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An Olympic effort … Fab Change Day

Jane Douthwaite, 3rd Year Student Midwife
12 October, 2016

An Olympic effort … Fab Change Day

I loved watching the Olympics in Rio. Waking up to an overcast English morning and switching the TV on and finding the sun rising over Copacabana beach; masses of tourists gathering to have their photos taken next to those five iconic rings in a picture postcard dream setting. Grabbing a quick breakfast and arriving on placement to find colleagues had stayed up into the early hours, still buzzing with excitement at 7am at the ‘Gold’ we won.

The spirit of connectivity, enthusiasm and pride evident to all.

If only we could capture this spirit; this passion and pride - if we could just harness it and throw it full force into our NHS?

The success of our Olympic effort has been linked with Brailsford’s notion of the aggregation of marginal gains. In its’ essence, it sounds simple: breaking the components down into small pieces and improving it by just 1%. The result was a significant increase in effectiveness and performance. Let’s say we could do this within the NHS? Surely we can improve something by just 1%? You may say that 1% wouldn’t be noticeable? Perhaps; perhaps not. But it could be meaningful to someone.

Maybe this works in reverse too and that’s one of the reasons why we sometimes have problems in our NHS - an aggregation of marginal losses? Finding yourself trapped in a place of bad habits and not wanting to embrace changes leading to that slippery slope towards dysfunctional teams and toxic cultures. The sum of many small choices can also lead to these big problems.

I want these small choices we make to be positive ones and I don’t want to focus on 1% as the target number. 1% has got to be the minimum.

This is where I think Fab Change Day fits in: a day of collective action for improvement on Wednesday 19th October 2016. This is a real opportunity to showcase long lasting change coming from the collective commitment of frontline staff in health and social care settings.

Formerly called NHS Change Day, Fab Change Day is a mass movement jointly coordinated by Helen Bevan’s NHS Horizons transformation team and Roy Lilley and Terri Porrett’s Academy of Fab Stuff alongside a group of national improvement leaders called Hubbies (which includes me). Positional power is irrelevant within Fab Change Day - I am in fact a Student Midwife. Yet movements such as this allow each and every one of us to demonstrate the significant difference we can make by simple acts and through coordinated efforts to drive long term and sustainable improvements forward.

There are currently 12 established campaigns running for Fab Change Day 2016. Many of these started on a grassroots level as individual pledges over the last few years and have grown massively across organisational boundaries and are now national campaigns. All change is seen as good and anyone can come up with ideas. 

This year we have a fantastic web based Change Day App – this can be accessed by pressing the ‘big red button’ on https://app.fabchangeday.net/. The app is really easy to use and allows you to create a change pledge that you can share on social media and print. This also means we can keep in touch with you and try and link you up with other people who are working on the same goals.

The other major part of Fab Change day are RCTs - not Randomised Control Trials but Randomised Coffee Trials ! A Randomised Coffee Trial is a simple but powerful idea – you are paired up at random with someone you don’t know and have the opportunity to enjoy a cup of coffee (or tea!) and a chat together. This isn’t about the coffee - the coffee is the enabler to the conversation. We want to break down organisational silos and get people connecting and learning from each other. Conversation is a seriously underestimated tool for learning and change and we believe that a RCT is a way you can build a new network, encourage collaboration and create real connections. We don’t prescribe the topic of the conversation – that part is up to you.

There are three types of Randomised Coffee Trials you could take part in:

  1. Set up your own RCT across your organisation or department
  2. Organise a RCT as part of a meeting or conference
  3. Register online for one of seven National RCT’s (Mental Health, Dementia, Staff Wellbeing, Patient Safety, Home First, Learning and Leading and a specific one for NHS England staff). You will be allocated at random a person to chat with and you can then hold your RCT via telephone or Skype !

Find out about registering for RCTs and download information packs to host your own RCT at http://fabnhsstuff.net/fabchangeday/rct/

I am proud to be a part of Fab Change Day and will be helping and participating in a number of events both on my university campus and within my placement NHS trust.

My placement NHS trust – City Hospitals Sunderland are embracing Fab Change Day this year. We are gathering together and holding a short conference style event where staff can share their stories of change. We will then hold a trust wide RCT and encourage everyone to make a pledge via the Fab Change Day app.

Once the trust wide events come to a close, we will move up to our midwifery department and continue with the fun. We plan to enhance experiential learning with all staff taking part in a ‘Lithotomy Challenge’… our midwives, doctors and HCA’s will lie on a bed in lithotomy with two CTG transducers around their abdomen, a blood pressure cuff around their arm and consider what is might be like to be a woman in this position.

Situations such as this can often be an emergency event, nevertheless we perhaps need to think more about how we could make this experience a little less scary and traumatic for women at this time. We will also launch our ‘Staff Shout Out’ Board (similar to this picture) where staff are encouraged to show their appreciation for each other. I think this could be a really effective morale booster and will raise some smiles.

I attend Northumbria University and we plan to hold a Randomised Coffee Trial at Coach Lane Campus where multidisciplinary health care students and staff will gather together over lunch and take part in interprofessional discussions which get people connecting and learning from each other. There will also be the opportunity for individuals to make a Fab Change Day pledge.

I am quite aware that not everyone likes the suggestion of change and members of staff, especially students can often feel that they don’t have the confidence or courage to put new ideas forward. The changes or pledges for Fab Change Day can be really small ideas, the cumulative effect of these as we spoke about with the Olympics can be massive.

So start small and build your successes. You can make a difference, one pledge at a time.

I now pass the baton onto you… What will you do for Fab Change Day?

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