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Changing behaviour of nursing professionals is the one of the biggest challenges in the field of patient handling and ergonomics. How do we make sure that nurses make adequate use of the equipment supplied, use the advocated  working techniques, stimulate  patient mobility and independence as much as possible, etc? The Dutch Voilà! method offers a proven, simple and effective way of dealing with this issue.

Ahead of the game

First of all as specialists we have to realise the danger of being too convinced that we know ‘what is best for our colleagues’.  We are tempted to be ‘pushy’.  Although the arguments as such are not questioned, the inevitable effect will be that our colleagues will start performing the behaviour we want them to demonstrate, but will soon relapse to their old habits. The situation will polarise: ‘I (as an expert) do anything to make clear that THEY are overloading their backs if THEY go on behaving like this’. 

Intrinsic motivation

Basically it is all about intrinsic motivation. People change and, more important, sustain their attitudes and behaviour only when they themselves have decided to do so, not because some expert want them to do so. The Voila! method, as a way of achieving intrinsic motivation, assumes that nurses themselves know their work best and also know how to solve 80% of the potential issues if they get the chance to do so. For this nurses need to be facilitated, empowered and obtain confidence from their managers. As in the end the nurse is the ‘problem owner’, she should be the ‘solution owner’ as well.

Huddle

The Voilà! Method uses three tools. First of all on ward level small groups of nurses (4 to 6 nurses) meet in so-called Huddles to discuss and solve ergonomic issues. Most of the time these Huddles are coached by ergonomic experts or peer leaders, but this is not necessary. The basic skills of the coach are asking the right questions, keeping the process going and empowering the nurses to solve their own problems.  Good ideas must be rewarded and honoured by immediate action. As the second tool of the Voilà! Method for each point of improvement, one page of the ‘ActionBloc’ is completed at the end of the Huddle, stating Who will do What and When. The third tool is monitoring: results of the Huddles (successes and failures!) must be presented at hospital level and communicated to all staff.

Success

Research in Dutch hospitals show solid and sustained results of the The Voilà! Method. In relatively short periods of time a great number of changes are implemented by the nurses themselves. The fact that the nurse herself can make the difference seems to be contagious. It appears that it not only enables solid ergonomic changes, which was the primary goal, but also relevant changes in other areas like the prevention of pressure sores, ward efficiency, prevention of cross infections, etc. Basically The Voila! Method awakens the nurses creativity and problem solving skills. A national campaign (‘Blijffris’) using YouTube video’s, brochures and posters and an e-learning module now is implemented to stimulate health care facilities to use The Voilà! Method. Some of the most intriguing questions of the e-learning module will be translated and used in the interactive presentation. The results will be presented in an interactive and attractive way. This will make it easier for the audience to pick up the best ideas and get inspired.