New Blog: SCORE Survey: Creating a Feedback Culture at Dunster Surgery

Kerry Westcott, Practice Manager at Dunster Surgery talks to us about their work using the SCORE survey.
“We carried out our first SCORE Survey in November 2016, shortly after we’d just merged two practices. It might not have been the best time to carry out the survey due to staff satisfaction – but it did highlight several areas to focus on. Once of these was leadership within the organisation; although we had just merged two sites we also had a sister site (and have since merged with them also). We noticed through the survey that there were huge differences between the two sites – where one felt more positive. What was made clear by the survey was that we didn’t give staff enough feedback. So we put staff meetings into place, ensuring that we reviewed significant events and fed back on these. We introduced feedback in a more positive way – and now any member of staff will email or note if someone has done something really good and we feed this back to the individual. When we were talking through the results, we realised that there were small pockets of negativity in the team and we were able to identify these and have since taken steps to try to combat any negativity affecting other members of staff. Staff also perceived ‘burn out’ to be higher than it was – and we were able to assure the team that doctors weren’t suffering from burnout.
What we discovered was that issues were arising mainly around the lack of communication and leadership, however there was positive feedback that suggested a strong sense that we had a good team.
Some of the poor communication was due to the layout and design of building. We obviously can’t do much about that, but with regards to cross team communications – we made sure that the GPs introduced an open door policy. We also found out that staff weren’t joining the GPs at coffee time – so now we encourage all staff to get together for coffee, which is really great. We also recruited a GP to free up more management time – and that is making a difference. We also decided to make our MDT meetings more formal, with a rep from each team, i.e. dispensary, reception etc and other professionals such as health visitors, palliative care nurses and the complex care team. Once a month we review a ‘worry list’ where the team can share any worries about particular patients.
We’re also improving management and leadership – I have increased the number of days I am in the surgery and one of our GPs went on a Leadership course. The LMC were asked to facilitate a succession planning away day with our GPs and myself, to make a plan for when the senior partner retires. We definitely needed staff learning and reflection opportunities, so we schedule set training time. We introduced a part closure of the Dispensary (for routine medication collection) at lunchtime – we have discouraged patients coming in between 12 and 2pm – which lets the dispensary team carry out more complex tasks prone to potential error to improve safety and also allows for shared learning time and feedback/ cascading of external courses.
We will be introducing the Learning from Excellence scheme to empower staff to make positive changes through recognising when something goes well rather than the traditional Significant event analysis. We also now swap the GP partners from one surgery to the other so they can see how differently the staff work and in preparation for the changes once the senior partner retires. It’s all really positive. The Score Survey gave us an opportunity to find out what we needed to do differently and I’d be really interested in doing it again!”
If you are interested in improving and developing safety culture within your organisation please feel free to contact our Improvement Lead joanna.pendray@swahsn.com, for further information.

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