The background The review of and learning from mistakes is important. It could be argued that too much emphasis is afforded to this and that negativity has become pervasive. The vast majority of practitioners dedicate their working lives to providing the best care they can in ways not clearly recognised or encouraged. We feel formal recognition of good practice could be used to encourage excellence.
The aims Cognisant of the potential negative effect of reviewing only failings we designed a tool by which positive events could be recognised.
Formally marking positive practice is not only a useful learning tool but helps propagate clinical excellence at an individual and group level. Furthermore, it has the potential to enhance confidence and morale while providing evidence for formal appraisal.
We call the tool the ‘Favourable Event Reporting Form’ or ‘FERF’.
The methodology A simple reporting form details an individual, a positive event and the perceived learning points. The form allows open-text description and any member of the team could complete one about any other staff member. Forms were submitted for monthly review. The process thereafter consisted of three stages: a letter of recognition from the lead consultant and senior sister; a summary detailing the event and its learning points was prepared for the FERF noticeboard (located so staff, patients and their families could view it) and each individual FERF was discussed at the Risk Forum Meeting.
The results A simple impact analysis was made after a six month pilot. We quantified feedback by category and semi-qualitatively assessed the impact of the FERF concept on attitude and team morale.
The results of this analysis demonstrated an increase in the amount of formal positive feedback being received by all members of the team. Morale has been sustained beyond the pilot and many respondents reported a positive change in their attitudes towards other team members.
While larger scale work is needed to further evaluate FERF as an educational intervention, the extraordinarily positive results from the pilot unequivocally suggest that the concept is worth pursuing. Recognising excellence should become part of everyday practice and appraisal.
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