Why Generic KPIs Aren’t Enough And How To Talk Metrics Like A Consultant

Hello and welcome to the Ace Your Consultant Interview podcast. I'm Tessa Davis.

And I'm Becky Platt.

And if you're a final year trainee or a locum consultant and you want to prep, not panic, then you're in the right place. Welcome back to our Ace Your Consultant Interview podcast. I am here for this episode once again with Becky Platt.

Hi, Becky. Hello. Here we are again.

Here we are. Okay, let's get stuck in. We're going to start with our Academy student question of the week. So something that we've been asked by one of our students, which we'll talk through how to answer it. What have we got this week?

So the question of the week is, I'm struggling to find the KPIs for my specialty other than generic ones like referral to clinic appointment, emergency admissions, and readmission rates. Where should I find them?

OK, shall we start with what KPIs are? Because we don't want to assume— I think so. Yes. So KPIs are key performance indicators. So these are any metrics that your service uses to measure how effective they are. And they can be anything, really, right? So it doesn't need to be— there's not specific things. It's anything that you use to measure your quality of care. Often, I think, as trainees, we don't really need to think about metrics. But you still actually know them. You just don't really realise what they are. So, anytime you're auditing stuff, looking at service improvements, even thinking about the things that are really frustrating about the way the service works, flow, things that are stopping patients get good care, there's probably metrics within them.

Mm-hmm.

So, once it clicks and you start to know them, then it sort of falls into place and you see them everywhere. So this person can't find, is thinking of some, and actually the ones that they're saying, so I guess they're in some sort of acute specialty. The ones they're saying actually sound fine to me.

Yeah.

They sound good.

Yeah.

So I think they're on the right track. So I'm not sure why they, yeah, these sound okay. But if you wanted to look and you weren't sure how to find them, what would you recommend to people?

So I think, you know, you know your specialty well, you know, as you say, you're going to know the kind of things that you're working towards anyway. But also look at your— look at guidelines from your college, you know. So for example, you know, we work in ED. ARCHEM have got some specific guidelines around, you know, who should be reviewed by a senior, you know. you know, febrile infants and people who are, you know, bounce-backs and, you know, unexpected reattendencies, those kind of things. So your college will have guidance around metrics that, you know, that you should be following. There's also things in the GIRFT reports that you could be looking at. There's likely to be some specific specialty-related metrics there. Also, ask your senior nursing team and your—

Yeah.

Service managers. They know the kind of things that you're working Because there might also be some stuff that you as a service are particularly working towards that's not a national metric. So, you know, you might have done a particular audit on, I don't know, time to people receiving pain relief after getting a pain score, for example. So, you know, that's a metric that you're working towards at the moment. If you've been involved in that, or maybe you've done a quip about it, that'd be a great thing for you to discuss.

Yeah, the best ones are— you look at the national, look at the college, look at the whatever national organisations you have that will produce these, but then you get to choose which ones. There's way more. There's going to be way more than 3 for your specialty. You can choose which ones to talk about in your interview. So choose the ones that are relevant. And exactly like you say, if they know that this is something that the service you're applying to is working towards, that's the ones that you should pick. But also relevant to them, but also ideally that you've got experience with. So if it's something that is one of your USPs, you've actually done a project on how to reduce emergency admissions or reattendance rates or whatever it is, this is a great one to choose.

Yeah.

Because then you're able to connect I know this is something that you're working on because you noticed you had high reattendance rates for whatever type of patient. I've actually done a project where we looked at reattendance rates and found X, Y, and Z. That's the goal of what you're trying to do. So, you don't have to pick— there's no best KPIs to pick or the right ones to pick. There's the right ones for you and for the service that you're applying for. So, just think carefully. Once you get the hang of it and it clicks, you'll see loads and loads of different options for metrics. And then be selective as to which ones you choose.

Yeah, as ever, the key is show them that you understand what the metrics are that they're working towards, and then show them how you are the person to help them deliver those metrics. That's the goal. So, you know, we've had people in surgical specialties, for example, talking about, you know, these are the strategies that I use to make sure that Our golden patient is always in theatre on time. These are my strategies for reducing on-the-day cancellations on my surgical lists. And, you know, this is the trust benchmark for that, and this is my number. You know, that's really powerful stuff if you can demonstrate that you are the person that's going to deliver these metrics for the trust. That's interview gold.

Yep, agree. And I'd say even if a metrics, direct metrics question doesn't come up, questions around flow, improving service, improving quality of care, they're all connected to this. And so you bring in these metrics, and that's why it's important to know them. It's part of one of the milestones we do in the Academy, because you can drop these in. And actually, when you're showing, I know that this is a metric, I know that this is a KPI, and I've done projects in it or whatever, that sounds really strong when you're going through your answers. We have next the golden example of the week. This is one that's working well in an MDT. I'll read it out and then we can see what we think. So this is an example where I'll just read what they said. I managed a complex child with a life-limiting condition and the parents wanted some particular intervention. I referred the child to a tertiary centre. The case was discussed in detail, and it was deemed that the intervention wasn't appropriate for this child. So I coordinated an MDT approach. I involved a tertiary team, local nurse specialist, palliative care team, and got everyone involved. I led the discussions with the family in a sensitive way to make sure that their wishes were heard, while we also clearly explained the reasons for the recommendation. And together we agreed on the limits of resuscitation and the ceiling of care. And after the child's death, I ensured ongoing support by linking the family with bereavement services. What do you think about this for an example of working well in an MDT?

So this person clearly did work well as part of the multidisciplinary team. Yeah, they did. I mean, that's undisputed. And I'm sure that they gave this child and their family great care. I think that my challenge with this one would be, You could have done this, and you probably did do this, as a registrar. So what you're not showing in this example is that you can think and act like a consultant.

Mm.

And I think there is a difference. So when we, when we think about working in an MDT as a consultant, we want you to be able to show that you've got system knowledge. You know, and so maybe there's some kind of service level change that you've effected rather than a pure clinical example, which is very likely to show that you are an outstanding registrar, but it's not the same as that senior level thinking. What do you think?

Yeah, I think this is a prime opportunity to bring in a USP, and almost everyone will have at least one USP that involves good MDT working, and that's what you're trying to pull out is In that USP, why did the MDT work well? What was good about it? And these themes, which are probably the same for all MDTs, but mean you can draw them out and showcase how you did that as part of your project. I led a quality improvement project on whatever, and during that time, I felt this is a good example of how we worked well in the MDT team. I'm going to pull out 3 themes of the MDT working, and they might be shared vision, having regular meetings, using everyone's skills. And then you can illustrate that. So, I made sure that everyone attended a regular 2-monthly meeting, and we made sure that everyone got their views, and we had an agreed plan of action and agreed shared vision kind of thing. So, that way, you're still showing a lot of these things, which is how you work with— and you can explain who's on the team in the same way. You can have your nurse specialist. You can have all of these same people on your quality improvement team, but actually what you're doing is a bigger project around improving the care for your whole population rather than this focus on, I delivered great care for this one patient. And I know we've talked before about the difference between consultant and reg, and in fact, we'll come on to talk about that later in the tips and tricks. But this idea of showing that you recognize that it's the whole service you're trying to make good. and work well in an MDT rather than just one particular patient, then I think that would be stronger. This isn't wrong. This isn't a wrong example. And you could, and like you say, it is a nice example of MDT working. But if you think about the other where you're using one of your USPs and showcasing that, then suddenly you think, oh, actually, I can see that's going to be much better. You're likely to impress the panel more.

Yeah. Absolutely. I think every time you get a question, kind of in the back of your mind, you should be thinking, why are they asking this at consultant interview? I guess, you know, what do I need to show them as a consultant in this answer?

Yeah.

And I think that's the difference between a clinical example and a service-level change, quality improvement Example.

Yeah, so we'd say don't, don't use this. If you absolutely have to, you could, but actually, you— I'm sure you can find something stronger.

Yeah, I think that's what we say.

Right, so next we've got the interview question of the week. I think you're going to like this one, Becky. This is right up your alley. So the question that we're going to look at is, what does psychological safety mean to you? Now, I, I think people might stress out when they hear this because then you're just panicking, like, what are you going to say? How are you going to come up with something concrete to say here. What do you think about this question? Well, you're going to say you like the question, don't you?

I mean, I like this question. This is right up my alley. This is all the things that I love. So I think the first thing to say is this is not just a question about what does psychological safety mean. What they're really asking and what you should answer is, OK, what is psychological safety? How do you create that? In your team, in your working day. I think there's tons of scope for talking about how you create psychological safety. And I would break this down into 3 sections and, you know, choose 3 different things. You could talk about how I create psychological safety in an emergency or in theatre or whatever. How do I make it possible for people to speak up? So that, that could be one thing, you know, how do I make it safe for people to make mistakes? You know, what, what, what do I do? That gives you an opportunity to talk about no-blame culture, PSURF. You know, there's a stuff you could talk about debrief, you could talk about psychological safety in teaching. And, you know, all of the ways that, that you create that for your colleagues. I think it's a gift of a question if you approach it in the right way.

Yeah. Do you think it comes up often? I mean, we've heard— obviously we've included it because it has come up. Um, do you— how often do you think this is likely to come up?

I don't think it comes up in this format very often, but I think that there's an opportunity for people to talk about psychological safety in other questions, and I think that it would often land well. So, because that actually, if you think about other questions that come up, you know, like, um, you know, how do you demonstrate that you're a great educator? Um, how do you, uh, create, uh, motivation and morale in your team? Um, those type of questions give you opportunities to talk about psychological safety as well.

Yeah.

And I think it's those, those kind of things that many people would describe as, you know, the softer side. I actually really hate that term, but, um, I kind of feel a little bit ick that I actually said it. But, um, you know, that I think is actually really worth just reflecting on what you do as a senior to, to make your team feel safe and secure and, um, nurtured as part of your team.

Yeah. Anything really to do with leadership, teamwork, this could come in, even if it's not this question directly. I think it's definitely good to think about around the broad area of the culture of the place you're working in. I would say quite often you get a question around culture, leadership, creating an environment that is safe, even if the phrase isn't used exactly like that. Uh, so yeah, it's definitely good to, to think about it.

I think it also aligns to a trust values question as well.

Oh yeah, that's true.

Um, because actually there's, there's always something in the, you know, trust values. Think about what they are. They're always broadly around caring, compassion, kind, inclusivity, collaboration.

You know, some might say soft things.

Some might say soft things if we use that term, which we don't, and I'm sure we don't say that. Yeah. So, yeah, I think you can align psychological safety to multiple different questions. And actually, I think that's a really useful thing that you can show at interview.

Yep. Great. We're going to go on to the tip and trick. And the tip and trick for this week is about sounding like a consultant. And one of the things that I'm going to bring in here is because we get asked this Well, it gets commented on frequently. What are the buzzwords? What buzzwords do I need to know to sound like a consultant? And much like you hate the term soft skills, I hate this idea about buzzwords. There's certain buzzwords you have to say in an interview so that they'll know that you definitely understand how to be a consultant. It just, yeah, it really, this is not right because you can say, if you say a load of buzzwords, you're going to sound like a—

A robot.

you're trying to speak like a manager, or you've read some sort of management consultancy textbook. So, you're not trying to say buzzwords. You're trying to show that you understand what the role involves as a whole across your whole interview, not as in, because I'm using a term, I'm using a particular word, but that you understand the whole idea of why you're there as a senior team. And that is the biggest difference. from being a registrar is that you're part of a broad team who are trying to deliver quality care to your entire patient body.

Mm-hmm.

As a reg, it's not that you're not doing that, but you're not thinking about that first and foremost. You're thinking about how to give the best care to the patients that you're seeing right now, the patients on your shift, the patients on your round, or in your clinic. That's what you're trying to do. You're trying to see them well. You're trying to deliver great evidence-based care to them. You want them to like you. You want to get on with the team, and you want to get it done efficiently. And while all of these are true to some extent, when you're a consultant, you have this broader perspective and priority over how can we deliver great care to everyone. And that includes budget, that includes getting patients in, through, and out. It includes dealing with complaints or safety issues. And that's the biggest difference. So, it's not a buzzword, it's a whole thought process. I think I was beginning to sound like ChatGPT then. It's not just— It's more than buzzwords. It's an actual thought process. That should come through in all your answers. And that's how you sound like a consultant. It's not one thing, but it's the whole thing. What do you think?

I completely agree. That was a great kind of rant about buzzwords. I really enjoyed it.

We'll call it an impressive monologue. Okay.

That's what we'll go with.

Cool.

No, that's just a very impressive monologue. Yeah, but I actually agree with it. I think that the other thing that you need to show, because you're right, it's not about saying stuff, particular words, it's about showing that you're somebody who understands the bigger picture, who is prepared to take responsibility for stuff, to recognise that you are the person now.

Yep.

That, you know, obviously, you know, you're not the chief exec or the medical director, but essentially—

Yet.

Yet. Yeah, but the buck stops with you, you know, that you can take responsibility for things. Also, you know, that you're somebody who not only cares for all of, you know, the patient body, but your staff as well. And, you know, that you're somebody who can recognise the strengths and values in your whole team, celebrate those, and support the whole team. As a multidisciplinary team as well. So it's about being a bit bigger picture and a bit inclusive in the way that you think about patients and team and the system, I think.

Yeah, smashed it. I think we've covered, uh, quite a bit there, and I think we shall wrap up there. So thank you, Becky, for joining me for another great episode. And next week we are going to look at lots more great things, including looking at question around what support you might need in your first 12 months as a consultant. So I will see you then.

Great, see you then.