Building a Better Health Service


Values in Action at the Healthcare Masterclass

Values in Action is about collective action by staff right across the health service, starting in the Mid West, to make the values of care, compassion, trust and learning a visible part of what we all do every day. It is a social movement to shape a positive culture – based on our values – in the health service, explained Values in Action lead  Kirsten Connolly at the Leadership Masterclass.

 “We know thousands of staff live the values every day, sometimes they are visible, sometimes they are not. Values in Action is an innovative approach to shaping culture through a peer to peer social movement, led by staff in our services. What is also unique is that we take behaviour-based approach, by translating our values into nine behaviours,” said Kirsten.  “These are the behaviours our champions are demonstrating, having conversations with colleagues about, and spreading so they eventually become the norm in the health service. “Values in Action gives us a common ground to unite us – as one champion said to me, “it’s for ourselves and it’s for our patients”. The aim is to enable better experiences for everyone – staff and patients.” She highlighted the importance of the role the champions are playing on the ground in 
UL Hospital Group and Mid West Community Healthcare.  “Today we have over 300 champions right across the health services in the Mid West. They are from all grades and all disciplines and all professions. And what is really special about our champions is that they have been chosen by their peers. Their colleagues are the ones that nominated them for being the most influential and the most connected people in the health services in the Mid West,” she said. The piloting of the initiative in the Mid West is just the beginning of Values of Action. A team at national level has just been established and the concept was introduced to the wider HSE when it was showcased at the Director General’s recent Leadership Masterclass at the Dublin Convention Centre. “The presentation and panel discussion at the Masterclass was part of the commitment to bringing Values in Action to many other parts of the health service. We are planning to partner with service organisations in order to bring peer to peer led culture change to other parts of the health system,” explained Kirsten.  She revealed that the response to the showcase at the Masterclass has been overwhelmingly positive. The feedback has been that it was authentic, innovative and quite a fresh and different approach. Many people seem to recognise the need for it and that the timing seems right, she said. “Next for Values in Action we will focus on the corporate centre of HSE. We are keen to show that HSE at corporate level can walk the talk and that we are fully committed to improving our culture. We are putting in place a project team to proactively shape the kind of culture we want at a corporate level so watch this space…

View from our Mid West Champions

One of over 180 champions in the Mid West, Ann Coady explained that Values in Action has put a name on the values that most HSE staff already hold. “I probably already had all the values but it certainly focused my behaviour. It has made me focus on the behaviours, on what I do and how I interact with my colleagues and patients,” said Ann, a Senior Speech and Language Therapist in the Derg Centre in Nenagh, Co Tipperary. “It was a validation of the values that I personally hold.”  Cathleen Osborne, a Clinical Nurse Manager 3, Cancer Service in University Hospital Limerick, admitted they have helped her improve her own behaviour in some areas of her work. “There are some that I knew myself that I needed to work on. To help with this, I take one of the nine behaviours on every week and I pay particular attention to that one for the week,” she said.
Champions in the Mid West like Ann and Cathleen are talking to their colleagues about the importance of spreading culture in a way that will make the health service a better
place to work and give patients/service users a better experience. It’s about sharing stories where the behaviours are being seen and talking about their positive impact.
Cathleen admitted that it was ‘very powerful’ and a ‘huge responsibility’ being selected by colleagues as a champion.  “It was such a privilege to know that your colleagues see you as somebody that could influence others,” she said.  The pair took part in the two-day intensive ‘bootcamp’ for champions. Cathleen said it was very powerful that Tony
O’Brien, Colette Cowan and Bernard Gloster were all there to speak about the plans for Values in Action.  “It showed that they were willing to be champions themselves and that gave the whole project a lot of credence,” said Cathleen.  “It was invigorating being there. We talked through behaviours, and shared lots of stories. It was very positive and there was great energy in the room. We were all very like-minded people. I loved the ‘Yes We Can’ attitude in the place.”  Ann added, “The two-day champions day
was very intense but what I loved about it was that it was full of people who were genuinely full of energy. The presentation to us showed that it was a change that was coming from the grass roots up rather than from management down and that was great to see. Everyone in the room was really hungry for change. “The difference with this initiative is that the focus in not on the service users but on the staff, teaching us that we need to look after ourselves and each other.”  And she said she believed Values in Action
was staff empowering themselves “People are beginning to be more aware of their own values and their behaviours. They realise that we have the power to positively
impact things and to influence other people,” she said. “We are taking that power and empowering ourselves. The whole Values in Action project is so empowering. Up until recently, at ground  level people would be constantly focused on waiting times; etc but the management have shown that they are not just supporting  the Values in Action but they are actively endorsing it.  “They are giving the staff permission to look after ourselves and in that way, the person on the waiting list or in the bed is not just a
number, we can treat them holistically. And that is what I love about what the Values in Action is doing for staff in the health service.”
Both champions revealed that becoming a champion has changed the way they behave at work also.  “Since I became a champion, I have become very conscious of my behaviours and whether or not they properly reflect my values. I have also become very conscious of any negativity in the working environment and if I am
contributing to that negativity or if I can do something to challenge it. I have become very good at self-reflection,” said Ann. “I now go out of my way to interact with my
colleagues and check in on them. It is very important that we help each other and pull together as a team.”
Cathleen added, “I try to lead as much as I can. There are people that show the behaviours very well and others that don’t do it so well so I try to talk to those people
and find out what they think about different things and have a chat about it. They do take everything on board.”  As for the future of Values in Action, Cathleen stressed that it was vital that the momentum is kept up. “It is important to link back in with the national project team, to meet regularly and see what others are doing and to keep it very
active and real. It’s very much about viral change. I want it to come full circle – in that somebody tries to recruit me as a champion.  Then I will know that it has gone all the way
around and back again.” Ann explained that locally, her and other champions have done a number of things with Values in Action in mind. “We have gone on group walks, we now do pilates every Tuesday. The champions here in the Derg Centre are planning a launch and have been chatting with people to get their opinions and suggestions on what they would like,” she said. “When I came back from the induction initially people were a bit cynical and I suppose a bit bewildered. They didn’t really know what it was. But they learned very quickly that it wasn’t a lecture – it was a movement. There are things like waiting lists that we can’t change but they have the feeling now that there are things that we can change – how we interact with each other and how we can positively affect the working environment we are in.

View from our Mid-West sponsors

Two of the key drivers behind Values in Action in the Mid West have been Colette Cowan and Bernard Gloster. The CEO of UL Hospital Group and Chief Officer HSE Mid West Community Healthcare threw their weight behind the roll-out of the ground-breaking concept because they believed in its power to change the culture among HSE staff.

“I think in the Mid West we haven’t just helped shape Values in Action, we have created the template for it and broken the ground for staff right across the HSE by coming up with the nine behaviours that underpin our Values in Action,” said Bernard.

 “There was a view that we could road-test a viral change approach and myself and Colette Cowan decided to take it on across the Mid West and not just to any one service entity – it was in the corporate end as well as the hospital groups and CHOs. “We felt it was important to get involved as we trusted the concept of Values in Action. We wanted to take the good behaviours that people use every day in an invisible way and use a method to make it visible and that would influence positively the behaviour of others,” he said. Colette Cowan underlined the importance of Values in Action in the health services in general. 

“The Director General wants to bring back the caring and compassionate nature of professionals. Staff had lost our way a bit in the tough years of the recession and a culture
change was needed so I was delighted to get on board in such an early stage,” explained Colette.  

“It has allowed people a safe environment to talk about the health service and where it is going. From the start, staff reacted so positively to it. When we asked them to nominate champions from their colleagues, over 200 were identified and that was a huge morale boost to these staff members. They felt valued.” Bernard added, “Many of the people weren’t people I would necessarily have identified but the whole point was that they were chosen by their peers, they were seen as the influencers. These champions have taken on the task with huge enthusiasm and have, in turn, brought more champions on board, so it has multiplied.” He highlighted the uniqueness of the Values
in Action concept. “The unique thing about viral change is that it is a pull factor, you are pulling a message up from the ground rather than pushing it down from above, from the management level.”
Colette said that she has immediately seen an impact on the ground in the Mid West. “The main difference has been the change in culture. Staff are feeling empowered to do
extra things, things out of the ordinary, out of the normal routine, in their work to make things better for themselves, their colleagues and the service user. Values in Action has given them the confidence and the courage to speak up on things they feel need to be changed or addressed,” she said. “I think Values in Action is transforming every
level of the health service here in the Mid West.  We have always believed in these values but now the behaviours that reflect those values are more visual, they are a key factor in all aspects of our work. It reminds us all the time about those values and how we can show them. “It has certainly transformed how I do my job. Now as part of my executive management team agenda, each item on it must have a clear action linked to our Values in Action. We don’t move on anything unless that box is ticked. It
helps to keep it at the forefront of our minds. “The future of the project is through our champions and identifying more and more people that can actively work to embody
the values of the HSE. It is continuing the movement across the health service,” concluded Colette. “It is important to note that these values have always been here, we didn’t make our staff adopt these values but we just made them more visible in a very clear way,” added Bernard.