Embedding storytelling in practice through CAKE – a recipe for team wellbeing and effectiveness

Background: CAKE, an interactive resource to promote individual and team wellbeing and effectiveness through storytelling was co-designed with community nurses in 2020. In Phase 1 of this project, CAKE comprised seven slices that guided teams through a process of connecting, storytelling, reflecting and action planning to promote wellbeing. It was developed in response to an increasing awareness of psychological harm experienced by nurses and other healthcare professionals. Levels of stress in the workplace are currently contributing to problems with recruitment and retention, and a lack of resources have impacted on practitioners’ wellbeing, and their ability to be compassionate caregivers and to contribute to healthful teams. Aim: Phase 2 of the project sought to: 1) develop facilitators of CAKE; 2) pilot test the prototype CAKE resource in a range of contexts; and 3) create a digital version of CAKE. Methods: An evaluation approach to pilot testing, using multiple methods of data collection, involved 130 health and social care practitioners at 17 sites across the UK. Eight facilitator support sessions, underpinned by the Critical Ally model were offered and data were analysed using thematic analysis. Findings: The findings revealed two overarching themes: facilitating CAKE and experiencing CAKE. In the former, three themes emerged: preparing for CAKE, trying CAKE and embedding CAKE. The latter had two themes: giving it a go and culture change. Following the study, the number of CAKE slices was increased from seven to eight by separating reflection and action planning, and minor amendments were made around spelling and grammar. Conclusion: We propose CAKE as a novel resource to promote individual and team wellbeing and effectiveness in health and social care teams. CAKE users acknowledge the challenges in creating space to use the resource, but when it is implemented teams embed practices that create healthful teams. As facilitators use CAKE, they develop their facilitation skills but they require preparation and support. Implications for practice: Taking time out to use CAKE can improve individual and team wellbeing and effectiveness Using CAKE supports the growth of gentle facilitation practices within teams CAKE has the potential to develop teams in which collective leadership is the norm Successful implementation of CAKE is dependent on support from managers and a culture that prioritises wellbeing