Intangibles and ‘ordinary excellence’

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I recently received an excellence report (IR2) from one of our nurses. The report detailed how I had supported the nurse after she had been involved in a medication error. Within the report was a description of what I had done, and why it was helpful. The final words were ‘he probably doesn’t know how helpful this was. Thank you.’ ┬áThis was true, I hadn’t realised that I had done anything out of the ordinary. I considered my actions to be normal and I felt that I was ‘just doing my job’.

A common criticism of excellence reporting is that we have created a system which serves to ‘reward’ staff for simply doing their job. A brief review of the reports would suggest there might be some truth in this – many of the reports describe normal activities and tasks. ┬áBut this view is missing an important point: excellence is defined by the reporter. Objectively defined outliers of high performance are rare, by definition. Whilst these are occasionally captured in excellence reports, they are a relatively infrequent theme. Much more common is ‘ordinary excellence’: a description of what would be considered a normal activity, but there is something intangibly ‘good’ about it. This intangible quality is the trigger for writing the report.

Why is important to capture and report these events? To answer that, you have to speak to the recipients of the reports. In the majority of cases they will tell you that they didn’t realise how appreciated their action was and that they will make small changes to their practice as a result. I write this as a recipient of such a report: I now conduct myself differently as a result of this simple act of appreciation. I am also more confident that this aspect of my practice will benefit staff and patients.

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