Compassionism: ‘Start with compassion…end with respect’
Case study summary
Poor feedback from staff and patients prompted Kettering General Hospital to introduce a new workplace culture: ‘Compassionism’. Securing buy-in from all areas, the trust shared information on the impact of incivility, and encouraged compassionate interactions.
‘Peer messengers’ were trained as ‘go-betweens’ to allow staff at any level to raise issues without fear of conflict with senior colleagues. In under 1.5 years, the scheme has attracted nearly 1,000 callouts, with 85% resolved to satisfaction at an early stage; staff feedback at all levels has been very positive.
Kettering General Hospital NHS Foundation Trust (KGH)
What was the aim/problem?
Feedback collected by KGH identified issues with compassion and respect – staff felt relationships with managers lacked respect, and did not feel confident in challenging senior colleagues when required. Patient complaints commonly noted issues with staff communication, attitude and behaviour.
Given evidence demonstrating the negative impact of incivility and rudeness on patient safety, the trust sought to develop a cultural shift embedding civility, respect and compassion.
What was the solution?
Led by the Deputy Medical Director, a new culture labelled ‘Compassionism’ was developed and pioneered by a multi-professional group of staff across the trust. The campaign consisted of three stages:
- Raising awareness: channels such as roadshows, speakers and patient/staff stories were used to communicate the detrimental impact of incivility on patient safety as well as the full patient/staff experience.
- Pledging compassionism: KGM staff at all levels – multi-professional, board to frontline, clinical and non-clinical – were invited to commit to the campaign by sending ‘heart selfies’; photos that were collaged into a trust poster.
- Implementing Compassionism: a commitment was made to two Compassionism challenges:
- Self-challenge – always begin interactions with a ‘hello and smile’; finish with a ‘thank you’; at the end, reflect: ‘Is this the best of me?’
- Peer challenge – ‘calling it out with compassion’. ‘Peer messengers’ were introduced as third party contacts who go between different people to receive, raise and resolve issues – particularly where large hierarchical gaps discourage junior staff from reporting problems to/about senior colleagues.
The campaign was introduced in a pilot phase including the board of directors and five other areas (clinical and non-clinical), with an aim to train 12 peer messengers.
What were the challenges and learning points?
Adept use of internal and digital communications was necessary given a soft launch amid the COVID-19 pandemic and its accompanying restrictions.
Early involvement of the trust board and HR was crucial to emphasise the new approach transcended traditional hierarchical structures and would fit alongside existing workforce processes, such as ‘freedom to speak up’.
Teams were given full ownership of process implementation and messenger nomination from the start, to allow coping with the difficulty of introducing the process while teams dealt with BAU pressures. Bespoke training and ongoing support were available, alongside a peer messenger network, helping alleviate ‘initiative fatigue’.
What were the results?
In the 16 months since the introduction of Compassionism, KGH peer messengers have received 944 ‘Compassionism callouts’ – about two per day. Of these, 85% were addressed to all parties’ satisfaction, with no further formal action required.
While it is too early to declare a tangible direct impact on factors such as drug error, pre-escalation resolution of staff grievance, resolution of patient complaints, the evidence to date – particularly staff feedback gained from listening events – is very positive. For example:
“[The] soft touch of Compassionism has been a game-changer. Previously staff were not raising issues because, firstly, they did not feel comfortable challenging seniors and consultants; and secondly, they did not want formal actions against their own team members. Our own ophthalmology peer messengers are brilliant. We are sorting loads out within the team. Everyone seems much happier.”
“Challenging the consultant on how he spoke to the FY2 in front of the patient was much easier using our peer messenger. I was surprised, as the consultant apologised to the FY2 and the patient. In fact, the consultant was gutted when he found out how he made others feel.”
[T&O Ward sister (TC)]
Next steps and sustainability?
- Compassionism has now been incorporated into the trust’s induction programme.
- Further rollout of the programme for teams across the hospital; then potentially group, system, regional, national.
- Build a regional network supporting implementation of peer messenger/‘calling out with compassion’ in other areas.
Want to know more?
- Dr Rabia Imtiaz, Interim Medical Director, KGH: Rabia.Imtiaz1@nhs.net; twitter @ImtiazRabia
- Claire Knibb, Medical Directorate Project Manager, KGH: Claire.Knibb@nhs.net; twitter @ClaireKnibb
- KGH Compassionism team: firstname.lastname@example.org; twitter @_compassionism