Improving care and patient experience using value-based interviewing

Exploring values in a job interview

It is well known that the values and attitudes of staff working in a health care setting have a significant impact on the quality of care given and on patient experience.

Value-based interviewing (VBI) is a technique used to explore work behaviours with someone applying for a job. It focuses on how and why the applicant has made certain choices in their work, and explores the attitudes and reasons underpinning their behaviour through probing questions. Examples of positive behaviour indicators given in the Health Education England guide, How to Design and Deliver Structured Interviews for Values Based Recruitment, include ‘Considers the needs/perspectives of others’; ‘Articulates the benefits of working together’; or ‘Is sensitive and tactful when raising difficult issues’.

Placing values at the heart of recruitment in an NHS trust

Oxford University Hospitals NHS Trust is a large teaching trust, made up of four hospitals. Each year around 2,500 new staff members are recruited. The trust recognises that there is significant benefit to the organisation and the patient if employees are recruited who share its values. It is one of the first trusts to implement value-based staff recruitment.

In 2011, the trust worked with staff and patients to define six core values: compassion, delivery, excellence, improvement, learning and respect.

Funding from the Health Foundation’s Shared Purpose programme enabled the trust to work on a project to apply these values to the recruitment process. The trust worked with the NSPCC, which has successfully implemented VBI, together with staff and stakeholders, to explore what the defined values mean in terms of positive and negative behaviours.

Joanne Durkin, VBI Project Manager, explains, ‘VBI enables us to understand the whole person, as opposed to just skills – the values, attitudes and beliefs of people who we are about to place so much trust in’.

Putting the idea into practice

Pilot areas were chosen – Care of the Elderly, Children's Services and the Clinical Support Worker Academy – and interested managers were trained in VBI. They reported getting much more from people than they had in traditional competence interviews.

Joanne says the trust has embraced value-based interviewing, with staff seeing the benefit as well as buy-in at board level.

‘Among people recruited through VBI there is a reduction in absence, and no performance management issues, or complaints from patients… We recently recruited for three director-level appointments and all had a value-based interview.’

Building on learning

More detailed evaluations have been undertaken this year, with positive results. Final reports are due to be published in the next few weeks and some of the most powerful feedback came from patients.

Joanne says, ‘One patient at a specialist palliative care service commented “You must have a very kind heart to work here”. I think that sums up VBI and reinforces why we’re doing what we’re doing.’

Wider assessments of the effectiveness of VBI have also been positive. An evaluation by Picker Institute Europe found that: ‘Staff who reported having a values-based interview were more positive about their experience than those who did not. They reported more positivity in areas such as managers and colleagues; career advancement; and how their roles contribute to organisational success and delivering compassionate excellence.’

Oxford’s VBI project will continue and has had a broader impact than anticipated. The trust found that working on values helped with understanding staff behaviour. Managers report that it enables them to understand staff and elicit appropriate behaviours. Having run a training course for managers, there’s now a demand for staff to have similar training. Joanne’s next project is to run a one-day course for frontline staff. She says, ‘it’s about helping staff to understand the impact their behaviour has…in a health setting, where the customers are vulnerable people’.

Sharing best practice – nine recommended steps

Joanne’s team have put together their ‘Nine recommended steps to value-based interviewing’ to help other organisations considering implementing VBI:

• Develop your values in consultation with staff, patients, stakeholders
• Get your values approved and sponsored by the board
• Develop your behavioural indicators that underpin your values in consultation with staff, patients and stakeholders
• Develop your questions and behavioural indicators
• Start training managers in the technique
• Provide ongoing support to managers using the technique
• Interview using the technique in a pilot area
• Evaluate the results
• Roll out the technique across your organisation

In addition to the evaluation reports, due out by the end of the year, the trust is also planning to hold an event to showcase the project. For more information, contact Joanne Durkin on 01865 223 099 or email joanne.durkin@ouh.nhs.uk.