One of the things I have enjoyed most about working with the ADHB, is the opportunity to work on a variety of interesting and meaningful projects. Recently I was asked to join the team at Kāhui Oranga, a collaborative health sector group, committed to employee wellbeing in the health sector. Our mission is to understand and define how we measure and monitor wellbeing for our people. What I love about this project, in particular, is it involves a complex web of stakeholders and priorities to weave together but more importantly, it has the potential to impact the wellbeing of 80,000 employees. On top of this, those employees are critical to the success of our largest organisation, delivering to the health needs of all New Zealanders.

Getting started on this project got me thinking about what is important when measuring wellbeing within a complex environment. I’d like to share some thoughts that may be useful to consider. The first thing that came to mind was, we should not measure the wellbeing of employees in isolation – we need to look at the bigger picture. When faced with a new opportunity or problem, I find its helpful to step back and take a look from the perspective of the larger context and consider all the stakeholders involved. When it comes to understanding the experience that someone has and their wellbeing needs, it is always part of a system of relationships and interconnected parts.

Experience is collective it does not happen in silos – an experience of an individual or stakeholder is always part of a larger, collective experience. For example, within a complex organisation like the ADHB. The individual or employee is part of a team, and that team interacts with other teams and within the wider organisation. That organisation also sits within the New Zealand health system and that in turn is part of our wider community that the health system serves. I’m reminded of the concept of a holon, a system that is a whole in itself as well as a part of a larger system. It can be conceived as systems nested within each other. All these stakeholders have relationships and connections and together they influence and impact the wellbeing of the individual and the overall functioning of the system. So when we look to define metrics, we should consider what is important to measure from the perspective of the individual, teams and whole organisational performance. Improvement for one stakeholder should not come at the detriment of another. When talking with clinicians, they describe this collective experience and the direct impact the wellbeing of patients and whānau has on their own wellbeing. How well they deliver care to patients, and are able to engage with whānau directly impacts their sense of satisfaction, self-pride and ultimately impacts their levels of stress and potential burnout. The patient, whānau and clinician experience is one collective experience and each can have an impact on the others in a positive or negative way. Robin Youngson talks about this collective experience in great detail in his book Time to Care. Robin says “Patient satisfaction and practitioner satisfaction are closely interrelated.” He also says that “research shows the doctors who are most empathetic and make the strongest emotional connections with their patients, actually have the lowest risk of burnout.” Another good example of collective experience in action, is with professional services firms. The relationship that an employee has with a client, is critical to creating a positive client experience. However delivering a great service and building enduring relationships creates a great experience for the employee as well. It is proven that the experience an employee has directly impacts the quality of the experience the client has and vice versa. Tracy Maylett and Matthew Wride of DecisionWise who have arguably looked at more “experience” data than anyone else have shown this to be true and created the The law of congruent experience – Employees will deliver a Customer Experience that matches their own experience in the organisation. They say “If your employees are having a great experience, so will your customers.” When interviewing clients and employees, I’ve noticed they both comment on the impact the other has on their sense of enjoyment and fulfillment with the work they do and the impact on their happiness and wellbeing. In my experience when people are involved in positive collective experiences it usually results in a sense of connection or camaraderie. Another thing that comes to mind when looking at wellbeing (or any human experience) is the importance of authentically connecting to the people involved. You can’t assume they you know what people need, for any change project or new initiative to create meaningful impact the actual needs of the people or users have to be understood and meaningfully addressed. Any experience improvement needs direct alignment with the actual needs of the individuals having the experience. It’s easy for organisations to go into problem solving mode and fiddle with processes and systems without engaging with the people who experience them. The two biggest mistakes I see happening within organisations are, doing it to the people, rather than with them and focusing on “fixing” one small area without understanding the whole that it is part of.

So to sum up:

• Always step back consider the larger context for the experience you are focused on
• Its important to understand the needs and priorities of all Stakeholders
• Where possible look to balance the needs of all not one at the cost of the others
• Experience is interconnected and collective, it doesn’t happen in silos
• Engage with the users or people with the lived experience and align change or initiatives directly to their needs