Programme for Directors of Nursing, Assistant Directors of Nursing and Clinical Nurse Managers 3 in the North East Region

from December 2013 – May 2014.

Leadership and Management Development Programme• Specifically designed to meet the needs of Senior Nurse

and Midwife Managers in the HSE North East Region

• Training Needs AnalysisLeadership Development Needs Preferred Model of Delivery of Programme

Training Needs

1. Strategic Systems Thinking

2. Setting and Monitoring Performance Management

3. Leading on Vision and Values

4. Stepping up to the Corporate Agenda

Training Needs continued

5. Empowering and Enabling Leadership Styles

6. Service Initiation and Innovation

7. Resilience and Composure

8. Negotiation, Communication and Influencing Skills

Provider Engagement Process

8 Day Programme December 2013 – May 2014

Co- Design Day

3 Two Day Modules

Celebration Day

Delivery Methods and Tools• Taught Classroom Sessions• Invited expert speakers• Team Working• Team Profiling Tool (TMSDi)• Use of Em/Wave technology for stress

management• Networking Opportunities• Circle Time • Action and Experiential Learning

Delivery Methods Tools Circle TimeConfidential Group Session

Organisational Raid Group of 3 visits an Organisation to look at Culture and Practices

Dragon’s DenPrepared and Presented Business Case to Senior Managers

Key Objectives of the EvaluationTo determine Extent to which the learning outcomes had

been achievedImpact of programme on knowledge and skill

levels of participantsImpact of programme on participant health

and well being Appropriateness of the learning methods used

To inform development of future programmes

Evaluation MethodologyAttendance and Attrition RecordsPOQA QuestionnairesParticipant Feedback from each ModuleFeedback from Presentations of

Participants Learning Service Developments and Initiatives

POQA (Personal and Organisational Quality Assessment) R4 QuestionnairesValidated questionnaire to measure

symptoms of physical and emotional stressBaseline questionnaire completed by

participants in Module 1 (January 2014)Repeat questionnaire on Celebration Day

(May 2014)External Analysis

Participant Feedback at the end of each Module

Feedback on how well the Learning Objectives for each Module were met

Administration and Organisation of the Course (including Venue and Refreshments)

Comments from Participants

Participants LearningWritten Consent from 15 participants to video

record their account of their learning on the Celebration Day

Transcribed verbatimCoded – Open Coding technique Detailed Codes and Categories identified Themes emerged Data and analysis reviewed by external reviewer

Findings – Attrition21 participants began the

Programme Only 1 did not complete Programme

(Attrition rate of 5%) Reason for non completion

(Health problems)

Attendance Overall Attendance rate of 92%

Reasons for non-attendanceIll HealthExtenuating Family Circumstances Exceptional Demand and Pressure in Clinical

Area (small no of cases)

POQA Personal and Organisational Quality Assessment R4

Over the Duration of Programme, participants reported

Emotional Vitality Increased by 13% (p=0.001)

Emotional Stress Decreased by 24% (p =0.001)

Physical Stress Decreased by 25% (p=0.001)

Organisational Stress Decreased by 18% (p=0.001)

Evaluation of Learning Outcomes In almost all cases the Participants rated the Programme

as either “good”, “very good” or “excellent” in helping them achieve Learning Objectives

Elements of all of the originally identified Training Needs were addressed

Some areas more extensively covered than others

Evaluation of Learning Outcomes

Participants - More training needed in area of Coaching

Setting and Monitoring Performance Management- needs further exploration

Programme Organisation and Venue

Administration and management - “very good” or “excellent”

Refreshments – positive comments

Venue – Room 4 in REC was too small

Emergent Themes from Participants’ Presentations of their Learning Areas of substantive learning from the

course

Response to various modalities/methods

Additional outcomes from the programme

Substantive Learning Effective LeadershipStress Management/Building ResilienceCoaching SkillsEffective Team WorkingProvision of Quality and Patient Centred CareBusiness Planning Systems Thinking

Responses to Various Modalities

Dragons’ Den

Initially Challenging /Daunting

“The Dragons Den now that was my idea of Hell”

“the most unpleasant thought you could ever say to anybody”

Dragons’ Den Continued Others

“I really enjoyed it ... I was in my element”

“The Dragon’s Den Project for me was a positive exercise”

Dragons’ Den Continued Opportunity for growth

Sense of pride in what had been achieved

“so I actually think I’ve slayed my Dragon. I’ll be well able if I have to do it a second time round you know “

“I now know that it is possible to work outside your comfort zone and I need that pressure to achieve this”

Response to various modalities

Circle Time“being a bit of an introvert I was challenged

going into the circle but there’s no hiding places in the circle. So I had to just sit tight and eventually come out and say a wee bit.”

“Circle time gave the group a chance to get to know each other”

“tapping into the wisdom of the group”,

“The circle to me was a place where I felt very comfortable and safe”

Heart Math/Em Wave

Difficult to use at first “I have been using the Heart Math regularly ........It allowed me to become focussed and centred before approaching challenging situation”

Reponses to Modalities

Team Profiling - TMSDiTeam Preference

Change in the ways of delegation

Identify areas for growth and development

“Well it did give me an opportunity to identify areas of my own leadership growth”

Response to Modalities Invited Speakers Very positive responses“Shona [Chaib] and Elaine’s [O’Connell] discussion I thought were really really powerful and very Thought Provoking”

“Colleagues in Powerful Positions who Bared their Souls”

Organisational Raid “fantastic”,“a good learning opportunity to see how others worked” Design Day “The inclusion of sponsors and having involvement in the course detail was evident that this course had the participants as drivers of learning and was different”

Response to Modalities

Additional Outcomes Support and Friendship

“The humanity in the room was there to be seen and to behold”

Time for Reflection and Personal Growth

Increasing Self Awareness

Increasing Confidence

Timeliness of the course

Service Initiatives Lean Product Principles to improve Procurement and

Distribution of stores in Louth PCCC

Regional Wound Product Review Group

Appointment of a Palliative Care CNS to acute Hospitals Cavan/Monaghan

Service Initiatives Cont’d.Business case for purchase of a Laser Machine

for prostate surgery has been advanced. (reduce L.O.S. from 4.5 to 1 day)

Appointment of Part Time Activities Co-ordinator in the Care of Older Persons Service in Louth.

ConclusionElements of each the Eight originally identified Learning

Objectives Substantive learning and skills development took part at

individual level Additional Outcomes: Networking, Friendship and

Supports, Personal GrowthContent was appropriate to Adult Learners Good balance of Challenge and SupportDecrease in Physical, Organisational and Emotional StressIncrease in Emotional Buoyancy

Recommendations Future Leadership Programmes

Involve Participants in Programme DesignInclude Experiential and Action Learning

Activities Balance Challenge /SupportOpportunities for Networking Include TMSDi or similarInclude Heart Math/Em Wave or similarInclude POQA Questionnaire or similar

Acknowledgements Nursing and Midwifery Planning and Development Unit

HSE North East

Co-author : Deirdre Mulligan NMPD Director.

External Reviewer: Dr Joan Hanafin