Happiness

This week in the hospital I gave a talk entitled, ‘Llamas, Lonely Old Men and Tepees.’

It drew quite a crowd.

As I said at the time, if you want to rouse interest, think of a catchy title. Clearly this will not work always, particularly if the talks are dull, but so far, I’ve been lucky.

&, on to happiness!

We all know that in Bhutan they measure Gross Domestic Happiness.

This doesn’t make the population richer although like most thing in life, the more you pay attention to something the more it grows. Think poverty, homelessness and so on. Not you, not me, collectively, the ruling parties.

Anyway.

Happiness in hospital. That was the theme.

Not my idea.

Essentially extrapolated from my hero Don Berwick and the work of his colleagues.

They began with something called the Triple Aim – this is to improve the health for as many people at possible whilst improving quality (aka safety/effectiveness), in as economically efficient way as possible.

All great and admirable stuff.

More recently it has been noted that there is a major limitation to this noble aim – you can’t really do more and more, better, without considering those delivering the care.

The analogy can be replicated in the physical world; take Star Trek, ‘The engine canny take it captain’ kind of thing; unless you strengthen the neutron rods, the Klingons will get you.

In health and social care, the engine is the people, the staff, the porters, pharmacists, receptionists, therapists, nurses, and, yes, not forgetting the doctors.

To achieve the triple aim, you need a fourth element; ensuring the happiness, experience, support of the staff – The Quadruple Aim!

Consider their wellbeing, ensure their experience is positive and affirming, then you at least stand a chance in a world of diminishing supply.

Now, here is the question.

How many of us are happy?

Going back to the Enterprise analogy, you can only go faster if there is effective ship maintenance and the engine (and OK, the crew) is looked after.

When your granny, your mum, you, ends up requiring care and support, those delivering the medicines, treatments, prescriptions and appointments can only do so in an efficient, effective, coordinated (we call this person-centred) way, if they also are in some state of wellbeing.

Happiness is an ineffable concept. Without beginning or end; it is unique to every person – what works for me might have the opposite effect on you. It has to be tailor-made; yes, again sigh – person-centred.

How many of us receive a person-centred experience of work?

Well, my suggestion is that much of this has to do with your boss and your colleagues. The equipment, environment and other pressures are really secondary – if you don’t believe me, read Victor Frankl.

The answer therefore is to accept that nothing good can happen unless the leadership have the relevant values. That is, they get it, they understand what is important. And yes, the patients are important, the equipment is important, but all of that is really secondary to the staff. If they are not considered to be your most precious resource, everything else collapses.

The next-level question therefore is, how many of us are being well-led?

This is how you achieve all the rest.

Now, there are many styles of leadership, ownership and governance. None work at all times and in all situations.

When the hordes are attacking, a contemplative, inclusive, hashish laced pow-wow might not be the most appropriate response; yes, sometimes we need command and control – although, usually, or at least in my experience, too profligate a use of this style is what results in the attack in the first place, and, like my lecture title trope, over-use of this results in a waning of the effect.

You want to prepare.

Humans have been doing this since time immemorial (or at least those who survived) – think Pharaoh and Joseph; stock-up on your grain when times are plenty (in the NHS this is the summer and spring) and use those supplies to get you through the famine (winter) aka, now.

It is too late when famine is all around to determine we need to tighten our belts.

Happiness like many things in life – cognition, rest, hunger are all finite. There is a pot which you can add-too and there is a point when that pot is empty.

The pot-filling is being good to your teams and staff when times are stable, ensuring their wellbeing, checking that they have adequate equipment, resources, rest, leave. Note, I don’t mention pay as, study after study suggests that what makes the difference are the non-technical aspects of a job. The finishing touches; pleases and thank you’s. Smiles. Little kindnesses.

So, here I suggest is where we need to go (putting winter aside and presupposing that this blog is read at some time in the future, ideally, next June or July), be nice.

It isn’t that difficult.

Check the emotional wellbeing, the spirits, the happiness of those you support and lead.

Be inclusive, practice kindness – reciprocal and personal, lead from the front – be present; listen to what those who have first-hand experience are saying – do not rely on your memories of another world, ‘When I was there, I did that and we should do this now,’ for memories become distorted and situations and people are always different.

Don’t wait for the skies to fall-in before you show your face! (That is too late.)

Check for happiness and do all you can to facilitate.

It will not always work, and, I am not suggesting a comme ci comme ca attitude; there is a line, but mostly that need not be reached so long as the needs of the individual are balance carefully against those of the collective.

Thank you and good night!