interviewee 16) “I had to make some clear statements from the word go about where it [SPI] was on the agenda, so it was, it has been the first item on the Management Board agenda for the last 18 months. The patient SPI, right, where are we, what have we achieved, what are we doing?..we've set, tried to set it in the strategic context of what the Trust is doing. The Trust Board adopted a new mission statement..that there would be three main themes..and one of them was the Safer Patient Initiative and patient safety.” (Interviewee 13) |
| 5.2 Structure change and embedding for sustainability | “[we need to] make sure that the elements of SPI that we keep are integrated into our performance management regime.” (Interviewee 4) “the way we've rolled out SPI..we integrated it into people's directorate objectives, that's why we keep the profile up.” (Interviewee 5) “that's how you begin..you narrow the gap between the activities of the initiative and disciplines around directorate management and delivery, you narrow that by drawing it together and holding people to account for outcomes” (Interviewee 14) |
CEO, Chief Executive Officer; SPI, Safer Patients Initiative.