I really wanted to work for the health system in Ireland because the Sláintecare principles are a great summary of learning around ensuring health and wellbeing of the communities we are privileged to serve and because I have personal affinity with the HSE values of Care, Compassion, Learning and Trust. By Dr Andy Phillips, REO HSE SW,
I had been developing and practising mindful kindness for some time and this is linked with, but not the same, as Compassion. As the leader, coming in to take accountability for HSE South West, integrating a number of different organisations, I considered that my highest priority was to ensure that together we designed ‘the way we do things round here’ – the organisational culture. So far, the leaders of HSE SW have drafted a set of commitments, that if lived, will ensure that our community feels proud of their health service.
Coming into the REO role, I knew that I needed to live the value of compassion, to listen with fascination, to the community, staff, stakeholders such as the HSE Board, Department of Health staff, politicians and Government.
The first part of this was to be compassionate to myself, understanding that coming into a new system I’d make mistakes, and whilst being determined to learn from success and failure, being kind, encouraging and understanding to myself, whilst acknowledging that having shortcomings and failures are experiences shared by everyone in leadership positions. So, of course, some things have gone wrong and I’ve felt bad about these but I’ve been able to use this as motivation to continually improve my leadership.
Practising compassionate leadership as ‘the way we do things round here,’ is particularly important to me as I wanted to ensure staff experience a compassionate working environment, a place of psychological safety. Of course, I want staff to be highly engaged and motivated and at the same time I wanted staff to be able to hold themselves to account for performance including tackling ‘wicked problems’ which otherwise might be avoided or hidden.
By establishing a culture of compassion I wanted to ensure accountability and management of performance challenges by setting the collective responsibility of teams for solving them. This collective leadership and accountability promote a culture of learning, where appropriate risk-taking is encouraged and we can continuously innovate.
As somebody who is attracted to working long hours, I knew from my coach that a personal challenge coming into the role was ensuring that I spent enough time on my own and my family wellbeing. I’m aware of my negative impact on others from spending too many hours at work and whereas we need to move to working 5/7, this definitely doesn’t mean 7/7. So, I need to keep working on my role modelling to be a better leader and supporting others to be good leaders whilst we establish working over 7 days. (where Saturday and Sunday are considered normal working days).
For me, compassionate leadership is not at all about fluffy, heartwarming statements, it’s about putting in place good management processes such as making certain that everyone is clear about their role, accountabilities and responsibilities.
In compassionate cultures it is accepted that there will be disagreement and conflict but the key is that these are resolved amicably and with the intended outcome that relationships are preserved or strengthened. Over many years and through working in many different cultures around the world I’ve learned the critical importance of building and sustaining strong, trusting relationships by careful listening and understanding the perspectives that people bring to the conversation. Many years ago my Myers-Briggs type was INTJ and the prayer for this is ‘Lord keep me open to others ideas, WRONG though they may be. Through practising mindfulness I’ve learned to really listen to other people rather than waiting my turn to speak. In this way I’ve worked hard on empathising with and supporting colleagues with the intention that they will feel valued, respected and cared for.
Of course, in building trusting relationships, a big part of my work is ensuring that all staff are able to make their best contribution, so I actively support people in their work and in their career development. Sometimes there are very difficult conversations where my assessment is that people may not be suited to a particular type of work, or may not be ready for promotion. These are the most challenging conversations in which it is easier to be ‘nice’ than to be compassionate.
Each day, I seek to empathise with colleagues and seek to understand the challenges they face both in their personal and working lives, committing to supporting people to cope with and respond successfully to work challenges. I find that an easy and powerful behaviour is to value and commend the positive behaviours I see, using the ABC of appreciation. This is describing the Action – what they did or said, the Benefit – the positive impact it had and asking them to please Continue doing this. Another important practice is to provide constructive feedback on negative performance. I use the BUILD model to do this by Describing Behaviour, making Observations not judgements, Understanding context, Describing Impact on the work, Listening to what was happening for them and asking what they might do Differently.
There’s a Japanese concept of ‘ikigai’, meaning a reason for being and this is related to the ‘psychological contract’ we have with healthcare staff. This means reinforcing through the work environment, processes and culture, the reasons for people choosing to work in healthcare and ensuring that they continue to thrive in their work. When pushed for time, I feel the temptation to stop ‘listening with fascination’ and instead thinking that in myself I have all the answers and that if everyone would just do what I tell them then we’d all be better off. Many embarrassing experiences have shown that it is much more effective instead to engage with the people with whom I work, with curiosity, to find shared solutions to challenges. I have learnt that by demonstrating these behaviours, this creates a compassionate and collective culture which results in improved care and better outcomes for patients.
By publicly signing the Compassionate Leadership Pledge, captured in a video on YouTube, I was inviting staff and community to hold me personally to account for developing and modelling compassionate leadership and creating a compassionate and collective culture within HSE South West.
