23 May 2023

A link to our interventions page.

Each site has their own page, accessible to those with the link.

14 May 2023

Our pre-intervention survey has finished.

We are now implementing our intervention in each of the 3 EDs. This coincides with ACEM Wellness Week 2023.

The intervention is a Positive Participatory Organisational Intervention (PPOI), a “complex intervention”.**

It consists of several parts, targeting different “levels” of the workplace. We are aiming at each of the :

  • individual level

  • team level

  • system level

We hypothesise that targeting one or two of these levels is insufficient for significant benefits. Each of three levels require intervention. As well, this intervention is a small part of what may help our wellbeing at work. Additional work within each of these levels may help. Work targeting other “levels” (leadership level, and outside the organisation) is required. These levels are vital, of course, and are outside the scope of this research.

**“An intervention might be considered complex because of properties of the intervention itself, such as the number of components involved; the range of behaviours targeted; expertise and skills required by those delivering and receiving the intervention; the number of groups, settings, or levels targeted; or the permitted level of flexibility of the intervention or its components…Complexity might also arise through interactions between the intervention and its context, by which we mean “any feature of the circumstances in which an intervention is conceived, developed, implemented and evaluated.””

Skivington K, Matthews L, Simpson S A, Craig P, Baird J, Blazeby J M et al. A new framework for developing and evaluating complex interventions: update of Medical Research Council guidance BMJ 2021; 374 :n2061 https://doi.org/10.1136/bmj.n2061

3 April 2023

We are going live with the pre-intervention survey part of the research. Please see local communications for these links.

Here is the latest poster of our plans

13/1/23

Here is a link to the site for the Local Champions Group.

Beware…it is under construction!

It will eventually require a password to access.

January 2023

Happy New Year!

Here is a “Plain Language Summary” of the planned intervention.

And the latest “One-Pager” (and as a power point)

December 2022

Here are a few documents that outline our plans, and some of the evidence behind those plans

Posters:

The latest from East London

A summary of their approach to improving workplace wellbeing using quality improvement

Our proposed intervention

Here is an outline

It’s a work in progress!

A hefty (worthwhile) read

In October 2022 the US National Academy of Medicine released “The National Plan for Health Workforce Well-Being”.

This is “intended to inspire collective action that focuses on changes needed across the health system and at the organizational level to improve the well-being of the health workforce”. Aspirational for us at Te Whatu Ora.

And, don’t worry if you missed the Triple, or Quadruple Aim… they are up to the Quintuple Aim!

ELFT

It was a privilege to meet the Quality Team team at East London Foundation Trust in late September 2022.

Along with Jess Perlo (lead author of the landmark “Joy in Work” IHI White Paper), Amar Shah led an excellent 1 hour presentation at the International Forum on Quality and Safety in Healthcare in Göthenburg in June 2022.

Here’s a video from Dr Shah discussing their approach at ELFT

And a couple of very important papers:

3 October 2022

Survey is done. Analysis of results awaited…will keep you posted!

Preliminary results are as follows:

  • Total EDs (annual patient census > 5000) in NZ and approached: 35

    • Aim was to have 2 respondents at each ED, so a maximum total of 70 responses

  • Total responses: 58 from 29 EDs

25 August 2022

Survey of emergency department workplace wellbeing and quality improvement capability

Here are the sources upon which the survey questions were based.

Most have been modified to make them appropriate for our situation.

18 Aug 2022

Thanks to our friends in London, here’s a “one pager” outlining some plans.

25 May 2022

Here’s a video from the Surgeon General of USA, and a link to news of his advisory.




23 May 2022

What is the IGLO(O) Framework for Positive Participatory Organisational Interventions (PPOIs)?

from Nielsen and Christensen 2021

“PPOIs focus on improving the work environment and employee well-being.”





“Such improvements happen through changing work policies, practices, and procedures…”





“…a collaborative approach where managers and employees jointly decide on the process (the design and implementation of the intervention) and the content of the intervention (changes to work policies, practices, and procedures).”





“PPOIs employ a problem solving cycle approach to change ...”





PPOIs require the participation of stakeholders at a multitude of levels in, and beyond, an organisation.

Individual

Group

Leader

Organisation

Outside influences









When implementing and evaluating complex interventions we may be wise to consider:

  • what works,

  • for whom,

  • to what extent,

  • under which circumstances,

  • and how.

This paper provides more detail.



9 May 2022

The ACEM Quality Standards were revised and published in April 2022. Congratulations and thank you to the team at ACEM! These standards, and toolkit, may be very important for our work and research.

Here’s a link to the ACEM Quality Standards

Here’s a “1 page” summary of those standards, from the perspective of Workplace Wellbeing and Quality Improvement

And here are some slides, complete with commentary!



21 March 2022

This is a brief outline of what we are planning for our further research:

  • Construct an intervention

    • By early 2023, we hope to construct an intervention

    • The exact intervention is uncertain at this stage… We will build our intervention based upon the following:

      • Review of literature

        • We suspect the main sources for our intervention will be the fields of

          • quality improvement

          • positive psychology in organisations

      • Study 1 to inform the intervention:

        • a survey of current knowledge and activities related to Healthcare Quality and Workplace Wellbeing in EDs around NZ

      • Study 2 to inform the intervention

        • a qualitative study of experiences with, enablers for, and barriers to improvement in EDs around NZ


  • Implement the intervention

    • We will aim to begin the roll out of our intervention to participating EDs around 1 March 2023.

    • EDs will start at different times, depending on various factors.

    • We estimate the intervention will be for 12 months in each ED.

    • We will measure burnout, wellbeing