27 November 2018

Making things better for junior doctors: can an app really increase Joy in Work?

Alana Ahmet, junior doctor and psychiatric trainee at North East London NHS Foundation Trust

Alana reflects on what makes us happy at work and what can be done to improve the workplace happiness of staff in the NHS.

Am I happy at work? Honestly: about 50% of the time. But why? As a junior member of the medical workforce I am acutely aware of the pressures that working the the NHS comes with. I work long hours, in a profession with limited resources. It is well recognised that some of the solutions to this can only be implemented at a national level: these take time and are often bound in red tape. Often underestimated are the locally implemented ‘quick wins’, which can help to improve the morale of today’s doctors and in turn encourage tomorrow doctors to continue or commence training.

Let me introduce ImproveWell, the subject of my post. ImproveWell is an employee engagement app that asks its users: how is work today? What is it that needs improvement? How can we make this better? With three simple reflective questions NELFT’s junior doctors found that the barriers to changing practice were broken down, unknown problems were brought to light and, as importantly, the sentiment and morale of those using the app improved.

At NELFT we have an active ‘you said: we did’ initiative led by our CEO. NELFT’s Medical Education team applied to be part of the ImproveWell pilot run by UCLPartners to expand on its already impressive QI programme, which chimes well with the ImproveWell ethos. We were successful in our application and all junior doctors were encouraged to download the ImproveWell app to their smartphones. To aid with adoption, there was a competition to see who could submit the most ideas via the app with a £50 voucher prize. We felt that it was a good idea to incentivise staff to start using the app to get the ball rolling.

The app is simple to use. The ‘share your idea’ button leads you to a form that you can fill in with the theme of your idea and a space for your idea itself. There’s also an ‘improvements underway’ button where you can see ideas that have been picked up already; an area to keep track of your submitted ideas; and then a messaging feature so you can converse with the team management. There is a ‘good day measure’ where you can simply answer the question ‘have you had a good day?’ and reply ‘mostly yes’ or ‘mostly no’. There are further features to track your happiness which is a really simple way to see just how content you really are in your job. During the pilot, team leads issued certificates to junior doctors who made suggestions to put in their portfolios.

Many great ideas were submitted during the pilot. All ideas were responded to and most were implemented. A poignant example of an implemented idea was a request for additional training opportunities for Foundation (FY) doctors, submitted by a Foundation year one doctor. He was concerned that the FY doctors gained limited experience of psychiatric specialties during their four-month rotations (FY1 doctors rotate through three or four jobs in different hospital specialties.) Following his suggestion that this needed to be addressed, a formal psychiatric taster day option has been put in place at NELFT whereby FY doctors can spend 1 day per month in different jobs related to psychiatry: a cost-free solution which improved the Foundation doctors’ experience and training opportunities.

After being involved with the pilot project of ImproveWell at NEFLT over the past twelve months, I want to share with you some of my thoughts about how we can encourage the entire workforce to make small changes to change their lives. Don’t get me wrong, ImproveWell did not make everyone jump for joy. But when used well, ImproveWell proved to be a useful tool for bridging the gap between problems and solutions; it helped to validate the concerns of junior doctors and equip them with the tools to move forward with solutions. ImproveWell gave junior doctors a platform to raise their concerns at any time, day or night, and know that these concerns were being heard by the right people. The app was a way of breaking down the barriers to reporting difficulties which otherwise may not have been heard. This not only empowered the doctors but also helped with the feeling of being respected.

I will leave the post with the concept of positive wellbeing: not merely being satisfied by lack of negative sentiment at work but striving for something greater. Is ImproveWell the answer to workplace happiness? I do not think that a single app is the answer to all the problems junior doctors face, but I do think that we are a strong cohort of doctors who know our jobs and know what can be done to make them better and ImproveWell gave us a platform to have our concerns, ideas and suggestions heard.

 

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