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Excellence Reporting

The idea is simple, if you see something good happening, submit a report to let the person know their hard work was recognised.

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Following a difficult few months in London, with four major incidents in a short space of time, we felt our staff needed some moral-boosting. This project seemed like the perfect solution. It provides positive feedback, rather than the previous system that encourages ubiquitous negative feedback through incident reporting and identifying error. Traditionally, safety in healthcare has focused on avoiding harm and learning from error; this allows no consideration as to why human performance normally avoids adverse outcomes. 'Learning from Excellence' suggests that by studying excellent practice in healthcare, opportunities can be created for learning and improving staff morale. This is achieved through implementation of reporting systems and 'appreciative inquiry', a root-cause analysis of excellent events. By launching this project, we aimed to boost staff morale and initiate the process of learning from excellence. 

We set up a simple system, with the use of online or paper forms to submit an excellence report. We used a short explainer video, posters and social media to tell people about the project. Our initial challenges were in implementing the project and encouraging staff to submit reports, so we led by example and the Excellence Reporting team started submitting reports to help spread the word; people then started to follow. We distributed the reports, shared themes and anonymous quotes with the department as a whole. 

Between May and September, we have received 85 reports for medical, nursing and administrative staff within and outwith the department. 

We are now focusing on automating the online process and gaining trust-wide involvement. Going forward, we aim to demonstrate increased staff morale and incorporate excellence reporting, and ultimately appreciative inquiry, into our clinical governance structure. 

Idea Title

Excellence Reporting at Chelsea & Westminster Hospital

How the Idea will inspire the experience and expression of gratitude within an organization.

This project creates an easy, quick way for staff to recognise their colleague's contribution at work. Staff receive formal positive feedback, which boosts their morale and can be used in their appraisal portfolio in the future.

Who are you innovating for?

This project will boost morale and allow staff to learn from excellent practice. We would suggest that both will improve patient care in the future.

What type of workplaces are you innovating for?

This project has been developed in the Emergency Department of a National Health Service hospital located in central London (UK), CHelsea & Westminster Hospital. The trust employs approximately 6,000 staff, across 2 sites and looks after nearly 1 million patients per year.

How you envision the Idea being introduced to your selected organization?

At present the project is being led by myself and the Excellence Reporting team in the the Emergency Department. It has been rolled out to the Medical team in the last month. The project involves marketing (i.e. posters, social media) to staff to ensure they are aware and encouraged to submit reports. The reports are then manually collated and distributed. To role out the project to the entire site, trust and beyond, we aim to automate the online process and would love to develop a mobile app that allows users to submit on the go as well as view updates and appreciative inquiries.

What obstacles, if any, do you foresee in implementing this Idea, and how would they be overcome?

Funding this automated process is a challenge - working within the NHS, funding is limited, and at present this project relies on the voluntary work of a few individuals, so would not be possible on a larger scale.

How will you test and prototype your solution?

We are currently piloting the project, as described above. In due course we will survey staff to assess their view of the project.

What immediate next steps will you take if you receive an implementation grant.

We will explore how to automate our process and develop online resources.

At what stage of development is your Idea?

  • Research & Early Testing: You are exploring an idea, gathering inspiration and information needed to test it with real users.
  • Prototyping: You have conducted some small tests or experiments with prospective users and will continue developing idea through these tests.
  • Piloting: You have started to implement your solution as a whole with a first set of real users. You may have started to develop a business model for your idea, including identifying key customer segments, relevant partnerships, go-to-market strategy, and draft financials.

Please describe from where your Idea emerged

We were inspired by Adrian Plunkett's 'Learning from Excellence' Project -

Tell us about yourself

Dr Rachel Stewart - Clinical Fellow (i.e. middle grade doctor) in Emergency Medicine at Chelsea & Westminster Hospital

Where are you / your team located?

Chelsea, London, UK

Please describe your legal and organizational structure

NHS Trust

Company / Organization Name

Chelsea & Westminster Hospital


Tell us about your experience

Lots of experience as a doctor, none with technology!

1 comment

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Hi Rachel,

Great to see you in the Ideas Phase! Is there any chance you could find an image to go along with it? Images help grab attention and tell a story. You should be able to use the Edit Contribution button on the top of your post and follow the instructions to add images from there.

Just a friendly reminder the deadline to update your post is today at 3:00 p.m. Looking forward to seeing more of your inspiring insights on OpenIDEO.