Projects

Internal quality audits for continuous development

Internal quality audits, as part of an organisation's quality management. Always with the same question: is the work in practice done the way the policy says it is?

The approach is threefold each time: look up what policy, procedures and work instructions lay down; establish what practice shows by talking to the professionals and looking at their daily work with them; and then chart the differences between the two. That is where the valuable information sits. A procedure overtaken by practice, the same policy read in different ways, or agreements nobody knew about? A quality audit can bring almost anything to the surface, which makes it a rich source of organisational improvement.

The audits have run in very different settings:

Each audit ends in a report with findings and an agenda for the period ahead. And because the audits come round year after year, it does not stop at observations: a cycle of continuous improvement takes hold.

The gap between what the manual says and what really happens is a goldmine for improvement.

Research into disturbed working relationships

On one healthcare ward, working relationships had broken down badly. A great deal had been tried already, but nobody could say any more where it had started; everyone had their own solution, and the team was getting nowhere.

An extensive study set out what was really going on. Through confidential conversations with everyone involved, alongside the information the organisation already held, the situation was untangled layer by layer: the trigger, the events that followed, the part played by the division of work and by management, and the patterns that by then were sustaining themselves.

The outcome was not a question of blame but a description of the situation from several perspectives, with practical next steps for improvement. Part of it the ward could resolve itself; senior management had its own duty and responsibility to take up. The report went both to senior management, who for the first time had a properly evidenced picture to steer by, and to the ward, which had specific actions to improve the situation.

From a situation nobody could get out of to a picture that could be talked about.

Workplace mediation cases

Mediation in organisations tends to bring to mind conflict between an employee and their manager, but as mediators we are just as often brought in for disagreements between colleagues.

In every case there is something that needs resolving: misunderstanding, communication that has gone stiff, and difficulty sitting down together and reaching agreements that work for everyone. As mediators we create a safe setting in which people can come to a shared understanding, with respect for each other and each other's experience. That sounds grand, but it starts with small steps every time: sitting down at the same table, listening to each other's story and, in the end, finding some understanding. The aim is not to be proved right or to get your way, but to find openings together for a workable future. Sometimes the outcome is parting ways, but parting with understanding, recognition and respect for one another.

One valuable case involved two healthcare professionals, colleagues, who deeply disagreed about effort and the division of duties, which indirectly affected the care of their patients. As professionals with their hearts in the work, they took part in a series of conversations, managed to listen to each other with respect and to acknowledge where each had been clumsy. Their opinions barely changed, and still they reached workable agreements.

Very different was a case within the HR department of a large company. An employee had been at home for a long time with mental health problems and, after a phased return, was managing to work again. The organisation then wanted to transfer them to a department with a different manager, at which point they dropped out once more. The mediation made clear that the new manager no longer believed the return could work in this organisation and was carrying a great deal of old, negative experience. The shared conclusion was that parting ways fitted better than a transfer. Because the management listened properly, explained itself and offered an apology, the parting still ended on a positive note: the employee found a good new job, helped by their former manager.

Mediation is usually brought in once relationships are already badly strained, but now and then escalation is prevented by talking earlier, with an independent and neutral facilitator. That is known as pre-mediation.

Getting the real conversation going again, before things escalate further.

The same work feels very different in another team

A questionnaire study of employee experience, analysed in depth, revealed large differences in management, culture and working conditions across four comparable teams. Several employees had felt for some time that the situation was unfair, and it went hand in hand with declining enjoyment of work, higher turnover and rising absence in some of the teams. Through the research, employees were heard by management, and many opportunities for improvement came to the table. The quick measures were put in place straight away; one finding was that the board needed to manage in a different way. Policy and procedures have been revised, agreements with employees re-examined, and work is under way on better alignment between the board and middle management.

Research shows why valuable employees leave.