'Capturing experiential learning to inform new ways of team working: the Caversham Integrated Care Project' •• •

The main aim of the Caversham integrated care project is to provide an early preventative service for families and children in need before a crisis point is reached requiring statutory intervention. The project is exploring new ways of working in primary care involving professionals from different agencies in order to address the socio economic determinants of health.

NOTE: All client quotes are in italics

Situation

The Caversham Integrated Care Project is an award- winning health and social care integrated service for children and families based out of the Caversham practice in London, NW5. Sparknow were invited by Camden and Islington Health Action Zone and the Primary Care Trust, to carry out a two phased course of action of first capturing the lessons learned; in order to support and develop the team into the future. As the lead GP said: “..the organisation was suggested to us by the PCT as a way of facilitating a workshop which was in turn a way of facilitating a new team direction and ethos."

The initial request was to help the team understand the lessons they had learned in their first year and specifically to discover and capture the knowledge of a key worker who was about to leave. This was then to be followed by a kick off event when a new social worker had been hired for the team, supporting the team in sharing the knowledge and experiences from the initial project with a view to the new team continuing the good work in an informed and focussed manner.

Intervention

Timelines, process mapping and story were the key techniques used to harvest the experiences of the team and to identify what had worked well and what could be improved from their first year of practice. By using real patient stories Sparknow helped the team to contextualise their knowledge and experience and to keep the patient at the heart of improvement planning.

"Deep down, in a quiet way, this project is beginning to highlight what used to be ‘nursing’"

The team came up with many ideas for improvement and methods for containing the experiences they had from the previous year. This material was all to be held in trust for the next chapter of the team when the new social worker had been hired.

A new social worker was hired in July 2003 and Sparknow were invited to revisit the team in the practice and to help use the work they had done previously to be better prepared and enabled for growing and developing the service. By building on the original engagement the team was able to design and focus the event explicitly on what needed to be done to make the team effective in as short a timeframe as possible: it looked at how the team wanted to be perceived, identifying audiences to take the work on further and looking at streamlining roles and responsibilities for maximum effectiveness.

"It helped pull together how we would sell the project. I think that was one of the workshop objectives suggested by Sparknow, and that was very valuable."

The day was designed so that the Sparknow presence was felt to be minimal and that the team would spend the majority of the experience working together to create new relationships and a new team ethos and vision:

"It felt like it was our day rather than your (Sparknow) day, it was done sensitively and unobtrusively."

Impact

Often with projects of this nature insufficient time and support is given to creating the right foundations from which to launch effective joint teams. The impact being disjointed teams with poor trust and understanding of what individuals can bring to integrated teams. This was addressed by approaching the project in this way and providing resource and time to kick off the team:

“It was a good opportunity for us all to share that knowledge so that we were all starting from the same point and we all knew why we were there."

The importance of creating the right space and environment for productive work was recognised and designed carefully into the day:

“I think it gave some of the quieter members of the team a voice that they might not otherwise have had. It was a safe environment…I learned a lot about people I’d been working alongside with all this time."

One of the key success factors of the engagements was to increase the speed of the learning curve of the new members to get them able to be productive quicker than an unsupported approach, this was achieved:

“I think that helped them to become more effective more quickly than they otherwise would have."

By recognising that it is not just a one off isolated event and that effort is needed to ensure momentum and sustained commitment to change, the use of but physical outputs are just as important. Sparknow created in a set of materials which is still being used and has had the required effect:

“We’ve still got the pack and we’ve since got together and gone through the outcomes of that day. We all have the objective to follow those things through and do refer back to the package that Spark sent us……it was useful."

Would you work with Sparknow again?

“Yes I would. I was very pleased with the way it went."

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