Kitchen tables vs meeting tables
By Phil Riddell
National Kitchen Table Week is almost upon us. Whilst it may be the last one officially led by the Sign Up to Safety team before the baton is passed to us as NHS staff, I hope it is not the last.
My first Kitchen Table event was at Central Manchester Foundation Trust, during their Clinical Audit and Risk Management Fair. I spent time sat with the Clinical Governance staff, who were running the table, and saw a diverse range of people come to give their perspective on what safe care looks like. They also spoke up about what is preventing them from delivering this care on a daily basis to their patients. I saw student nurses talk about the benefits of the mentoring relationship formed when they were assigned to shadow a single nurse and how this helped them feel like they could contribute to safer care. In contrast, Consultant’s sat down to talk about the barriers they faced in their own departments. The ‘hosts’ sat and made listening a priority, making notes before taking these away to work on after the event.
Contrast this with some of the more formal meetings I have been in. I’ve noted that the majority of people who attend these are the ‘managers’ – senior figures within the department (both clinical and non-clinical). Their wealth of experience and knowledge is something to aspire to and respect, but this can inadvertently become intimidating for more ‘junior’ members of the team. In my opinion, this means that these meetings have lost a key component– the variety of perspectives on the same problem.
I have been sat in these more formal meetings as one of the few junior members of staff present and felt intimidated when my suggestions and comments have been glossed over. More experienced staff have paused their conversation, as if acknowledging what I have offered, before promptly resuming their conversation without responding to what I have said. This unintentional dismissal has been interpreted by myself as meaning that my suggestions were not welcome, although I am very aware that this is probably not what the rest of the team intended. The result is that I am then reluctant to share any further thoughts. They don’t have my perspective on the topic of conversation.
My other issue with some of these formal meetings is that they fail to capture the breadth of perspectives that the NHS has to offer. Our team consists of so many different staff members, including Nurses, Porters, Scientists, Healthcare Assistants, Skills Practitioners, Cleaners, Managers and most importantly, the patients themselves. If we discuss these issues in a forum where a clear hierarchy is present, I feel we will inadvertently lose various perspectives simply because people don’t feel able to speak up.
We each have our own unique viewpoint and experience of a particular situation. Nobody will truly see this, unless we choose to share it with others. If we, as less experienced staff members, feel intimidated in these ‘traditional’ meeting formats, then perhaps a solution lies in changing the meeting format?
This is where the Kitchen Table comes into its’ own. For me, it is a forum where staff of all roles and levels of experience can feel welcome to offer their perspectives in a safe, non-judgemental environment. When facilitated correctly, I have seen colleagues who are usually quiet in meetings come up with the most brilliant suggestions, whilst the more extroverted people have taken a less vocal role and learnt about the same problem from a different perspective.
I have seen Porters sit down with the Chief Executive (and have even seen a Chief Executive working as a Porter, although that is another story). Students have given feedback directly to the Head of Nursing so that they understand the problem from their perspective and Consultants have sat and listened to the impact that a job is having on their junior staff. All of this around a table where hierarchy has no place. Everyone has walked away with a better understanding of the problem and potential solutions that work for more staff groups.
Plus, a little bit of tea and cake always gets people chatting.
Thoughts to take away
- Do your meetings tend to reinforce the hierarchy?
- Whose perspectives are shared at these meetings? Do some perspectives get inadvertently missed?
- Could a Kitchen Table help you gather a wider perspective of the challenges facing your team?
About the author;
Phil Riddell is a doctor working within East Anglia after graduating from Medical School in 2017. After positive experiences at Medical School, he is planning on pursuing a career within the field of Patient Safety.