Day 62: Chief Nursing Officer Summit - Part 1

Today was the first day of the annual Chief Nursing Office Summit.  It’s invitation-only for all Directors of Nursing from across the NHS in England.  It’s publicly streamed live online to be accessible to a wider audience.  There was also a lively conversation on Twitter through the hashtag: #CNOSummit.

There’s far too much from today to mention in this blog, but I will break my 100 words rule to share an element of the inspirational talk by @ElaineInglesby about how we improve patient safety through culture change.

There’s been much talk previously about how the culture in the NHS needs to change; today Elaine spoke passionately about some of the practical ways we can make this happen.  She shared a leadership example from the USS NIMITZ, an American Navy Aircraft Carrier.  This isn’t the most obvious comparison to draw for the NHS and certainly differs to commonly used examples from the airline industry.

On the NIMITZ they apply simple principles to bring clarity of role and effective leadership.  This ensures the safety of 5,500+ crew and the aircraft that can take off and land at a rate of every 25 seconds.  Read the principles below, as I think they speak for themselves and the NHS can learn from this. You don’t have to look to hard to see our Culture of Compassionate Care #6C here:

“We are NIMITZ professionals and we apply the following principles all the time, in everything we do.

INTEGRITY:  We expect honesty from all our Sailors.  We expect our Sailors to take responsibility for their actions and to never avoid accountability.  We expect our Sailors to take ownership of their tasks, their spaces and their ship.

FORMALITY:  To accomplish the mission, Sailors aboard USS NIMITZ work as a team.  But they also perform their individual tasks in a manner that contributes to team success.  To do that, each Sailor communicates well by giving precise orders, providing verbatim repeat-backs, listening to repeat-backs and adhering to established NIMITZ standards.

PROCEDURAL COMPLIANCE:  This principle takes formality a step further.  Aboard NIMITZ, established procedures have evolved over many years from the lessons learned following mistakes made by others.  We don’t want our Sailors to re-learn old lessons the hard way, so we insist on using the right procedures for each evolution.  We train our Sailors on what the procedures and we also train them to understand the ‘why’s’ behind its use.”

LEVEL OF KNOWLEDGE: We know that a sound level of knowledge leads to intelligent on-the-spot decisions.  We train our Sailors to understand the how and the why of their contributions to the ship’s mission.  We believe that if we’re not learning and teaching more each day about our job and our ship, then we’re not doing our job right.

QUESTIONING ATTITUDE: A questioning attitude is both a critical thinking skill and an exercise in vigilance.  It is a personal trait that it  learned, yet requires practice to remain sharp.  Aboard NIMITZ, each Sailor is encouraged to have a questioning attitude.  Many of the best ideas on how to improve processes and procedures have come from our junior Sailors.  A Sailor with a questioning attitude is learning more about the ‘why’ and that can help improve their level of knowledge.

FORCEFUL BACKUP: NIMITZ Sailors watch each other’s backs to ensure an evolution is being conducted safe and proper.  The ‘forceful’ part of this principle is tied to integrity.  Being ‘forceful’ when backing up shipmates means our Sailors have the courage to point him or her back on the right path if they’ve started to stray from it.