Compassionate and Collective Leadership

Professor Michael West discusses the importance and role of compassionate leadership in today’s NHS. This presentation reminds us all of our shared vision…not just HEE, not just trusts, not just individual clinical teams, but the vision created for and with the entire country.

He talks about a more compassionate community and delivering high quality car against backdrop of complex challenges and debilitation levels of work stress.

Over 40% of NHS report being unwell each year in the NHS which effects quality of care, error rates and ultimately patient mortality.

Caring for the health and wellbeing of people is fundamental to the vision and values of both health and social care sectors. Those working in these sectors often have aligned morals to this and are drive to deliver high quality continually improving care.

Are you modelling compassionate leadership? Are you listening, understanding the causes of distress and having an empathic response, so we can help the other person?

Michael West (00:19):
” Thank you very much. I have a disclosure to make. I may be ahead of thought leadership. My wife’s title is supreme galactic empress, so do humility. How do we respond to the huge challenges which Adrian outlined in providing health and care for our communities? These challenges are just enormous in all of our countries around the world, but what strikes me most forcibly when we look at this context is that we are damaging the health and well-being of the people we ask to deliver high quality healthcare for people in our communities. We’re damaging the health and well-being of the people who deliver healthcare. When you look at the culture and engagement surveys in British Columbia, you see that’s the case.”

Michael West (01:20):
“In England in the National Health Service, 1.4 million people, 50% more staff in the NHS report debilitating levels of work stress compared with the general working population as a whole. Every year, 40% of staff in our system report being unwell as a result of work stress during the previous year, and that’s replicated across different countries. It’s important because it’s damaging the lives of people who deliver healthcare, but it also affects the quality of healthcare that we provide. It effects error rates. It affects our ability to be compassionate and in the acute sector in hospitals, we know that it’s associated with higher levels of avoidable patient mortality. What are we to do? There are various national initiatives.”

Michael West (02:17):
“You hear from your provincial government and from different national governments, national initiatives that focus on our health and care systems. Often they’re very worthy initiatives, very important, but for the most part, they don’t get to the core cultural problems, which I think underpin some of these issues to do with staff stress and poor health and well-being. What are we to do? I think we have to go back to the core of what our healthcare systems are all about. When public health was introduced in Canada, it was a with a commitment to providing free care to all those who needed it regardless of health, wealth background.”

Michael West (03:06):
“In our National Health Service in England, we introduced a system in 1948 designed to be inclusive, and I think it represented, it manifested a core national value of compassion that post-war society wanted to create a compassionate and inclusive system. We’ve been fiercely protective of it ever since because it’s such a core societal value for us I think as it is for you here in British Columbia also. All of you and all of the people who you work with made a decision at some point to dedicate an enormous part of your unique, precious, mysterious, magical lives to caring for your fellow people, to caring for your communities, so you too and though all of those you work with embody that core work value of compassion.”

Michael West (04:10):
“Compassion for me is the healthcare assistant, the very junior healthcare assistant I saw who sat for an hour after her shift had ended, holding the hand of an elderly lady who was in distress and speaking with her lovingly and caringly, until she was calm again. It was a general practitioner in South London who told me recently that she danced in her surgery that day with an elderly, lonely man when she discovered they had a shared interest in dancing. Beautiful and I’m sure you see and embody acts of compassion like that every day, but let’s probe a little deeper. What is compassion? If Lyn here, forgive me Lyn, is in distress, then for me to be compassionate, I first of all have to be present with you.”

Michael West (05:02):
“I have to be here and now with you. I find Nancy Kline’s wonderful phrase listening with fascination to you really helpful as a way of embodying that. Second is I have to understand what the causes of your distress are and ideally, we do that through a dialogue. Third is I have to empathise with you. I have to feel your distress at some level because that gives me the motivation for the fourth step, which is asking how can I serve, how can I help you with your distress, so attending, understanding, empathizing, and helping or serving. Does that make sense? Those four elements of compassion, does that make sense to you?”

Audience (05:49):
“Yes.”

Michael West (05:52):”
We know that when healthcare staff are able to provide compassionate care, that patient service users are much more satisfied with the care they receive, and that in turn has an effect on the well-being and the commitment of staff. We get virtuous cycles of compassion, and the challenge for us therefore is how can we create the conditions where staff can deliver the high-quality compassionate care they wish to deliver? That’s about how we can create cultures of compassion. Culture’s the most powerful influence on our behavior, in workplaces, and every interaction by every one of us, every day shapes the culture of our organizations.”

Michael West (06:41):
“How civil we are, how kind we are, how humorous we are, how irritable we are all shapes the culture of our organizations, but the role of leaders is particularly powerful, what leaders pay attention to, what they monitor, what they talk about, what they reward, what they model in their behavior tells us what they value, and values what we value, not the words on the website. What we value in practice is the culture of our organization. In order to create compassionate cultures in healthcare, our leaders have to embody compassion in their leadership. That means leaders who pay attention to those they lead, who listen to them with fascination.”

Michael West (07:26):
“One of the most common complaints I hear from health and care staff is we only ever see our senior leaders when something goes wrong. Second, it’s about leaders understanding the challenges those they lead face and ideally, that happens through a dialogue so that it’s both are more accurate and a shared understanding. Third, it’s leaders empathizing with those they lead, feeling for them. Given what we know about the levels of stress for health and care staff, our leaders should be empathizing without being overwhelmed by feelings because that gives the motivation for the fourth step, which is asking the question how can I serve, how can I help you?”

Michael West (08:13):
“Another complaint I hear from health and care staff is actually some of our leaders are really good at coming around and talking to us, they’re really good at listening, but then nothing ever changes. In order to create cultures of compassion, we need leaders to embody these four behaviors in their leadership. In England, the national bodies that oversee the national health service, 1.4 million staff have sponsored a new framework, a leadership development and improvement framework which has at its core, a commitment to developing collective, compassionate, and effective leadership at all levels of our system, from the secretary of state down to the frontline supervisor, and a commitment to developing improvement methods so that all staff are equipped to do the kind of quality improvement that the minister was referring to.”

Michael West (09:14):
“Those national bodies have also pledged that they will commit to changing their cultures, so that they embody the compassionate and collective leadership which they’re prescribing for the rest of the system, and to model those collective and compassionate leadership behaviors in their dealings with the organizations that provide health and care. That approach is also being adopted by other countries now by Northern Ireland and elsewhere because of a recognition I think of the centrality of compassion to cultures that deliver health and care. We’ve also been able to identify through research over the last 20, 30 years the key cultural elements that really make a difference to the performance of health and care organizations around the world.”

Michael West (10:08):
“If we know what those key cultural elements are, that tells us what we as leaders should be focusing on. There’s so much stuff that comes at us as leaders in health and care, but the research evidence tells us that these five areas are absolutely critical in organizations around the world that consistently deliver high quality health and care. I want to describe them briefly to you. The first is a vision, a vision that’s focused on providing high quality, continually improving, and compassionate care. This can’t just be a bunch of words on the website. It’s about ensuring that that vision is embodied by leaders at every level every day.”

Michael West (10:58):
“If it’s simply a bunch of words on the website, but what people in the organization see is inconsistent in terms of leadership behaviors with those messages about the vision of the organization that corrodes trust, that corrodes commitment. It corrodes engagement, and that means that we need to be vigilant about making sure both at provincial level and at national level that our leaders are not spending more time talking about financial performance, productivity than they are about high quality care for people in our communities because otherwise, the message goes out that what our leaders value above high quality care is financial performance, and that’s a slippery slope.”

Michael West (11:45):
“The second is the importance of making sure that we translate visions in our organizations into really clear priorities. What we see in health and care organizations is that there are all sorts of groups and leaders who are setting priorities. Your minister sets priorities. Your board set priorities. Your departments and directorates set priorities, and we’ve come to call them in our research team the priority thickets because there are so many priorities, we can’t see clearly what’s important anymore, and people are overwhelmed at the frontline.”

Michael West (12:22):
“We also know from the last 60 years of research on human motivation and performance at work, Gary Latham from Canada, one of the leaders in the world in this area that people’s motivation and performance is highest when they have agreed a limited number of clear, challenging goals aligned to the vision for their work. We also know from 30 years of research on healthcare teams that the most important determinant of the effectiveness of healthcare teams is whether they have agreed rather banal conclusion, whether they’ve agreed a limited number five or six of really clear challenging objectives for their work.”

Michael West (13:06):
“What’s really important in our organizations in terms of culture is that as leaders, we make sure that there is alignment of people’s efforts towards that vision, then having agreed a limited number of clear priorities at every level, beginning with the top, management team in organizations and going down to every team within the organization as a whole. There’s some examples there of the kind of dimensions we could consider as being part of health and care team’s objectives. One of the objectives of every team should always be improving the effectiveness with which we work with other teams in our organization or outside our organization to ensure high quality compassionate care for people in our communities.”

Michael West (13:56):
“The third principle is the importance of people management, and that’s about leadership. What we know about good leadership is that we need leaders who are authentic, genuine in the way that they interact with those they lead, leaders who are open and honest wherever possible, leaders who display the characteristic of humility which we know is linked to high quality leadership. Leaders who are always asking how can I lead you better, what do I need to do more of, what should I do less of, how can I be a better leader for you because none of us is the finished product as a leader. Leaders who are optimistic, leaders who are compassionate, and leaders who are appreciative.”

Michael West (14:41):
“The single most common complaint I and my colleagues here from health and care staff is apart from patient service users, no one ever comes and says thank you to us, and yet saying thank you, appreciating people’s contribution sends ripples through a kind of emotional contagion through our teams and organizations. Unless you think this is simply ideology, we’ve been gathering data for the last 14 years from the National Staff Survey in England that’s completed by a quarter of a million NHS staff every year. What that survey has enabled us to do is to identify how working in healthcare is changing from the perspective of staff over time, and we’ve seen that the percentage of people reporting having an appraisal has gone up from 66% to 86% over that period.”

Michael West (15:39):
“The percentage of people who say it’s been a helpful conversation hasn’t shifted from 38%. The data also tell us about those organizations that have been successful, for example, in reducing stress levels and keeping them at a low level. What that tells us is high levels of stress, poor health and well-being, that doesn’t have to be the case within health and care organizations. We see examples of organizations that have raised engagement level and sustained levels and sustained them at a high level, examples of organizations that are effectively dealing with discrimination.”

Michael West (16:18):
“Most importantly, what we’ve been able to do is to link the data from the staff survey to national outcome data, patient satisfaction, care quality, mortality rates, infection rates, and the evidence is incontrovertible. The most important determinants of patient outcomes and patient satisfaction is how our staff are treated within our service. When staff say there are too few staff, patient say there are too few nurses. They’re not treated with the respect and the care and the dignity that they wish for. When staff report poor health and well-being, that’s related subsequently to lower levels of care quality in organizations, significantly worse financial performance, and in the acute sector to higher levels of patient mortality.”

Michael West (17:16):
“When you think about the data I talked about at the beginning in terms of levels of stress, it is so important that we don’t see that simply as a byproduct of working in health and care, but an area of central concern for those who lead in our systems. The most significant determinant or predictor in our staff survey of the outcomes of healthcare organization work, be it mental health organizations, community care organizations, hospitals, ambulance services, is the measure of staff engagement. It predicts financial performance, care quality, patient satisfaction, and we have some in Haitians from those organizations that have been successful in raising levels of staff engagement and sustaining them at a high level about what are the factors that are associated with that.”

Michael West (18:09):
“The first is that these are organizations that have generally developed a strong, compelling, narrative vision about what it is they’re seeking to deliver for the people in their community, and their leaders live it. Secondly, what they’ve done is to retrain their leaders to adopt more positive, supportive leadership styles. For example, Nottinghamshire Healthcare there has a program called Invest to Lead where they’ve retrained all of their managers and leaders to adopt more positive, supportive, compassionate leadership styles. Berkshire Health has retrained its 700 leaders in compassionate leadership, and third is that they have given staff the skills and the freedom and the resources to undertake quality improvement projects.”

Michael West (18:59):
“Wrightington, Wigan and Leigh is a hospital in the northwest of the country that has partnered with a private centric car parts distributor called Unipart and adapted the lean techniques that they use for use on the wards. You see staff huddled around whiteboards on the wards every day looking at real-time performance data, so they can adjust their performance. Fourth is these are organizations that have built a high level of trust. We know from all of the research on engagement internationally that trust is the most significant determinant of people’s engagement in their organizations, their preparedness to bring their life experience to their work, their emotional intelligence, their compassion, their creativity, their courage.”

Michael West (19:46):
“They do this when they feel they can trust their organizations. In our organizations in the National Health Service in England, one of the key barometers of trust is levels of discrimination against groups that tend to be discriminated against. It’s still the case that if you have skin, my color in the National Health Service in England, you’re four times less likely to be involved in disciplinary processes than if you have skin of a dark color. If you have skin of a dark color, your one and a half times less likely to be appointed from a selection panel, and the group that’s most discriminated against is staff with disabilities. God forbid, you should be a Muslim woman with a disability working in our health service.”

Michael West (20:37):
“Trust is about the way that we create fairness and openness within our organizations, and also the fifth area is stability of senior leadership. I went to Wrightington, Wigan and Leigh not too long ago, this organization that has been really successful in raising levels o staff engagement and maintaining them at a high level, and they kept talking about the horse. At their engagement committee meeting and I asked about the horse. They told me the story of a patient, Sheila Marsh, who was sadly dying in the palliative care ward and had just hours left to live. One of the staff asked her if there was anything they could do for her in her final hours and she said, “I would really love to see [Bronwyn 00:21:24] again.”

Michael West (21:26):
“Turned out that Bronwyn was the horse she raised over a 25-year period because she worked at paddock park racecourse nearby. The staff got into a huddle, picked up the phone, called a family and said, “Can you bring Bronwyn in?” They arranged for a horse box and Sheila Marsh was wheeled out on her bed into the carpark. The horse clearly recognized her and nuzzled her and kissed her, and it was a really moving moment for Sheila Marsh who sadly died a few hours later. It was actually also really moving and affirming for her family who were really grateful for the staff taking this action, and actually was really affirming and moving for the staff as well. Nobody called a health and safety department.”

Michael West (22:22):
“Because there was a culture of engagement and compassion, staff did the right thing and they were supported, and our challenge is how do we create cultures where staff will do the right thing in our organizations. The final point in relation to the kind of people management is we know from so much research evidence to the importance of positive emotion in human behavior. The more positive emotion we experience in our lives, the longer we live. If you induce positive emotion in a 3-year-old and give her paints to play with, she’ll produce more creative paintings and play more altruistically with other 3-year-olds. The same is true of 53 year olds as well.”

Michael West (23:14):
“If you induce positive emotion in a doctor, give her a bar of chocolate or something, she will make better medical diagnoses. Research evidence is clear, if you induce positive emotion in people and then subject them to the common cold virus, they’re less likely to contract the virus. We thrive on positive emotion. It’s really important that as leaders in our organizations in a context where there is so much negative emotion, fear, pain, anxiety that we don’t add unnecessarily to that by the way we lead, but that we seek to create positive, optimistic, appreciative, supportive environments. It doesn’t mean turning up for work on a Monday morning in this kind of clown, comedic type character or personality.”

Michael West (24:06):
“It means being authentic and open and expressing humility and being appreciative and compassionate in the way that we lead, but it also means making sure that we create the space for staff to talk about the negative experiences they have in the workplace because those negative emotions are powerful and important. When a service user takes their own life, the staff in the mental health organization are devastated. When a neonate dies in intensive care, the staff are devastated, and we know that we need to give staff the space and time to validate, legitimate those sorts of negative emotions. We’ve been introducing across the NHS in England what a course Schwartz Rounds.”

Michael West (24:54):
“Some of you will be familiar with them. They are meetings where groups of staff come together over lunch and a small group will discuss some negative experience in the workplace, not with a view to problem solving, but with a view to sharing emotional experiences, negative experiences usually at work. The data we have, we know from our research on stress in the NHS that around 26.8% of our NHS staff suffer from debilitating levels of work stress that would have them categorize as suffering minor psychiatric morbidity, 26.8%. Those who regularly attend the Schwartz Rounds, we’ve just finished the evaluation are on about 12%.”

Michael West (25:42):
“It’s really important that we create the spaces for people to be able to legitimate and validate the negative experiences they have at work, and it’s also about making sure that we deal with those intimidating or aggressive behaviors, particularly among senior staff that corrode the kind of cultures that we know are important for the delivery of high-quality care. If you have senior medical staff who are intimidating or aggressive, those behaviors are as dangerous to patient care as medication errors or dirty wards because staff are afraid to challenge those behaviors. As leadership communities, we must address those behaviors. How are you doing? You with me still?”

Michael West (26:30):
“These three areas vision, clear goals at every level, great people management and leadership are vital areas that we must focus on as leaders in our organizations. The fourth and it was the minister alluded to it is the importance of innovation and quality improvement. We know that those organizations that are most successful in health and care are the organizations that have succeeded in creating cultures of innovation. Last year, we published a paper in The King’s Fund based on a review of all of the literature on innovation, not just in healthcare, but particularly as it applied to healthcare to identify those factors that we need to have in place to enable our organizations to be innovative. You can download that from the website.”

Michael West (27:18):
“It identified the key elements that need to be in place, and I think in healthcare, we tend to focus very much on skills and capabilities, QI capabilities, systems and processes and support for quality improvement, but tend to neglect some of the other areas. I’ll mention them briefly, but what emerged from maps review was the fundamental importance of compassionate leadership to innovation. The compassionate leadership behaviors attending, understanding, empathizing, and helping are fundamental also to innovation. Those behaviors seem to create the conditions that reinforce the fundamental altruism and intrinsic motivation of health and care staff.”

Michael West (28:09):
“Where there’s compassionate leadership, staff are much more likely to take risks within safe boundaries to try new and improve ways of doing things like bringing Bronwyn into the hospital. Compassionate leadership creates what Amy Edmondson at Harvard calls the psychological safety in healthcare teams, where people feel safe to speak up about errors, concerns, problems, issues. Compassionate leadership encourages people to develop ideas for new and improved ways of doing things in the workplace and implement them.”

Michael West (28:46):
“Importantly, compassionate leadership is associated with teams that are characterized by higher levels of cohesion, optimism, and a sense of efficacy, precisely the conditions for innovation in teams, rather than fear and blame which have precisely the worst conditions for innovation, but what also emerges from that review and research on innovation generally is the importance of autonomy. We conducted a review to look at cultures and climates of healthcare excellence all around the world, and we found that about the worst style of leadership that you could adopt is command and control leadership. For a workforce that is the most highly motivated highly skilled in our countries, why would we adopt command and control hierarchical approaches to leadership?”

Michael West (29:41):
“It’s about how we can create freedom from the bureaucracy, the rigidity, the hierarchies that characterize some of our healthcare organizations. What we’ve been advocating is the importance of moving towards leadership being seen as a collective activity, away from leadership being about people in authority, or leadership being about individual heroes, to leadership being a collective activity where everyone sees that they have leadership responsibilities. The very junior administrator I saw a couple of weeks ago presenting in a major London conference on their quality improvement initiatives, it’s where their shared leadership in teams, although Lyn here maybe the hierarchical leader when Christina has the skills or the leadership naturally shifts.”

Michael West (30:34):”
“It’s leaders working interdependently across boundaries, prioritizing patient care overall, not just their area of responsibility, and it’s making sure that we’ve got consistent approaches to leadership within the organization. What’s your name?”

Lawrence (30:53):
“Lawrence.”

Michael West (30:54):
“Lawrence. It’s no good if Lawrence is here in one department, this warm, compassionate, supportive, positive, appreciative leader. He’s nodding vigorously.”

Audience (31:10):
“He totally is. He totally is.”

Michael West (31:11):
“He totally is, yeah? Then in the next department, you’ve got Christina who is this despotic, demonic, tyrant.”

Audience (31:19):
“Here, here.”

Michael West (31:19):
“Do you know what I mean? We have to have consistent approaches to leadership in our organizations, characterized by authenticity and openness and humility and compassion and appreciativeness. Our challenge is how we create that kind of collective leadership in our organizations to promote autonomy and to encourage support, but it’s also in the most innovative organizations, everyone’s voice is heard. The voices of the people who dissent, the voices of the people who may be discriminated against, the voices of people in the community, not simply as token voices representing the community, but genuinely involved in the co-design of services for communities, genuinely involved in shaping the vision of the kind of healthcare systems that we want to create for our communities in the future.”

Michael West (32:28):
“It’s about of course the importance of team working as well in our organizations. We have abundant evidence of the importance of team working, and I’m not going to dwell on this particularly other than to say when we think about the extent of team working and health and care in our system in the NHS in England, and we ask our staff to work in a team, 96% of them say they do. We’re not quite sure what the other 4% do, but then we say, “Does your team have clear objectives? Do you meet regularly to review your performance, and do you work closely together,” which we think of the defining characteristics of teamwork. Yes? Clear objectives, meeting regularly to review performance, working interdependently, then the figure drops to 40%.”

Michael West (33:19):
“We think 40% are working in something like real teams and around 55%, 60% of people working in pseudo teams. If you look in the acute sector, the more people working in pseudo teams, the higher the levels of errors, stress, and injury this group on the right of the people working in real teams. We see a really clear relationship between quality of team working in healthcare environments, whether it’s mental health or the acute sector and errors, stress, and injury, injuries that could harm patients or staff. When we look in the acute sector, we find a very strong relationship between quality of team working in hospitals and mortality.”

Michael West (34:01):
“We estimate using the most conservative estimates and taking account of other confounding factors, that if we could increase the percentage of people in our system working in real teams from 40% to 65%, that that would be associated at a minimum with the prevention of 5000 avoidable deaths annually. Team working, the quality of team work is not just a nice to have. It’s essential to the delivery of high-quality care. We need to make sure that our teams are working effectively, and what we’ve discovered from a research program we’ve been running for the last 25 years is it is a mistake to require our teams simply to spin the hamster wheel faster and faster.”

Michael West (34:56):
“We began to ask the question of healthcare teams, what happens when you take time out from your business to review what it is you’re trying to achieve, how you going about it, what you need to change? We found whether we’ve looked at breast cancer care teams, primary healthcare teams, executive teams, community mental health teams, teams that take time out on a regular basis to review are much more productive and much more effective. A recent meta-analysis and research has been replicated around the world. A recent meta-analysis by Tannenbaum [inaudible 00:35:33] based on accumulating the data from 49 separate published studies showed that teams that do this are on average 25% more effective.”

Michael West (35:51):
“We shouldn’t just be encouraging teams to take time out to review. We should be requiring it. It’s counterproductive not to. Make sense? We need to be building effective team working and building dream teams in our organizations with inspiring visions and regular and useful team meetings, and making sure also that there are not chronic interpersonal conflicts in teams. They are simply a disaster for team effectiveness and therefore, will damage in the case of healthcare delivery teams, the quality of care that’s delivered to people in our communities. It’s also ensuring that in our teams, people are committed to inquiry, listening to each other, wanting to learn more from each other, rather than pushing their positions, and leading that into team working.”

Michael West (36:43):
“I mentioned earlier every team should have as one of its objectives improving the effectiveness with which we work with other teams in our organizations and outside them indeed. It’s about ensuring that we have team leaders who know how to lead their teams effectively. I’m not going to go through this. My mother strongly recommends that book on effective teamwork to you as a place to learn about team leadership. How do we achieve all of this? The challenge that we recognized in our system was it’s not enough just to advocate these kind of cultural values in organizations. We need to create them and culture is about leadership, and that means we need the leadership that’s committed to these values at every level of our systems, and that means creating effective leadership strategy.”

Michael West (37:35):
“We’ve designed a system to help every health and care organization in the world look at their existing culture and leadership, and then design a strategy to deliver the collective, compassionate leadership that’s needed for them to be effective and to implement it. The principles were that we wanted to design a system that could be delivered internally that would be evidence-based, rather than fads and fashions and consultancy based, and that would be open source. It’s available for you to download the materials, and it’s delivered by an internal change team, and we have guidance on how you set that up. I’m not going to go through all of these.”

Michael West (38:16):
“These are some of the tools that are up on the website to help you build team-based working, to help you develop cultures of innovation, to help ensure that you have an organization characterized by a commitment to vision and values, and where you have an approach to clarifying goals and ensuring effective performance. Then those materials are all available on the website for you to use, and there’s a community of practice as well, but I want to finish by going back to the beginning of what I was saying today, and that is that we have to ensure that we care for the people who deliver care in our communities because it affects not just the quality of care, but of course their lives, their families, their well-being.”

Michael West (39:03):
“We need to build a sense of well-being by paying attention to some of the key factors that affect our well-being, spending time with people we love and who love us, quality time with them, exercise of course, being present, being here and now, learning, growing, and helping others make such a difference to who we are and to our quality of life. Most importantly, if you only take one message away from what I’ve been able to share with you today, it is the importance of compassionate leadership. I keep thinking that if all of the people who work in health and care in British Columbia, probably one in 10, one in 15 of the population come to work and encounter compassionate cultures, compassionate leadership.”

Michael West (39:59):
“They take that out to their families and their communities and if all of the people who use the services of health and care in British Columbia, every year encounter compassionate care, they too take that back out into their families and their communities, and it spreads through processes of emotional contagion. The potential contribution of the health and care system to our society above and beyond the delivery of health and care is enormous, and it begins with the people in this room. We have to model that compassion in our interactions, but in order to have the resilience and the capacity to be compassionate in our dealings with others, we first of all have to be self-compassionate.”

Michael West (40:52):
“That means paying attention to ourselves, listening with fascination to ourselves, understanding the challenges we face in our lives and in our work, empathizing with ourselves, caring for ourselves, and then taking intelligent action to help ourselves in order that we can be who we can be and stay close to the core values that give our lives meaning like courage, wisdom, humanity, justice, gratitude, and compassion, and enable us to have deeper and more authentic connections with all. [Foreign language 00:41:39]. Thank you very much. Thank you. Thank you.”

Audience (41:41):

“Very good.”

Try these web resources to find out more:

• Person Centred Care
• Developing People
• Leadership Styles for Care Managers

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