A new way of doing things

We are in a digital age, so it is about time we got risk practice and training out of an analogue world. By this I don't mean more forms to be filling in, I am offering a new opportunity for how practitioners are supported in going about day-to-day best practice. The software packages for documenting and auditing information will remain, but I believe they do little for informing and guiding best practice, focusing as they do on documenting the administrative requirements of an organisation's approach to risk assessment.

We can now enable practitioners to access resources that will inform and guide their practice direct to smartphones, tablets or laptops. I have distilled my 30+ years of experience and 60+ publications into an online 'Positive Risk-Taking Membership Site'. Brief training videos, detailed presentations, audio podcasts, practice checklists, tools and handouts are structured into 5 modules, with an on-going wealth of bonus resources being constantly added. The modules can be worked through sequentially as training materials, or randomly dipped into for specific information. And instant access to a free training webinar introduces these resources by clicking the following link:

https://app.webinarjam.net/register/21360/99e6026a97  

Risk Decision-Making

Positive Risk-Taking: From Rhetoric to Reality.

You've heard the words, but do you know with clarity what they mean? Do you confidently put it into practice?

I solve these questions.

Practitioners, teams and organisations frequently engage with bureaucratic solutions to the practical challenges of identifying and managing risks; but spend less time on the realities of making good risk decisions and taking risks appropriately.

I provide a variety of training resources and solutions to meet these challenges. Check out my free training webinar at:

https://app.webinarjam.net/register/21360/99e6026a97

Creative Best Practice (a four-part trilogy!?)

Working as a case manager I am fully aware of the importance of skillful care coordination for the most successful clinical and social outcomes for people needing health and social care services. This is also why I published 'The Art of Coordinating Care' in 2009, to promote a values-based approach to the creative thinking required in this role.

Contact with different types of teams reinforces my appreciation of the need to carefully consider how we assess, manage and take risks for positive outcomes... in our own lives as well as our work with others. This is also why I published 'Risk Decision-Making' in 2013 as guidance for promoting best practice in making carefully reasoned and defensible risk decisions.

Working with people in teams, in organisations, and with those in need of services has reinforced my long-standing belief in the importance of developing strengths rather than overly focusing on fixing weaknesses. This is also why I published 'Working with Strengths' in 2014 to draw together the evidence, influences and guidance for keeping us focused on excellence rather than driving mediocrity. 

The weekly podcast show 'The Strengths Revolution' commenced in April 2014 to reinforce all of the above messages about genuine strengths-based person-centred ways of working and being. Creative coaching and practice development is also available through the Practice Based Evidence consultancy.

Playing with numbers

I am often mindful of the need to criticize the quality of leadership and management in health and social care services; particularly the obsession with numbers, the tick-box mentality, and the blind faith placed in targets for driving change and daily practice across services. I am surely not a lone voice in this critique, but is it valid or just a reaction against the sound of the pips squeaking?

I do believe that an absence of targets or defined outcomes, and a failure to establish high standards for provision of services only leads to inconsistencies between practitioners and teams… what is often referred to as a postcode lottery. Service users don’t deserve to be on the receiving end of either stressed out practitioners fearful of constant criticism, or laid-back practitioners doing their own thing. Audit and regulation have a place, but surely they need to be clearly joined up to practice, not existing in a vacuum somewhat disconnected from the realities within which good practice has to operate.

The ever-growing chasm between person-centred practice and business-focused managerialism does little to promote a culture of organizational collaboration that may encourage a more engaging form of audit and regulation across services. My solution would be to eliminate most of the current audit requirements imposed on practitioners and teams, particularly that which they experience as wholly time-consuming and unhelpful. So far so good, say the practitioners amongst you; please do share your thoughts, but read on before you do…

Over the last 12 years, through the Practice Based Evidence initiative, I have been developing tools designed specifically for use by practitioners and teams. These tools have flexible uses: personal reflection, individual supervision, team development and team evaluation. Used diligently they should be able to provide a host of qualitative and quantitative data, which in turn should offer useful feedback to practitioners and teams for practice development purposes. The Risk Decision-Making publication includes examples of these tools, and a specific example of data emerging from their use in a specific organization to help identify good practice and priorities for further development.

So, the sting in this tail is that practitioners and teams need to own the processes of audit and regulation if they are to reflect and develop good practice. For those auditors and managers fearful of losing their jobs if Practice Based Evidence emerged as the norm, you could always make use of the data to tick your boxes; better still, you could prioritise your time more effectively by getting in and alongside practitioners and teams to support a quality revolution. You might then be in a stronger position to challenge and inform the thinking of the inter-galactic warlords from distant planets a.k.a. commissioners, Department of Health, Care Quality Commission…

These are just a few thoughts I am passing on as I reflect on years of connections with so many people who are desperately trying to do good work despite rather than because of their masters. Do feel free to offer your thoughts and ideas (with an accompanying dictionary from those of you who find ordinary language an alien concept… with all due respect to the demands of the Plain Language Association).

Risk and Leadership

Leadership is often lacking, and management is all too often to the fore where considerations of risk are concerned in health and social care agencies. In this scenario fear and back-covering hold the attention, while good practice is presented as an unconvincing façade. Managers strangely play down any questions about excessive bureaucracy while still demanding all the paperwork is completed as the primary target. If something goes wrong it is the paperwork that gets sole attention, and real practice considerations are relegated to a place somewhere to the right of obscurity.

'Good paperwork is a sign of good practice' becomes the convenient smokescreen. This would be true if there was less management and more supportive leadership, as the need for paperwork would be put into perspective: as the essential minimum to support good practice not to hinder it. Good tools are a range of checklists and formats that have been shaped by good practice, and thus they are able to guide and prompt firstly, and capture good practice as a secondary function.

The Risk Decision-Making publication is the update of 17 years of working with individual practitioners and teams across countless organisations, both from within the Sainsbury Centre for Mental Health initially and through the Practice Based Evidence consultancy since 2001. The tools and guidance are informed by what we know from the national and international research, but more significantly through the practice based evidence of hundreds of practitioners across all disciplines and service sectors. Most importantly, this publication refocuses the attention on risk as everyone’s business; so it is structured throughout to address issues from the perspective of individual’s, teams and the leadership & management of organisations. Whatever systems your leaders have bought or put into place there is still a role for guidance on best practice, so look no further.