Jean Balfour explains how she has helped the safety team at NHS Tayside, part of the Health Foundation's Safer Patients initiative, work together more effectively and engage others in their safety improvement work

One in 10 patients admitted to hospital in developed countries suffer harm as a result of medical errors. Research evidence indicates that improved team working can help to reduce errors and save lives.

Jean Balfour is a leadership development consultant who has been working closely with the patient safety team at NHS Tayside, part of the Health Foundation's Safer Patients initiative.

In Ms Balfour's.view, the progress that NHS Tayside has made in patient safety has not just come about due to.improvements to systems and processes but also from a clear recognition that leaders need to be developed and empowered at all levels.

'If leadership is left to the few, particularly in a senior role, then it stops change, innovation and improvement being able to permeate through the organisation,' Ms Balfour explains. 'Whereas if leadership is shared with clinicians throughout the organisation, it enables people to lead change and improve things at all levels.

Leaders at all levels

'In the case of NHS Tayside, we have.seen that by developing and enabling leaders throughout the organisation at all levels, we can actually help to speed up the improvement process.'

Although Ms Balfour gave the team some formal coaching, much of her work focused on the facilitation of discussions. 'A lot of my role was helping them work out how they were going to work with people who were not.so engaged. How they were going to influence them, get them on board, teach them and help them to change their own practice,' she explains.

They used Myers Briggs type indicators to understand how to deal with different personality types in the team. This helped them to devise more effective influencing strategies. In addition, Ms Balfour used problem-solving action learning sessions to promote dialogue. She says: 'By using these sessions, we got people to come together and explore issues such as how to spread hand-washing compliance across the whole of the hospital. They then set about unravelling the problem together.'

'As a leadership consultant, it is.rare for me to be so rooted in a clinical setting but it has.been so rewarding for me to see this work result in improved outcomes for patients,' she concludes.