How vital is psychological safety in the workplace? What impact does it have on overall wellbeing and productivity?   Deputy Director of Improvement Cymru, Dominique Bird talks to Nicola Williams, Executive Director of Nursing, who shares her insights and experiences on psychological safety initiatives at Velindre University NHS Trust.  Nicola has been a leading advocate for psychological safety initiatives. As Executive Director of Nursing, she has spearheaded efforts within the Trust, including being the Exec Lead for the Safe Care Collaborative. Nicola will discuss successes, challenges, and the importance of fostering a psychologically safe environment for both staff and patients. It is important to foster an environment, she says, "where teams feel they can take risks, express ideas and concerns, where they can speak up when something has gone wrong, and admit to mistakes which can be very difficult for some without fearing there will be repercussions or negative outcomes to that."  This episode will explore the essence of psychological safety, its implications for individuals and organisational culture, and practical strategies for implementation and improvement. Nicola's expertise sheds light on the significance of prioritising psychological safety in healthcare settings for enhanced well-being and performance.improvementcymru.net/podcast X: @ImprovementCym

In this episode of Talking Improvement, we delve into a groundbreaking collaborative project aimed at reducing unnecessary ambulance call outs for falls at home.   Dominique Bird, Deputy Director of Improvement Cymru, hosts a discussion with Eleri D'Arcy, Demi Catterall, and Amy Jenkins, key figures from different organisations involved in this initiative.   Recognising the significant impact of falls, particularly among older adults, the project sought to address the issue of unnecessary ambulance callouts for non-injurious falls.Bringing together representatives from healthcare, at-home care providers, and local government, the project fostered a multi-dimensional approach to tackling falls, leveraging diverse expertise and resources. Utilising technology such as the ISTUMBLE app, the project introduced efficient assessment methods and alternative care pathways.By empowering care providers to respond effectively to falls, the project not only reduced long lies and hospital admissions but also bolstered confidence among service users, enhancing emotional support and fostering a sense of security within the community.  With special thanks to the following for their help with this project:Diane Patterson and Andrew Thorne from Simply Safe, Ben Scott from Welsh Ambulance Services NHS Trust, Sheena Morgan and Sharon Jackson from Swansea Bay UHB, Francesca Ormeno, Anna Wake, Fiona Broxton, Alex Thomas and Shann Cowap from Swansea Council and Joanne Powell and Lee Wheeler from Improvement Cymru.improvementcymru.net/podcast X: @ImprovementCym

How can the increasing pressure on emergency departments and ambulance services be reduced? In this episode, Dr Dewi Rogers, an out-of-hours GP at Cwm Taf Morgannwg University Health Board, discusses an innovative collaboration called the Clinical Navigation Hub with Dom Bird, Deputy Director of Improvement Cymru.As part of the Safe Care Collaborative, this hub provides central resources to care homes, offering timely advice and support, thereby easing the strain on critical healthcare services.Dr Rogers explains how the Hub enables care homes to make informed decisions and deliver tailored care, reducing unnecessary hospital visits. If the patient is stable and not in immediate danger, instead of calling an ambulance straight away, Dr Rogers encourages them to contact the Hub. "We see tremendous success with what we're doing. From 80% to 90% of the calls we receive from nursing homes, we manage to avoid transporting these patients to the hospital and keep them at home where they want to be and manage them safely," he says.improvementcymru.net/podcast X: @ImprovementCym

If patients or their family members are concerned about their worsening condition, who should they turn to? In this first episode of a new series of Talking Improvement we hear about a successful service for patients and their families that does what it says on the tin - Call 4 Concern. Dom Bird, Deputy Director of Improvement Cymru talks to three guests who have been involved in the introduction of the Call 4 Concern services in their respective organisations. Chris Subbe, Consultant Physician in Acute Medicine, and Eirian Edwards, Advanced Nurse Practitioner both from Betsi Cadwaladr University Health Board discuss why and how the new service was introduced in April 2023.“Sometimes we all miss something,”, says Chris, “and then we offer patients and relatives this opportunity to get somebody to their bedside who's got additional skills and usually comes with a critical care background.” Eirian explains how they allayed suspicions from doctors and other team members and how members of the public have used the service responsibly.  Fiona Davis, Nurse Practitioner from the Patient at Risk Team at Cardiff & Vale University Health Board explains how the initial pilot introduced there in November 2023 has led to greater interest from departments in the hospital. ”It's just going to grow and grow and grow, I think,…we’ve just got to embed it and normalize it.“ she says.improvementcymru.net/podcast X: @ImprovementCym

In this episode, Sarah Patmore, and Nick Pearn, Principle Specialist at the Toyota Lean Management Centre sat down to discuss working together on various improvement projects, with a particular focus on improving process efficiency of lab tests during the height of Covid-19.Nick talked to us about the work Toyota Lean Management Centre do and how lean principles at the heart of the Toyota Way can help address challenges being faced by NHS Wales. Nick said, ‘We learned quite early on that one of the principles that Toyota stands very firmly behind is a desire to contribute to society. And when we've asked how we can do that, we've come up with little better option than working with health services.’

For this episode of Talking Improvement, we discuss improvement and innovation with Dr Philip Webb, Chief Executive of Respiratory Innovation Wales (RIW). When asked about the principles of design thinking. Philip said ‘I think design thinking is a kind of a combination between an emotion and a philosophy for me. If we are truly putting people at the centre of everything that we do, then we must involve people in the process of coming up with new ideas and new ways of doing things.’

In this episode of Talking Improvement, Terence Canning, Welsh Executive Director for UK Sepsis Trust spoke to Martine Price, Lead Nurse with Improvement Cymru about the importance of raising awareness of sepsis. Terence said, ‘But what we would say with sepsis is, it’s so indiscriminate, it affects everybody. So we need to collect these patients’ stories just to highlight the fact that, you know, it's not dependent on age or ethnicity… it can be absolutely anybody.’

In this episode of Talking Improvement, Catherine Roberts, Director of Operations, Merthyr and Cynon Integrated Locality Group and Robert Foley, Head of Patient Flow from Cwm Taf Morgannwg University Health Board sat down with Prof. John Boulton, Director of Improvement Cymru, to highlight the ongoing work to improve patient flow and patient safety within Prince Charles Hospital in Merthyr Tydfil.Describing the impact of Covid and the challenges on our workforce, Catherine Roberts explained the importance of creating an approach that was supported by staff, ‘how could we create in the hospital, an approach where the chance to improve was supported and also the opportunities to fail, were not criticised. Because anyone who gets involved in improvement knows that you try some things and some things work and some things don't. But you have to create a culture where both things are acceptable, it's not only improvement is cheered and everything else is not welcome.’Robert Foley elaborated on the impact of Covid-19 and the culture, ‘one of the things that I learned through COVID and was quite clear to hold on to was the decentralisation of power. So taking power from a central core group of people and giving it back to those who are doing the doing. And I think one of the biggest achievements that we've done is create a coming together of all of the ward managers, taking this site meeting away from a select few, and opening up that site meeting to all of the ward managers, all of our other services such as diagnostics, pharmacists, etc.’

Welcome to Talking Improvement. This is a podcast from Improvement Cymru where we create a safe space for those people working in health and care in Wales who want to make the system work a little better for everyone. In every episode, we’ll speak to some of the leaders in the improvement field to get their insights and their personal experiences.