A scientific approach to living your best work life

When did you last feel a buzz at work, or try something new to improve how you do your job?

We all know that veterinary life can be deeply rewarding. We all know that it brings challenges too, many of which have been magnified in recent years. It’s natural to have tough days and wonder what we could have done differently – but we don’t have to wait for our circumstances to change, or do some CPD to shake up how we feel and work. In fact, we can all do something – today – to help lift our spirits and performance.

The Institute for Healthcare Improvement (IHI) is a US not-for-profit organisation aiming to improve the lives of patients, the health of communities, and the joy of the health care workforce around the world, based on improvement science. IHI has studied the workings and outcomes of a wide range of health care teams in the US and beyond, which has resulted in the “Joy in Work” framework – also known increasingly in the UK veterinary sector as the “What Matters to You” framework. That’s because IHI’s research has shown that understanding our colleagues’ values and motivations is at the core of improving how we feel and work – to the benefit of teams, patients and animal owners. There’s a simple, structured way to do this. It doesn’t require a budget, but it does take an open mind and commitment.

• Find out more in the first article in this series (VT51.49).

Steven Shorrock, interdisciplinary humanistic, systems and design practitioner

If we’re honest, there are little things in every workplace that aren’t quite right – things that need fixing, replacing or reorganising. Usually, we find ways to work around them, and it might seem petty to complain about them. However, these irritations can affect how something is done at a key moment, or simply mount up and get us down. In short, when things don’t work as well as they should, we don’t work as well as we could. Tackling these irritations systematically with our colleagues is a surprisingly effective way to improve motivation, satisfaction, team cohesion – and outcomes.

• To learn more, see the second article in this series (VT52.11).

Of course, even the best workplaces have room for improvement. IHI has defined nine components that make for happy, healthy, and productive people in the caring professions. Some are more obvious than others. Evidence indicates that physical and psychological safety; meaning and purpose; and choice and autonomy are particularly important. In other words, when we are confident in the value and goals of our job, have some say in how we go about it, and feel secure in our environment and culture, we are most likely to feel and perform at our best. Different roles in a practice lend themselves to leading on certain components, but there is something all members of a team can do to improve how the team measures up across the nine areas.

• Read about these factors in the third article in this series (VT53.05).

Psychological safety is a powerful tool for any practice that prides itself on always trying to do better. We all have our own personal take on how far we feel able to speak up without fear of retribution. By its very nature, this may be a subject that not all of us are comfortable discussing. This is where IHI’s approach bears fruit, as it is underpinned by a focus on the whole team and concern for the feelings of our colleagues. The Rolling Take 5, based on the NHS’s Going Home Checklist, is an easy and valuable way to build psychological safety into our day-to-day, helping improve communication, systems of work and outcomes all the while.

• Discover its simple effectiveness in the fourth article in this series (VT53.13).

Jo Civil, operations manager and QI officer, 387 Veterinary Centre, Walsall

We know from recent UK veterinary research that our team is the most important factor in why we stay in our jobs. Solid teamwork has been proven to enhance communication, inform effective leadership, maximise learning opportunities and improve patient outcomes. On the other hand, evidence shows that unsupportive behaviour towards colleagues can diminish team spirit and motivation, leading to compromised safety and poor outcomes. Many ways to build team spirit are available, and we can all do our part, regardless of our role, experience or personality.

• Explore the value and aspects of camaraderie in the fifth article in this series: (VT53.24).

Changing how we feel about work, or how we work, can be daunting. Consequently many of us – consciously or subconsciously – expect others to do this for us. Often, we consider changing workplace if our morale is consistently low, or past attempts to suggest new ways of doing things have fallen flat. However, IHI’s framework shows us opportunities are present all around us, in the present moment, that we can seize to kick off change. Crucially, any team member in a practice can make positive change through Quality Improvement: proposing and making process changes, then collaborating with colleagues to measure results and modify approaches as necessary.

• For inspiring and relatable examples from colleagues in the UK veterinary sector, see the sixth article in this series (VT53.34).

Donald Berwick, president emeritus and senior fellow, Institute for Healthcare Improvement

At a time of high pressure for many in the professions, IHI’s emphasis on team well-being and joy is not only welcome, but gets results. Early last year, other veterinary teams were reading the first article in this series. Today many of those who decided to give joy in work a go are benefiting from tangible improvements in how they feel and work. Some of them have even been recognised in the RCVS Knowledge Awards for the strides they have made in teamwork and patient care.

This time next year it could be you, reflecting on a period of professional growth and team accomplishment. RCVS Knowledge has adapted IHI resources in a range of formats to back you up all along your journey, with tips for success and getting colleagues on board. Right now, all you need to commit to is mentioning the framework to your colleagues. Keep us posted – we look forward to hearing about the difference it makes.

Louise and her team embarked on several small projects. For example, they made ward multidisciplinary meetings more structured, and began holding twice-daily “BOSH” huddles to ask:

B – has everyone had a break?

O – are we all okay with our workload?

S – are there any sick patients?

H – does anyone need help?

Both projects improved teamwork and morale, and more projects followed. A great enthusiasm was shown for this work, but at times it was a struggle to prioritise it and not see it as an “extra”. The commitment has paid off. A recent survey found that 100% of Louise‘s 70-strong ward team felt supported. Furthermore, formal patient complaints have fallen from 17 to 1 per year.

“The impact that all those small changes have is massive,” said Louise. “The more the staff see the impact those changes have, the more buy-in you get. This is not a burden. This work is a gift.”

Useful free resources

• What matters to you? (resources for veterinary teams; rcvsknowledge.org/what-matters)
• RCVS Knowledge Award winners (Joy in Work award winners’ case examples; rcvsknowledge.org/quality-improvement/qi-awards)
• What is Quality Improvement? Starting the conversation with your team (rcvsknowledge.org/WhatisQI)
• Quality Improvement boxset (getting started with Quality Improvement; qiboxset.org)
• Improving workforce well-being and joy in work: health system examples (Institute for Healthcare Improvement Joy in Work case examples; bit.ly/IHIexamples)