Clinton Waight - Radiopharmacy, RIE

Improving Culture, Improves Performance

Radiopharmacy is a small team of eight, who prepare sterile radioactive injections for use in Nuclear Medicine departments and theatres across nine hospitals throughout South-East Scotland.  Like all teams over the past few years, Radiopharmacy have experienced good and bad times – which have been reflected in our iMatter results.  In 2017, not everyone in the team responded to the questionnaire, which resulted in no report being produced.  In 2018, the manager provided staff with links to iMatter and reminded all staff of the ’go live date’, resulting in a team report.

The results showed that all 20 categories assessing team and line management performance returned scores of less than 90, with the key question of “My Team Works Well Together” returning a score of 62.  Following a discussion with the team leader and the team, we agreed to develop an Action plan which would address the team culture.

One of the three actions agreed in 2018 action plan was to re-establish team culture, by agreeing the unique set values which defined the Radiopharmacy team, and by which we wished to be known.  The team responded extremely positively to this discussion, suggesting several answers (shown below) to the question: when people hear the name Radiopharmacy, what words do we want them to think of?

In the end, Radiopharmacy want to define ourselves by the following four values:

• Quality
• Knowledgeable
• Efficiency
• Approachable

With these four values defined, the team culture was established, but it is not just about writing these on a white board.  It is important that we continually discuss these values in day to day work and in meetings, as well as rewarding examples of these values being demonstrated and holding one another accountable to them, in the interests of the team’s reputation. 

A values board was designed to introduce visitors to the department. It shows:

• Who we are: informal photos of all team members are displayed, in no order of seniority, without any job titles, or even surnames
• What we are: the values that define our team, including evidence of those values being demonstrated in graphs of statistics, quotes and photographs

The improvement in joy at work among the team was immediately evident and this was reflected in the team’s 2019 iMatter report,  where 20/20 categories relating to team and line management performance, returned scores of greater than 90, compared with 0/20 a year earlier!  In addition, the key statement “My Team Works Well Together” improved from 62 to 97. 

However, the improvement was not only reflected in iMatter results.  What became apparent in the following year was an unexpected rise in all areas of performance, as measured by key performance indicators (KPIs).  Performance across seemingly unrelated activities improved to see the Radiopharmacy meet all of our KPIs for the first time since records began five years earlier, indicating a strong correlation between staff enjoyment and our performance at work.

The improvements in performance were as follows:

1. The staff absence rate reduced from 8.8% to 1.7%. This means that Radiopharmacy have the appropriate number of staff available on 73% of days, compared with 33% the year before.
2. The proportion of products available on time increased from 99.1% to 5%
3. The number of items requiring adjustment reduced by half, from 2.5% to 1.2%
4. Aseptic technique improved, with finger dab failures reducing by half, from 6% to 3%
5. Clean room environmental monitoring failures reduced by half, from 2% to 1%
6. Closing of deviation investigations on time improved from 63% to 93%, improving our learning from errors - which we were making far less often

The iMatter report from 2019 did not highlight much to improve on, with all categories scoring higher than 90, but even though things are good, it doesn’t mean they can’t get better!  Therefore, this year’s Action Plan focused on how to maintain this positive culture and further improve the team’s joy at work. 

Several of this year’s actions have already been completed.  To promote Radiopharmacy’s culture, the team plan to purchase Radiopharmacy team hoodies (designed by us) and have set up Twitter and Instagram accounts - @edRadiopharmacy Why not give us a follow or a like!

The iMatter process shone a light on a potential cultural issue in Radiopharmacy and gave the team’s leaders the platform and incentive to address this.  The iMatter feedback session provided an ideal opportunity to initiate a discussion about culture and values, which had an immediate and sustained effect on the team’s experience at work and their performance.  While the purpose of this intervention was to enable staff to enjoy their work in an environment that promoted mutual respect and acknowledgement of quality work, it has delivered a measurable, sustained improvement in performance indicators which continues to be realised.