A service evaluation comparing the effects of pre-hospital anti-thrombotics to heparin on disease severity and mortality in hospitalised COVID-19 patients

Appreciative inquiry (AI) is a powerful philosophy and change management technique that centres on an asset-based model It seeks to explore why successes occur (Safety 2) rather than a deficit-based model that focusses on why mistakes occur (Safety 1) Safety 2 compliments Safety 1 by focussing the healthcare lens on what works well, and recently, formed part of the National Patient Safety Strategy [1] Too often, we seek to improve teams by understanding how they have failed This project used the written word to understand the core qualities that our staff display and their successes to build stronger teams Methods Using AI, we collated cross-departmental feedback on the positive aspects of work in the NHS during the COVID-19 pandemic At a time when teams were overwhelmed by online communication, we created a poster with a user-friendly post-it note interface and asked for responses to one of two statements: 'I am grateful for ' and 'I am proud of ' The main aim of this project was to identify each team's existing strengths and values by (1) sharing visible statements of positive working environments, (2) generating conversation in individual departments and (3) performing qualitative analysis of the responses for feedback to the departments for further action Results A total of 14 posters were displayed in pairs across three different departments in the John Radcliffe Hospital In total, 225 post-it notes were completed over 3 weeks Conversations generated at the posters saw demand for them across the trust with eight further departments seeking to take part Qualitative data analysis was done using NVivo software Thematic scrutiny divided the replies into those related to work and those related to life outside work A high level of responses (n = 98) championed the respondents' colleagues with the maternity team using names more frequently Other responses focused on being grateful to simply be 'well equipped', 'well trained' or be 'able to work' or 'have a job' Outside work staff commented on the value of the public support of NHS and the work of teachers Discussion For the first time in our institution, AI was used to analyse an existing Safety-2 culture and build up our teams by focusing on their strengths and values, at a time that was fraught with anxiety and fear Following on from the success of this project, we have developed further posters covering courage, joy at work, and what respondents have learned individually and as a team