Something to think about!
So you've sweated over your rostering policy, and have delivered (cue trumpets and possibly angelic choirs) a nice, neat Word document. It is clear and concise, and you've even collaborated with other Trusts (and perhaps specialist agencies like ours) to create a bulletproof grimoire, a tome to be revered, packed full of lessons learned and tweaked best practices.
Congratulations, you’re ready to save the world/NHS – or at least, save your Trust a bit of cash. But close to publication, a sudden fear creeps up on you, icy fingers tripping down your spine:
What if no one reads it?
What if the senior nursing community has a major wobble?
And will anyone actually work to policy, anyway?
In short, was your work any more than a box-ticking waste of time? Sadly and probably, no. Here’s why:
You’d be darned lucky to get a busy nurse to find your SharePoint portal, let alone read any documents longer than a paragraph.
New starters will learn more from culture, custom and practice (i.e. learning via mimicry) than policy (and there are a lot of new starters to keep educated).
Custom and practice will “trump” policy in any case, “It's OK, we just don’t do it that way here - we’re a special case”.
The noble ambition of assuring on minimum standards is great, but you have no way of measuring compliance to these out on the Wards.
And possibly - “Paranoia Alert” - people never did really like you, anyway ;-).
But “Aha”, you riposte, “We are working with Oceansblue – each of our roster plans is automatically analysed via their Sentinel product, in whichever way I wish. In my mobile alerts, I can see exactly what’s going on with no fuss. I springboard off poor compliance into education, where I work with my Ward Managers when I see they need more support.”
My friend, we wouldn't disagree with that and you follow a path superior to most, but your work is not yet complete.
What happens when things go wrong?
Let’s use a common example – Annual Leave allocations. For a regular ward (and at a time where the consultants are not off skiing) you've mandated that leave must equate closely to our 14% headroom allowance. There are two bad outcomes:
If a Ward publishes a roster with more leave than it should, it will run the risk of additional cost (in temporary staff) or risk (if shifts are not covered to the correct levels). Can you persuade Gemma to cancel her romantic city-break to Florence? Of course not.
If the roster has insufficient leave, you've stated the Ward Manager ask for volunteers, and then dish out extra leave if none are forthcoming. Short of firing someone, or asking for extra hours on a Friday night, this is the least popular task ever. It seldom happens.
Ward Managers are mostly not Ward budget holders, so when the chips are down, may prefer to place a higher value on retaining staff goodwill than a transient, nebulous, “The Trust is big and ugly enough to look after itself” financial penalty. I mean, where’s their motivation?
So, if there’s no solution anyway, what’s the point of having this item as a policy component? Good general point and something to consider during policy reviews. But for this example, is there any way out at all?
Well, yes, actually:
Disruptive techniques to aid Matrons in shuffling staff to different shifts inside a Ward or between shifts across Wards can be very valuable.
And looking further ahead, automated, impartial, intelligent analysis of multiple rosters can prevent “planned in” problems creating headaches close to the working day.
Even in a pressured situation where time is short, we really wouldn't just want to throw temporary staff at the problem.
So let’s go back and think about that policy document again from a different perspective. Imagine we’re not just setting the rules, but had to implement them ourselves, out on the Wards.
To make a difference, it is our view that every policy component noted shouldn't just state rules, breach terms or what have you. It should assume things will go wrong, give examples, and guide a Ward Manager through the crapulence (and this is when a Ward Manager really needs your expertise) to a solution.
Setting up a policy without this last part is to consign a valuable document into the ether, whilst burying our heads in the sand, hoping vaguely for some positive outcome - and getting frustrated when our treasured policy drives no discernible change.
Now, you really don’t have to make it so difficult for yourself. You do the policy bit, and we (Oceansblue, I mean) can fill in the blanks to give you the tools and framework you need. Together, we can lever the transformation you dreamed about...