Building a Better Health Service


How the nine Values in Action behaviours were developed

Colleagues have described the behaviours  as ‘straight forward’, ‘not necessarily new’, ‘things you can easily do’ and that’s exactly what we had hoped for when we began to develop the behaviours in June 2016. Four members of the Mid West Values in Action project team were tasked with researching, developing and testing a set of behaviours that would be integral to creating an environment where people can see and feel the values in action. You’re probably wondering why behaviours are so important.

Why behaviours are so important.

Behaviours are something people do, they are concrete and visible. People understand what is meant by them and importantly, people can copy them; shaping new ‘norms’. Values in Action is based on the belief that real sustainable culture change is shaped by the behaviours of influential individuals at all levels across the organisation.

We all talk about ‘our aims and objectives’, ‘our vision and mission’ or ‘the outcomes we want to see’ but oddly enough behaviours don’t come up as often in conversations. Focusing our attention on behaviours was something new and different. The HSE values of care, compassion, trust and learning are important words but sometimes they are just words on a wall. What do they mean to people? and How do we know we are living these values?
We needed to translate these words or values into behaviours that people could easily adopt.
That was definitely easier said than done.

Research, research, research

‘Research’ was the word of the day, week, month, as we got stuck into reviewing staff, patient and service user surveys, strategies and policies, and direct engagements and complaints. Much of what we found were issues that could be worked on or fixed such as how we communicate with patients and service users. Patients often felt their interactions with staff were transactional rather than person centred and that they were not kept informed of what was happening with their care.

Another recurring issue that came up was around a lack of awareness of how our actions or stress levels can impact on how patients and service users feel and experience the health service. This resulted in patients feeling anxious and vulnerable.  On the flip side, patients and service users acknowledged when staff went above and beyond for them and the lasting impression this had.  We used these insights as the starting point for our next phase. We had a large whiteboard with a colourful array of words and insights representing staff, patient and service users’ experiences. What we called our ‘Shopping list’. To get a clearer picture we started to categorise these insights into groups and so the ‘Shopping list’ became more organised. The insights soon reflected our interactions with patients and service users, our interactions with each other as colleagues and how we behave as individuals.

After many meetings and calls the team had developed 9 behaviours that reflect the three dimensions in our working lives – the personal dimension, the colleague’s dimensions and the patient and service user dimension. We brought this first set of behaviours to the project team for their input. The project team is made up of colleagues from UL Hospitals Group and Mid West Community Healthcare, National HR, Communications, Quality Improvement Divisions and the Programme for Health Service Improvement. With such diverse backgrounds and disciplines, their feedback was hugely helpful in refining the behaviours even further.

 One question we are asked is why some behaviours are statements and some are questions.  The use of questions prompts us to take some time to reflect. This can often be neglected but it’s very important. You may also have wondered why there are three dimensions and three behaviours under each dimension. Simply put, 3+3+3 is pattern that is well recognised and memorable.

 Testing the behaviours

Our next job was to sense check the behaviours with staff and patients and service users, identify if there were any gaps and to check if the behaviours delivered the intended outcome for patients and staff. We held three focus groups, two with staff and one with patients and service user representatives. We presented the suggested behaviours to the groups and asked them a range of questions like, Do these behaviours make sense to you, do you understand them? Do you think these behaviours are relevant to a healthcare setting?

Do they make sense in your workplace? We also asked the groups to consider examples of where the behaviours could be demonstrated. For the patients and service user group we asked them if the thought the behaviours would make a difference to their care.

Behaviours grid

Behaviours booklet

However our work wasn’t quite finished! We wanted to ensure that there was no ambiguity around the behaviours. So we set about providing some context to the  Behaviours, providing examples and suggestions of where and how they could be used. We developed these further into a handy Behaviours Booklet which is provided to new champions when they attend Bootcamp. The behaviours were further tested when Values in Action moved from the Mid West to a national roll out. The behaviours were reviewed to ensure that they universally appropriate for Health Service staff.  Our behaviours are best summed up by Katherine Considine,

“It doesn’t matter whether you are in admin or on the frontline, whether you are sweeping the floors or running the organisation, everyone can adopt these behaviours easily through self-reflection and contribute to improving experiences for staff and clients on a daily basis".

Elaine Connolly Communications Manager, UL Hospitals Group @elainconnolly
Roisin Guiry Communications Division @roisinguiry