Can you evaluate your communications whilst still in the eye of a crisis and with resources stretched like never before? Yes, and here’s how…
by Amanda Nash
Communicators up and down the country, particularly those in the NHS and public sector, could be forgiven for feeling a little, well, jaded right now. It’s been an intense three months. There have been plenty of long days, nights and weekends. It’s intellectually and emotionally exhausting being simultaneously in response and creative mode for so long. The last thing on our minds is looking back, learning and introducing yet more change within our own practice.
Our natural elasticity is to spring back to what is known and comfortable. It’s a human response. Change is hard and while a little alteration keeps things fresh and exciting, we take comfort in the known – it’s less threatening and demanding on our brainpower.[i]
Inertia to change is a strong force. Throw into the mix a global pandemic and everything changing at the speed of the latest government graphic around us – the last thing we want to do as communicators is toss a bit more novelty into the mix.
Yet, if we are, to Emerge Stronger with a new <-2m-> normal, as we have branded our restoration programme in our organisation, we have to pause, reflect and learn.
At University Hospitals Plymouth NHS Trust, as a Communications Team we are working hand-in-hand with our colleagues in Learning and Organisational Development to run a deep reflection and learning programme. At a corporate level this involves using a PULSE survey, small virtual drop-in meetings and the sharing of personal stories and experiences of COVID-19, among other things. At a department level, it’s about encouraging teams to reflect together on what has happened, think about what they want to take forward from this pandemic, what they want to stop and what adjust.
While we hope the learning will be rich and informative, the process itself is both therapeutic and regenerative. Allowing people time to talk, share their different experiences and look back on what, for some, may have been quite a traumatic experience is part of recovery and moving on. It allows us to reconnect with ourselves and others.
Of course, as a Communications Teams, we should be doing this already within our own teams. It’s been a time of frenetic activity. There’s much learning to be mined. Taking stock, looking at what has worked, what hasn’t - it’s the dreaded E word: Evaluation.
I wonder why evaluation strikes fear into us and why we’re not proudly sharing our good practice and learning from this time. For me at least, there’s a sense that we can’t quite capture the impact of what we do. Therefore any data we produce (be it qualitative or quantitative) doesn’t quite do justice to our work. There’s also real skill in areas such as gaining insight and analysing it using statistical techniques and thematic analysis. I think this can sometimes put us off trying. But until we do this systematically we will always struggle to demonstrate value.
I wrote back in April about Why Communications is an essential service and acknowledged at the time that evaluation kept slipping to the right-hand side of our agile board – forever to do. But, with input from everyone in our team, and some sheer determination on my part to crack it one weekend, we have had a good go. Last week it was presented to our Board. It’s not perfect, it doesn’t slide as nicely onto the AMEC framework as I would like but it gives us some sense of what we did, what has worked well and where future improvement may lie.
For us as a small team, it’s also been hugely rewarding to pause, reflect on what we’ve done, and the impact it has made. I think it has helped us make sense of this period in a meaningful way as professionals and that has made me see evaluation in a new light. Evaluation, after all, is essentially about pausing, reflecting and making an assessment about the value of something. So here is a sample from our full evaluation:
If we look back to our objectives at the start of the pandemic, when we were in Crisis Communications mode, they would fall broadly into the below categories. We didn’t write them down or plan them out in detail, we didn’t have time. Instead we worked in a deliberately agile way. But our ongoing relationship management work meant we knew which stakeholders we were looking to communicate with and where our priorities lay.
Focus on constant communications in a time of threat:
Information and reassurance for staff and responding to their questions and issues
Supporting communications between patients and families
Reassurance and education for patients and public
Explanation and invite to co-operation for GPs and partners
Link with other organisations in Plymouth to share key messages and amplify voice
Mapping our activity between April and May against these objectives, I have picked out just a few examples from our full evaluation to look at the impact we have made:
Objective 1: Information and reassurance for staff and responding to questions
We produced comprehensive daily bulletins covering everything from how to don and doff PPE through staff wellbeing information to heart-warming personal stories and uplifting news coverage. Comments back from staff on these give a sense of how they were received:
And a special thank you for the remarkable seemingly 24/7 job you do of keeping social media, the press and Derriford all where they should be. I really do value the work you do. I'm sure I feel more proud of the Trust than I would because of all the great press you ensure we get
As Syeeda wrote in her blog piece entitled Ramadan, COVID and Me “receiving constant reassurance from the Trust and receiving daily updates about COVID has been very helpful”.
In the PULSE survey for staff, one of the questions asked was about communications. We have 8,663 staff. 1,800 staff responded to the survey, of which 87% agreed with the statement: “I am receiving timely communications about the Trust’s response.”
We were a bit blown away by this. To put this into context, in last year’s Staff Survey less than half (42%) of staff respondents agreed that communication between senior management and staff was effective.
We have worked hard to help staff tell their stories and share their experiences. We used our blog site for this. As Wadds wrote - stories matter.
“Stories is what the brain does. It is a ‘story processor’, writes the psychologist Professor Jonathan Haidt not a ‘logic processor’[i] – as author Will Storr argues. Stories are how we give meaning to events and they are a way to understand and connect with our colleagues and, in our case, our patients.
During April and May we told 15 staff stories. These have been shared both in our daily bulletins for staff and on our blog site, which was visited by 4,121 unique visitors during the final two days of April and throughout May. The response from staff has been overwhelmingly positive including comments such as “more of the same please”. We have helped staff create and share their words and video diaries in a way others can connect with. I challenge you to watch Becky’s video diary and not find something in your eye.
We have run three all-staff briefings with questions (April – June) attended by 856 staff. This far outstrips any face-to-face briefing we have ever done.
Without our team filming 40+ videos to enable virtual induction, it would not have been possible for 415 new staff to have undergone their induction and start work in our organisation.
Our online Support Hub offering psychological, practical, physical and professional support and signposting on to other sources of support, received 12,352 page views across April and May, whilst our online Advice and FAQ resource drew in 74,917 views across the same time period.
Of course, context is king - a global pandemic produces a threat state which turns people into information-seekers. It would be difficult to replicate this in more normal times. But initial analysis of the themes of the qualitative comments received through the PULSE survey finds that staff appreciate:
· Regular communication from senior management, in particular their visibility and openness
· Improved communication within teams and between departments and
· the sense of being part of a bigger Trust team with a clear, common purpose
· A number of staff commented that they like the virtual briefings and wish them to continue post COVID
Our learning for improvement includes: a need to move away from a reliance on email for all staff communication (we are moving to App and closed Facebook group to complement) and we wish we had captured all the staff questions we have responded to. We did use these to drive content but an ongoing curation of issues log would have been a useful learning tool in hindsight. We did do this for junior doctors who we met with several times per week alongside one of our Deputy Medical Directors. But we could have done this more systematically.
Objective 2: Supporting communications between patients and families
For our second objective, we have found the impact in this area really moving as a team, including:
We set up a ‘Send your loved one a message’ online scheme which began on 8 April. Between then and the end of May, 1,575 messages had been sent to patients electronically which were then turned into real cards and delivered to the wards. As well as enabling this technically, designing the cards and implementing the scheme on a daily basis, we hand-delivered the cards. My colleague Christian in our team collated some of the comments received from families about the scheme:
o “Thank you Derriford for the FANTASTIC work you do year round and specially now. It is a matter of pride for all the SW and everyone is part of a well knit team. This send a message service is just a small example of your caring and thoughtful attitude.”
o “I think that this is a lovely idea especially when patients cannot have any visitors due to the corona virus and it lets them know that they have not been forgotten.”
o “This is a beautiful and kind way to help us send messages to our loved ones in hospital. Thank you.”
o “This is an absolutely brilliant idea.”
o “Such a lovely idea, thank you!”
We have supported the set-up of video consultations – technically on our website and we also run the insight group with Patient Experience colleagues to make sure we learn from patients and clinical staff about the benefits and limitations of this type of consultation. This learning will help inform the shape of our future outpatient programme. By the end of May, 1,665 video consultations had been undertaken – appointments that otherwise would likely have not happened as only urgent appointments were being undertaken face-to-face. The surveys are currently up and running and we are waiting for a response rate that we can have confidence in before analysing.
Working with colleagues in Patient Services and IM&T, we have set up 20+ iPads on our wards for patients to communicate with their families. Some of the feedback on the difference these have made, particularly to patients at the end of life, have been emotional to read. Becky’s video diary gives a sense of this – shared with the permission of the family in question.
We are now working with our nursing and patient experience colleagues to look at how we safely reintroduce visiting and communicate that effectively to families.
Learning points include – we should have gone bigger, earlier with the iPads. The rate limiting factor wasn’t hardware, it was having sufficient email addresses to set up Zoom accounts.
Objective 3: Reassurance and education for patients and public
We have driven 284 items of news coverage of which 70% were significantly or marginally positive.
We have created 588 social media posts and our engagement rate was up by an average of 739% across our three main accounts (Facebook, Twitter and Instagram). Average inbound sentiment was 65%. This was our most popular tweet across April and May – posted one Friday evening.
We produced eight public information videos in April and May. An example of this was when we moved the minors section of our main Emergency Department off-site to another hospital and, in the light of reduced numbers of people with conditions such as heart attacks attending as emergencies, we created content to reassure people our hospital was safe to return to in an emergency with the #WeAreHereforYou message. Our video and information received:
1.1k views on Youtube
108.7k reach on Facebook with 10.2k post clicks
3.2k reactions, shares and clicks
2031 views on website
3,213 impressions on Twitter
We also undertook media work with local BBC and newspapers. If we look at our discharge from Emergency figures, this work coincides with the early start of a return to normal-level attendance rates.
These are just a few examples of what we have done against three of our objectives and the difference we can demonstrate this work has made. I am hugely proud of my small team (circa 8WTE) who have shown flexibility and resilience beyond anything I had a right to expect. They are superbly capable and compassionate and that has shone through during this period. I would like to publicly thank them.
But we are also a great example of a bigger multi-disciplinary tea – we work hand-in-hand on so many joint projects with excellent colleagues in HR & OD; Patient Services, clinical colleagues, IM&T and so on. Without them, we wouldn’t have been able to co-deliver any of this. We are part of a much bigger #1BigTeam as we refer to it in Plymouth.
Our overall learning from our full evaluation includes a need to move away from a reliance on email for all staff communication, that virtual briefings and consultations have a role and benefit extending beyond pandemic periods and we need to understand the benefits and scope of these, that the growth and demand for video storytelling is considerable and a reminder that sharing people’s stories always matters.
After all, what these socially-distanced times have reminded of us - sometimes in a painful way - is the importance of our fundamental need to feel connection with others[i].
Amanda Nash, MCIPR, is head of communications at Plymouth Hospitals NHS Trust. You can say hello on Twitter at @manickmanda
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Image via Mike Cohen
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[1] Scarlett, H. (2016) Neuroscience for organizational change: An evidence-based practical guide to managing change. London, England: Kogan Page.
[2] Storr, W (2019) The Science of Storytelling. London, England: William Collins
[3] Lieberman, M (2015) Social: Why our brains are wired to connect. Oxford, England. Oxford University Press
