A friend recently returned from India, having spent time with a development project helping women and children in one of the poorest communities in the world. The thing which is immediately overwhelming when you arrive, she tells you, is the smell of sewage. Running down the sides of the paths between the rows of shantytown houses. Our human reaction is to help, to find a way to improve this seemingly intolerable situation, and provide sanitary facilities. That’s what we would want isn’t it, if we found ourselves thrust into those circumstances: priority one= a clean toilet block.
We’d like to honour you, said the charity workers to the women of the slums, to gift to you something you could never imagine having, to restore some dignity and hope. Let us build you a sanitary facility.
No thanks, said the village leaders. We’d just like a bucket each.
We can do so much more for you! We would be delighted to provide this superb facility for you! More than you’d ever dreamed of having for you, your children….
No thanks, We’d just like a bucket
Because a toilet block would be at the edge of the village. Away from safety. We’d like a bucket so, after dark, after 5pm, if we need to use the toilet, we don’t have to use the other bucket, the one we use to clean vegetables, wash clothes, fill with drinking water. Because we can’t go to the edge of the village in the dark, we can’t let our children go.We’d just like a bucket.
How often have we as improvement leaders offered people a toilet block. We can see the grand gesture, the large scale project, the mutlifaceted business proposal we can provide data for. The improvement project stretching months ahead, demonstrating the cross-speciality lean processing pathway which would offer benefits beyond our dreams.
But sometimes, if we stop for a moment, we’ll see that perhaps the only thing someone wants is a bucket. It’s more accessible. It’ll be available immediately. There’s no risk; no fear that, ‘if we do this we have to make it work’; no resistance to process change to overcome; If we offer the small change which staff are asking for, it’ll pave the way for when we approach them with the next change proposal.
Does this really work? Yes!
@15s30m at Bradford Eye Clinic have watched the most incredible, unexpected change unfold from a small 15second mission
Let’s spend 15 seconds, say the nurses, filling a box with clinic equipment at the end of clinic, and store it in a cupboard centrally. Then the next day, its all in one place, making it really quick to set up the clinic rooms. It’ll reduce frustration, increase joy and improve the quality of care we give. What used to be a 20 minute task for each of 10 staff is now a 5 minute job for 5 people.
But the real change? It’s what they’ve done with the spare time.
They’ve asked if they can learn more about urgent eye care. Not by being enrolled on a specialist course every month for two years costing thousands of pounds (not to mention staffing headaches for the clinic sister.) They just asked for another bucket. “Please could you teach us all for 20 minutes before clinic starts, just once a week. Because now we have the clinic boxes, we can cover each other and take it in turns to be free for teaching.” We call it “triage chit-chat”.
And so the next change the nurses came to us asking for. Can we offer a new triage service to ensure patients with eye problems are seen in the right place first time – be that A&E, community optician, pharmacy or the eye clinic. Now we have more knowledge, we can offer more effective triage advice.
What would have been an unthinkably large improvement project twelve months ago has evolved naturally from within the team themselves. The staff feel empowered, encouraged, high in team morale. They are desperate to use their new skills, experiencing Joy in Work which comes from feeling like you have truly made a difference.
The training they asked for has enabled this much bigger improvement project to happen without any increase in staffing or needing to release staff for study time away from the department.
They asked for a bucket.
What we, and they, have got in return is so much more than that.
Want to know more about our social movement to reduce frustration and increase joy in work? Quality Improvement for those who think Quality Improvement isn’t for them.
@15s30m Info@15s30m.co.uk www.15s30m.co.uk