So, my HFMA workshop presentation came and went. How was it for me? Well, I thought it went on too long. I stuffed too much material in and didn’t give the audience enough time for questions. How was it for you?

My official feedback was unexpectedly good, but recognised there was definitely room for improvement. Overall that’s most fair me thinks. Except, on reflection – here I go again – I’m not sure exactly where the improvement is required? I wonder if my own reflections mirrored those of the audience? The feedback wasn’t at that level of detail, but then unless delegates had been asked to give a detailed view of my performance – and of course that might have completely switched them off from providing the feedback in the first place – how do I know exactly what they liked and what they didn’t?

Feedback is vitally important isn’t it? I start thinking about how will we know that the redesigned stroke pathway we implement is better than the existing one and as good as we had planned? Not only that but is it as good as planned, great or just okay? We are clearly going to need some absolutely defined and robust performance indicators to measure this pathway.

Measures that skim the surface, that are generically applied to all contracts and keep telling us at a superficial level that we are doing okay won’t be enough. The indicators need to be locally defined to meet our city’s health and social needs. We should be getting them to confirm that, not only are clinical and safety standards being surpassed, but also, that the quality of the service is second to none. How do you do that, when ‘how’ something feels is such a personal thing?

I’m going to ask the people who experience our services.  The next big event is coming up and maybe we can spend some time working on how we will know we have achieved what we planned to. We need to determine not only that we have passed the test, but actual performance is better than expected and we can see how we might move on and really stretch our providers to do much more in the future. That must be something we accountants, no I mean ‘seen the light’ service improving accountants, will want clarity on?

I bet you’ve had those over-enthusiastic moments haven’t you? You know where it seemed like a good idea at the time, and then all of a sudden you are propelled into the ‘how did I get here’ and ‘repent at leisure’ time zone? Hmm, me too.

I remember I have gainfully volunteered myself to run a workshop session at our regional HFMA annual conference, in front of my peers, telling them all about how the secondment is going so far and what I have learned to date. Typical, now as it looms ever nearer, and only now, I wonder whether my audience will find the whole thing as exciting as I do. Will I keep their attention? How can I get them to interact and bring the session to life? I’ll let you know next week.

In the meantime what have I learned so far? I suppose the biggest surprise for me is the scope for change and improvement. This has to be carefully defined though as it can come over in a blog like this that what’s already in place must be pretty poor. This is absolutely not the case. There are so many people out there doing such a fantastic job, living within the constraints of the system they work in. Maybe that’s the issue – these constraints we have in place, now that’s where the true scope is. Who said you can’t do this? Why does it need to be like that? Are these constraints real or imposed?

It takes time and audacity to be able to ask those questions in a measured way and during the pressure of working the day job it sometimes seems almost impossible to ask why we do things the way we do. It’s so much easier to just get on with it and keep our heads down. However, service improvement projects are designed to challenge. Even the smallest of changes can have a huge impact if they’re in response to the right questions and staff are willing to make things happen.

Staff need to feel comfortable so that they don’t take no for an immediate answer. Those being asked questions need the courage to answer in an honest and objective way and everyone needs to be able to make space for change.

You all know what I mean don’t you? Bet you’ve all been to some sort of workshop session, brainstorm event or time out when you have come up with loads of stuff you want to change, you’ve agreed to change and then…?