4 March 2021
Reflecting on personal change

Lee Bridgeman

At the end of September I took a chance in moving from an organisation I had been at for 4 years and moved to Medway Foundation trust taking on the role of Head of QI & GIRFT. This was not a decision I took lightly, my previous organisation was going through a restructure and as a senior member of the team I felt some apprehension around leaving and not supporting my colleagues and friends through the turmoil. The new role looked exciting, a challenge, a step up.

It is a newly created post with lots of elements including heading up the Innovation Institute, developing the QI strategy & curriculum and leading the Trust in coordination of the GIRFT (Get It Right First Time) programme. My experience of transformation across the public sector, previous roles in the NHS and my studies of QI methodology & Health Care Leadership meant I was (and still am) confident in my ability to deliver the work.

The Institute had a great start and I knew that I would be building on a great foundation. I had experienced the Kaizen training the Trust had previously adopted so understood some of the history of QI at the trust. I had written strategies, change policies, business cases and project plans for years so developing new documentation and processes didn’t faze me. GIRFT was new to me, but seemed a logical and sensible programme with some great recommendations that could be turned into QI projects at the heart of it. So what was the apprehension?

The title of ‘Head of’ was daunting, the added responsibility and a step into a senior role held some fear and of course excitement. But was I ready to be a ‘Head of’ something?

I am a true believer that all senior managers in the NHS have elements of an Inferiority Complex mixed in with traits of someone with a God Complex and I am no different. There is that side of me that truly questions if I know what I am talking about and if I have the ability to actually do what is asked of me and at the same time there is that part of me that knows I can do anything given the time and resources. I have come to the conclusion that having this mix is not a bad thing because sometimes we are asked to deliver so much it takes someone who believe they can achieve anything to keep calm and carry on, whilst also having that element of doubt pushes us to do better and ensure that the fears of inferiority don’t win through.

I was talking it through with one of my colleagues and a friend, who reminded me that previously I had advised her to watch Ted Talk by Amy Cuddy focused on body language and how you can ‘fake it till you make it’. So I went back and re-watched it reminding myself of the lessons that come out of it: first tiny tweaks can lead to big changes and second don’t fake it till you make it but fake it till you become it. Anyone who uses QI knows that small changes can make a big impact and how we reflect on these changes and record the outcomes is the fundamentals for using PDSA cycles and I felt understanding this was a good starting point for accepting the role. As for faking it, is that what I needed to do or at least to believe that I could fake it (feeding the inferiority complex) or is it that I could do the job it I just need to trust that I can become it? Needless to say I decided that it too great an opportunity to pass up and here I am.

6 months later the restructure at my old organisation is complete and my old friends and colleagues have (mostly) found their new place in the world. I have met and am working with some new great people and developing the institute to be a driver for change not just in MFT but across the local health care system. I am working with clinicians to deliver the GIRFT recommendations, making real changes, no matter how small, to facilitate positive impacts for patients and staff.  I am working with execs to lead on strategical changes to QI methodology and training and I’m leading on collaborative working with ICP colleagues. Have I made it yet? No. Am I faking it? Not all the time. Will I become it? Damn right I will!

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