What Matters to You?
When healthcare teams take time to improve how they feel at work, engagement, motivation, energy, satisfaction, and productivity all increase, burnout and turnover rates drop - and quality of care rises, sustainably.1
Research by the Institute of Healthcare Improvement shows that improvements in how we feel – and work – are possible in even the most pressured circumstances. What’s more, all team members can play a part in making work life better for themselves, their colleagues, and their patients.
RCVS Knowledge has developed a set of structured resources to support veterinary teams to improve the contentment and buzz they experience in work, based on the Institute for Healthcare Improvement’s tried-and-tested Joy in Work framework. The articles below talk you through each stage in the process. It is important to work through each stage in order to make change successfully. UK veterinary teams on this journey have already made award-winning changes - why not join them?
1. What Matters to You? And why that matters
We work closely with our colleagues, often for years, to give animals the best possible care, so we know what matters to our team – or do we? Taking time to ask can be the first step to improving workplace wellbeing – and your clients’ and patients’ experiences.
Asking colleagues ‘What matters to you?’ creates an opportunity to listen properly, in order to understand their values and what gives them a sense of purpose in their work. By understanding what truly matters to our team, we can identify barriers that limit how much we enjoy our work – and then devise meaningful changes together to overcome them.
What this article covers
The first article in this series introduces the Joy in Work framework, an evidence-based approach to beating burnout and increasing satisfaction and pride among care teams. The framework is applicable to all types of practice and is being used successfully by a growing number of veterinary teams in the UK. The article covers:
- The work of the Institute for Healthcare Improvement (IHI).
- The scientific background of the Joy in Work framework.
- The business case for improving joy in work.
- How to have productive What Matters to You? conversations.
Supporting free resources
In this podcast, Jesse McCall, who co-leads the Joy in Work Results-Oriented Learning Network at the Institute for Healthcare Improvement, discusses the factors that diminish joy in work, and practical steps that teams can take to work together to nurture their workforce and address the issues that drive burnout and sap joy in work. Recorded at SPVS-VMG Virtual Congress in May 2021.
Adapted from the original IHI framework, this resource is intended to support leaders within the veterinary sector in introducing the Joy in Work concept to their teams. The conversation guide will support you in setting up initial and continuing conversations with your team to identify any workplace frustrations, or ‘pebbles in your shoes’, and to engage and empower the team to identify potential solutions. [PDF 37KB] (Published February 2022)
With demanding priorities to deliver the best possible care, it's no wonder that veterinary professionals are concerned with stress and burnout within the profession. This presentation, recorded during the SPVS VMG Congress in May 2022, demonstrates how the Joy in Work framework can be used in veterinary settings, and the steps that can be taken to connect teams in meaning and purpose.
You can also listen to and download a podcast version of the 'What Matters to you? An antidote to burnout' presentation.
This case example by Bracken Veterinary Centre, part of the Active Vetcare Group owned by CVS, focuses on re-finding Joy in Work by carrying out a baseline survey to discover how the team felt about working at the practice. They introduced ‘What Matters to You?’ training and followed the Joy in Work framework. The team felt more engaged and felt they were being listened to and the Practice has a productive approach to addressing issues. (Published June 2023).
RCVS Knowledge regularly publish QI Features covering shared leadership, team culture, human factors, job satisfaction, compassion and more. These features discuss how clinical human factors relate to patient safety, improved outcomes for our patients and owners, and how they can improve the experiences for those providing care.
- IHI Framework for improving joy in work (register for free to access)
This white paper from the Institute for Healthcare Improvement is intended to serve as a guide to encourage engagement in the participative process where leaders ask colleagues at all levels of the organisation “What matters to you?”
Read article 1: What matters to you? And why that matters when caring for patients.
McCall, J. and RCVS Knowledge (2022) What matters to you? And why that matters when caring for patients. Vet Times, 51 (49), pp. 12-14. Available from: https://www.vettimes.co.uk/article/what-matters-to-you-and-why-that-matters-when-caring-for-patients-cpdteams/
2. The pebbles in your shoe
Workplace frustrations, however small, can sometimes feel insurmountable in these demanding times, and they can prevent us from working at our best. Addressing them together can lift your team’s spirits and help you deliver quality care.
‘Pebbles in your shoe’ are things that don’t work as well as they should, and make it harder for us to work as well as we can. These can fester or combine to affect our wellbeing, and even the quality of care we provide, so stopping to deal with them is time well spent.
What this article covers
The second article in this series introduces the second stage of the Joy in Work framework. It sets out how to tackle seemingly minor aspects of work life that bug our team, and why this can have a major impact on our collective mood – even during the most challenging times. The article covers:
- Understanding of the formal definition of pebbles in our shoe.
- Effective ways for teams to identify and tackle pebbles.
- How to encourage participation by all.
- The variety of roles team members can adopt.
- Practical ways to sustain engagement and improvements.
Supporting free resources
Adapted from the original IHI framework, this resource is intended to support leaders within the veterinary sector in introducing the Joy in Work concept to their teams. The conversation guide will support you in setting up initial and continuing conversations with your team to identify any workplace frustrations, or ‘pebbles in your shoes’, and to engage and empower the team to identify potential solutions. [PDF 37KB] (Published February 2022)
The QI Boxset is an educational series that supports veterinary teams in implementing Quality Improvement (QI) into practice. Each free-to-access Series covers a different QI technique, helping you learn through podcasts, webinars, additional reading, guides, and templates.
The QI Boxset is hosted on the RCVS Knowledge Learn Platform, our dedicated free online learning portal. Courses are designed to be easily accessible and you can pick what you want to read, watch or listen to, working through modules at your own pace. This link will open in a new window and requires registration.
Shobhan Thakore, Clinical Lead for the Scottish Quality and Safety Fellowship Programme at the time of recording, gives an approachable and personal perspective on how to get your team on board to deliver quality improvement. This presentation was an Adapt, Improve, Achieve session by RCVS Knowledge recorded at SPVS-VMG Congress 2020 in Newport as part of the Quality Improvement stream.
-
IHI Patient Safety Leadership WalkRoundsTM Tool (register for free to access).
Patient Safety Leadership WalkRoundsTM are a systematic method of conducting weekly meetings focused solely on safety concerns. The tool aims to connect senior leaders with those working on the front line — both as a way to highlight safety concerns to senior leadership and to signal to front-line team members the senior leaders’ commitment to creating a culture of safety.
Read article 2: How the little things can have a big impact on wellbeing and care.
McCall, J. and RCVS Knowledge (2022) How the little things can have a big impact on well-being and care. Vet Times, 52 (11), pp. 22-24. Available from: https://www.vettimes.co.uk/article/how-the-little-things-can-have-a-big-impact-on-well-being-and-care/
3. The top 3 factors of joy at work
Feeling joy at work might seem too much to ask in the current climate, but research shows that there are three areas that can have a big impact on how your team feels and performs.
A Head RVN said: ‘This has given the team a sense of control and power, they are coming into work with a real sense of ownership.’ Practice management told us this has been a real gamechanger, and feel like post-Covid, things for the team are starting to move in the right direction.
Mark Moreton, Small Animal GP Vet and Small Animal Veterinary Director for CVS
What this article covers
The third article in this series introduces the nine components necessary for happy, healthy and productive people, according to the Joy in Work framework. It describes the three factors that can make the most difference in a short space of time to how a team feels, and how you can achieve them. The article covers:
- Understanding of the nine components of workplace joy
- Understanding of the top three components of workplace joy and distributed leadership
- How to explore how your workplace measures up in these areas
- How to strengthen these components in your workplace
- The importance of measuring improvements
Supporting free resources
Our free resources will introduce you to different QI techniques, and help you understand the processes you can put in place to help improve outcomes. Access the free tools, templates, case examples and QI Boxset, including the Clinical Audit CPD course.
- Webinar: The power of the growth mindset: Why certain habits of mind matter in clinical improvement.
Bill Lucas, Director of the Centre for Real-World Learning and Professor of Learning at the University of Winchester at the time of recording, shares the habits of mind that can help to develop a culture of continuous improvement in health, education and other sectors - and how you can help cultivate those in yourself and your team. This is a recording of a presentation sponsored by RCVS Knowledge at the SPVS-VMG Focus on Leadership and Management Virtual Summit on 1 December 2020.
You can also listen to and download a podcast version of the 'The power of the growth mindset: Why certain habits of mind matter in clinical improvement' presentation.
Read article 3: The three factors of joy at work - Why and how to gain them.
McCall, J. and RCVS Knowledge (2023) Top three factors of joy at work- why and how to gain them. Vet Times, 53 (5), pp. 6-7. Available from: https://www.vettimes.co.uk/article/top-three-factors-of-joy-at-work-why-and-how-to-gain-them/
4. The power of 5 questions
Some days it’s hard to leave work behind when you close the practice door. Five simple questions can help teams put even the most unforgettable shifts to bed, and get in the best shape to deliver excellent care.
On a recent busy Sunday shift, having stayed late, we took five minutes to catch up with the team members ending the shift and the members just starting theirs. The shift had been a difficult one, but taking a moment to reflect allowed us to learn and potentially change future shifts, to benefit not only our patients but also our team. I left the shift feeling much more positive about our achievements and more bonded as a team.
Rachael Bacon RVN
What this article covers
The fourth article in this series introduces the Rolling Take 5, a key tool for psychological safety as described in the Joy in Work framework. It explains how a simple, quick and free routine process to check in with your team can make a tangible difference to wellbeing and performance. The article covers:
- The proven wellbeing and practice benefits of discussing difficult experiences
- The proven safety benefits of checking in with team members at the start of a shift
- Use of the Going Home Checklist in human healthcare
- Understanding of the Rolling Take 5
Supporting free resources
Take a moment before the start and end of the shift to discuss these questions with your team. The discussion can help improve communication between shift teams, to identify areas for improvement, to identify processes that have worked well and flag up required support for the team [PDF 615kb] (Published August 2020).
What can we learn from the NHS's approach to patient safety over the past 20 years? Suzette Woodward, a paediatric intensive care nurse who is now a Professor in patient safety, discusses the safety concepts and science within the NHS - as well as what we could do differently. This session was recorded at SPVS VMG Congress, Newport in January 2020, as part of the quality improvement stream.
RCVS Knowledge regularly publish QI Features covering shared leadership, team culture, human factors, job satisfaction, compassion and more. These features discuss how clinical human factors relate to patient safety, improved outcomes for our patients and owners, and how they can improve the experiences for those providing care.
Read article 4: The power of 5 questions.
McCall, J. and RCVS Knowledge (2023) The power of five questions. Vet Times, 53 (13), pp. 8-9. Available from: https://www.vettimes.co.uk/article/the-power-of-five-questions/
5. The key to joy and excellence at work
New research shows that our team is at the heart of what keeps UK veterinary professionals coming back to work, day after day – but a strong team spirit can also drive consistently excellent care.
We realised that to improve our workplace culture and re-find our joy, we needed a plan! The leadership team adopted the Joy in Work framework to empower team members to identify workplace challenges, action solutions and re-join decision-making. The team really enjoyed the “What matters to you” sessions that we ran. They identified four ‘pebbles in their shoes’ which were addressed with measures they suggested. We now have a fortnightly ‘What matters to you’ meeting, a Joy in Work board listing pebbles in progress, and a ‘pebbles pouch’ for further suggestions. Many team members now feel more engaged in helping set the practice direction, and that they have a productive way to address day-to-day niggles.
Jenny Brown, Senior Clinical Director, Active VetCare Bracken
What this article covers
The fifth article in this series focuses on the importance of teamwork and team culture to joy and excellence in work. It demonstrates how simple actions can have a genuine effect on your team’s camaraderie, joy and performance, and how this is critically important to patient safety. The article covers:
- The proven connections between camaraderie, joy and excellence
- IHI’s definition of team spirit and examples of how this is demonstrated in practice
- Understanding of how camaraderie improves the quality of our work
- Practical steps all team members can take to improve team spirit and performance
Supporting free resources
RCVS Knowledge regularly publish QI Features covering shared leadership, team culture, human factors, job satisfaction, compassion and more. These features discuss how clinical human factors relate to patient safety, improved outcomes for our patients and owners, and how they can improve the experiences for those providing care.
Article three in the first-person QI Features discusses how culture is an essential part of organisational health and success.
Article eleven in the first-person QI Features discusses how compassion acts as a powerful team behaviour for improving care quality, and, from a business perspective, effectively improves employee retention and teamwork.
This case example by Bracken Veterinary Centre focuses on re-finding Joy in Work by introducing ‘What Matters to You?’ meetings and following the Joy in Work framework. Following the initiative, the team felt more engaged and felt they were being listened to and the practice has a productive approach to addressing issues. This case example was awarded Highly Commended in the 2023 Knowledge Awards.
Adapted from the original IHI framework, this resource is intended to support leaders within the veterinary sector in introducing the Joy in Work concept to their teams. The conversation guide will support you in setting up initial and continuing conversations with your team to identify any workplace frustrations, or ‘pebbles in your shoes’, and to engage and empower the team to identify potential solutions. [PDF 37KB] (Published February 2022)
With demanding priorities to deliver the best possible care, it's no wonder that veterinary professionals are concerned with stress and burnout within the profession. This presentation, recorded during the SPVS VMG Congress in May 2022, demonstrates how the Joy in Work framework can be used in veterinary settings, and the steps that can be taken to connect teams in meaning and purpose.
You can also listen to and download a podcast version of the 'What Matters to you? An antidote to burnout' presentation.
- IHI Framework for improving joy in work (register for free to access)
This white paper from the Institute for Healthcare Improvement is intended to serve as a guide to encourage engagement in the participative process where leaders ask colleagues at all levels of the organisation “What matters to you?”
Read article 5: The key to joy and excellence at work.
McCall, J. and RCVS Knowledge (2023) The key to joy and excellence at work. Vet Times, 53 (24), pp. 16-17. Available from: https://www.vettimes.co.uk/article/the-key-to-joy-and-excellence-at-work/
6. Feeling and working better - it starts with you
Some days, it can seem unrealistic to aim for more than just getting through the day. Research has identified nine components that lead to happy, healthy, productive people at work, helping to consistently deliver high-quality care.
When a vet who was passionate about QI asked for volunteers to get involved, I thought it didn’t apply to me – I thought you’d have to be clinical and full time, and it’s not for us receptionists, but she showed me that there was a role for us. It’s great for teamwork: for the audit team we set up, we try to have a vet, a nurse and a member of reception, so that you get lots of perspectives on the audit itself. It means everybody can understand the whole of the business, and it’s really rewarding for everyone to see that you’ve actually improved on something. If you can do a job that’s easier than how you were doing it before, and achieve a better result, that’s ultimately going to have an impact on your health and wellbeing
Jo Civil, Lead Receptionist and QI Officer, 387 Veterinary Centre
What this article covers
The sixth article in the series focusses on how all of us can help nurture wellness and resilience in ourselves and each other. It demonstrates the shared principles of the Joy in Work framework and Quality Improvement (QI) approach to problem solving, and how any team member can use QI to make things better. The article covers:
- The connections between Quality Improvement and improved workplace wellbeing.
- Demonstrates the varied roles in the veterinary team undertaking improvement activities.
- The practical steps that can be taken to encourage whole team involvement.
Supporting free resources
Hayley Potter from Old Golf House Vet Group, part of the CVS Group of practices, introduced a ‘What Matters to You?’ initiative to improve workplace wellbeing with Joy in Work resources used to aid the change. The introduction of wellbeing meetings brought about several interventions to help boost morale and Net Promoter Score (NPS) score
This session, led by Pam Mosedale, explores the role of practice managers, nurses and the reception team in ensuring Quality Improvement is properly understood and embedded throughout the whole practice team. The session was recorded at SPVS-VMG Virtual Congress in May 2021.
Listen to Pam Mosedale, QI Clinical Lead, chat to Jo Civil about her role as a veterinary receptionist and Quality Improvement officer within practice. This podcast was recorded for the QI Boxset - Series 1: Episode 2: Getting started with Quality Improvement.
Shobhan Thakore, who was Clinical Lead for the Scottish Quality and Safety Fellowship Programme at the time of recording, gives an approachable and personal perspective on how to get your team on board to deliver quality improvement. This presentation was an Adapt, Improve, Achieve session by RCVS Knowledge recorded at SPVS-VMG Congress 2020 in Newport as part of the Quality Improvement stream.
RCVS Knowledge regularly publish QI Features covering shared leadership, team culture, human factors, job satisfaction, compassion and more. These features discuss how clinical human factors relate to patient safety, improved outcomes for our patients and owners, and how they can improve the experiences for those providing care.
The QI Boxset is an educational series that supports veterinary teams in implementing Quality Improvement (QI) into practice. Each free-to-access Series covers a different QI technique, helping you learn through podcasts, webinars, additional reading, guides, and templates.
The QI Boxset is hosted on the RCVS Knowledge Learn Platform, our dedicated free online learning portal. Courses are designed to be easily accessible and you can pick what you want to read, watch or listen to, working through modules at your own pace. This link will open in a new window and requires registration.
Read article 6: Feeling and working better - it starts with you.
McCall, J. and RCVS Knowledge (2023) Feeling and working better - it starts with you. Vet Times, 53 (34), pp. 4. Available from: https://www.vettimes.co.uk/article/feeling-and-working-better-it-starts-with-you/
7. 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?
Veterinary life can be deeply rewarding but 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 gifts of hope, confidence, and safety that health care should offer patients and families can only come from a workforce that feels hopeful, confident and safe. Joy in work is an essential resource for the enterprise of healing
Donald Berwick, president emeritus and senior fellow, Institute for Healthcare Improvement
What this article covers
In the last of this series, RCVS Knowledge and Jesse McCall from the Institute for Healthcare Improvement take a look back at how implementing this tried-and-tested framework can help us feel and work better every day, no matter what your day is like, and includes links to all previous parts. The article covers:
- The work of the Institute of Healthcare Improvement (IHI) and the scientific background of the Joy in Work framework.
- Defining the small, every day frustrations, or pebbles in our shoes, that can have an impact on our teams, and how to overcome them.
- Understanding the components of workplace joy that can make a difference in how a team feels and works.
- The proven wellbeing and safety benefits of checking in with team members and discussing difficult experiences.
- Practical steps all team members can take to improve team spirit and performance.
- The connections between Quality Improvement and improved workplace wellbeing.
Supporting free resources
In this podcast, Jesse McCall, who co-leads the Joy in Work Results-Oriented Learning Network at the Institute for Healthcare Improvement, discusses the factors that diminish joy in work, and practical steps that teams can take to work together to nurture their workforce and address the issues that drive burnout and sap joy in work. Recorded at SPVS-VMG Virtual Congress in May 2021.
Adapted from the original IHI framework, this resource is intended to support leaders within the veterinary sector in introducing the Joy in Work concept to their teams. The conversation guide will support you in setting up initial and continuing conversations with your team to identify any workplace frustrations, or ‘pebbles in your shoes’, and to engage and empower the team to identify potential solutions. [PDF 37KB] (Published February 2022)
Read about how others have implemented Quality improvement (QI) in there setting, including case examples by previous Award Winners Hayley Potter from Old Golf House Vet Group, part of the CVS Group of practices and Bracken Veterinary Centre who focused on re-finding Joy in Work by introducing ‘What Matters to You?’ meetings and following the Joy in Work framework.
RCVS Knowledge regularly publish QI Features covering shared leadership, team culture, human factors, job satisfaction, compassion and more. These features discuss how clinical human factors relate to patient safety, improved outcomes for our patients and owners, and how they can improve the experiences for those providing care.
The QI Boxset is an educational series that supports veterinary teams in implementing Quality Improvement (QI) into practice. Each free-to-access Series covers a different QI technique, helping you learn through podcasts, webinars, additional reading, guides, and templates.
The QI Boxset is hosted on the RCVS Knowledge Learn Platform, our dedicated free online learning portal. Courses are designed to be easily accessible and you can pick what you want to read, watch or listen to, working through modules at your own pace. This link will open in a new window and requires registration.
Read article 7: A scientific approach to living your best work life.
McCall, J. and RCVS Knowledge (2023) A scientific approach to living your best work life. Vet Times, 53 (44), pp. 14. Available from: https://www.vettimes.co.uk/article/a-scientific-approach-to-living-your-best-work-life/
There are further articles and resources to come that will help you on your What Matters to You journey. To be alerted when new content is released, sign up to our regular newsletter, intheKNOW.
Do you want to start What Matters to You conversations with your team? RCVS Knowledge has adapted the IHI framework to create a conversation guide that supports veterinary leaders to introduce the Joy in Work concept to their teams. It includes advice and examples on setting up and continuing conversations with your team to identify any workplace frustrations, identify solutions, and build team engagement and empowerment. Download the What Matters to You – Conversation guide for leaders. [PDF 37KB] (Published February 2022)
References
1. Perlo, J. et al. (2017) IHI White Papers: IHI framework for improving joy in work. [Institute for Healthcare Improvement] [online]. Available from http://www.ihi.org/resources/Pages/IHIWhitePapers/Framework-Improving-Joy-in-Work.aspx