TRAINING
Inside every adult is a child Psychologically, inside every adult is a child, and no matter how logical, reasonable, rational, and grown-up they think they are, if they disliked the schooling they received, it creates an inner turmoil that unknowingly is out of their control. This triggers a barrier that refuses to engage properly. ‘Dumping information’ with the expectation that they will learn will not be appreciated, or indeed change their professional behaviour in the long term. To achieve sustainable improvements within training and education strategies, understanding and appreciating the different levels of human development, while purposefully involving people in the process of their own personal and professional growth, is fundamental. In 2017 I gave a talk at the Central Sterilising Club conference called, ‘Let’s change and improve practice; Rethink the training strategy in 6 steps’, inspired from having observed some of the same mistakes, problems, and challenges, being reported during my 30 years working in the world of water, decontamination, and infection prevention and control in healthcare, and 13 years’ CSC membership.
Reference book
I had also co-written a chapter around water, published in the reference book, Decontamination in Hospitals and Healthcare 1st Edition.5
became apparent as to why practices Three key factors
Figure 1: Factors working for and against current operating procedures.
hadn’t appeared to have significantly or sustainably improved: n The new generation of employees was not staying, or encouraged to stay, longer than three years in their respective roles. This led to high staff turnovers, and leaders feeling that they were investing in people’s training for them to simply leave and take their knowledge elsewhere. One of the consequences has been to minimise
investment losses through the creation of the short-term generic ‘train everyone’ solutions.
n Reliance on equipment suppliers to provide ‘training’ as part of the product /service supply package, without checking who is training their trainer, and their competency in training skills and subject knowledge.
n A shift in training approaches, using e-learning as the initial means of raising awareness of the subject. Delivering information in a linear format, culminating in a test, does not improve practice. This instructional knowledge- based e-learning requires the use of short-term memory to retain information. To embed new practice or change behaviour (which both require long-term memory) requires problem- solving through scenario-based e- learning.
If we apply the concept of the ‘Chain of Infection’ to the ‘Chain of Repeated Mistakes’, how do you break the chain and create quality improvements and practice change that are both sustainable and easy to transfer to new team members? The principles of quality improvement are like those of infection prevention and control, in that there is a set of standard actions/procedures that should be applied every time there is a ‘performance’ challenge.
Figure 2: The seven ‘key steps’ to moving from an organisation-led to a worker-centred approach.
68 Health Estate Journal October 2019
Measurably improving performance If the principles are understood and worked consistently, performance will measurably improve. The tricky bit is that the actions/procedures rely on people engagement and human behaviours in the given situation. To break the chain of repeated mistakes and make progress, one needs to start with the identification
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