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Listening into Action (LiA) 3 rd July 2013

Listening into Action (LiA) 3 rd July 2013. Acute Care Division. Our Mission To Improve the Emergency Department & the Acute Admission Process. Our Outcomes. Improve the working environment for staff Remove the barriers that cause frustrations everyday

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Listening into Action (LiA) 3 rd July 2013

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  1. Listening into Action (LiA)3rd July 2013 Acute Care Division

  2. Our MissionTo Improve the Emergency Department & the Acute Admission Process

  3. Our Outcomes • Improve the working environment for staff • Remove the barriers that cause frustrations everyday • Improve patient flow through the department • Improve patient safety • Improve patient experience

  4. Case for ChangeNeed to ‘Listen to the people who know’ We are the first impression for a lot of patients and families Only a short time to make a big impression Efficient, high quality care

  5. Links with Trust Values and Goals

  6. Our Approach Small Core Sponsor Team Mark Buchanan, Morag Devoy, Nicola Drinkwater, Tom Fitzharris, Kate Fletcher, Doreen Glover, Emma Halls, Gill Heywood, Philip Lawrenson, Sue Malone, Bethan McGuigan, Leanne Monaghan, Theresa Montez Brown, Chris Oliver, Sarah Pickstock, Julie Tunney, Clare Weaver Sponsor:Mr David Allison – Chief Executive Catalyst: Big Conversation on 2nd April 2013 LiA VisWall

  7. Suggestions ? Improve staff training Improve safety Reduce wait in the ED Improve the patient Journey Improve on tools IT Equipment Improve Staffing Privacy and dignity Reduce Overcrowding Improve the environment

  8. Review Night Staff Numbers Review New Staffing Model Publicise Vacant Posts Suggestions ? Improve documentation Bigger resus Improve Communication Increase ECG/ Phlebotomy Improve sickness No Use of Middle Communication Courses Review Handover Transfer Team New Trolleys Stop Redirects Escalate Broken Equipment Improve response of Support Services Improve Junior Doctor Support Improve Team Spirit Wards aware of Patients in AC More Wheelchairs Uniforms who’s who Improve Security at Night More Siderooms

  9. Quick Wins Improve the Environment Reduce wait in the ED Stop Redirects No use of Middle Reduce Overcrowding More capacity in the chaired area (in AAU) 4 – 8 chairs. Ordered as a result of LiA and now in use. Benefits:

  10. Quick Wins Improve on tools and IT equipment Improve communication • Better Communication • News letter produced • Staff Engagement Meetings • You Matter Update (well being) Review new Staffing Model Improve Team Spirit

  11. Quick Wins Improve Documentation Improve Communication Improve Junior Doctor Support • More Computers available. • PCIS on more computers • Better connections to printers • Moved computers to more usable sites. Reduce wait in the ED

  12. Other Quick Wins • Ordered New Patient Trolleys (36) (due July) • Publicised staff vacancies • Increased capacity in ambulatory care clinics • Flow Charts re broken equipment reporting • Reduced redirects

  13. 3 High Impact Actions Review new Staffing Model No use of Middle Reduce wait in the ED Reduce Overcrowding Improve the Environment Improve the Patient Journey Privacy and Dignity Stop Redirects 1. Create a single Triage area:

  14. Old Model • Ambulance patients triaged by Senior Nurse and ECSW into Trolley Area • Walking Patients Triaged by Junior Nurse into Waiting Room. Inequality of Assessments

  15. New Model • 1 Senior Nurse, 2 Band 5 Nurses and 1 ECSW work as a team All patients receive the same service

  16. How did we make the Change? • Pilot • Well received by all staff • Improved Flow • Reduced patients in the middle • Now funding to improve the environment further: purpose built for the new system

  17. Benefits Better Flow Better HAS screen compliance Reduced ambulance turnover (from the worst to the best) Safer Care Different staff model Improved Morale

  18. Staff Education • Nursing: ED • Morning Education Sessions. • Nurses freed up to attend • Delivered by Consultants, Speciality Nurses, Paramedics. • Future - Expand and replicate in Acute Medicine

  19. Improve safety Improve staff training Improve documentation Improve team spirit Improve the patient Journey Improve communication Improve Staffing Improve response of support services

  20. IT Support and Infrastructure • PC’s in areas of most need • moved computers more accessible areas. • PCIS on computers • Increased by 4 • IT lead for the division • Caroline Bridgwater allocated Tuesday am. • Working with IT.

  21. Reduce wait in the ED Improve on tools and equipment / IT Improve the patient Journey Improve communication Improve documentation Improve the environment

  22. Measures of Success • Friends and Family • Complaints • 4 hour HOSPITAL target • Ambulance turn around • Moral (e.g sickness)

  23. Summary and Next Steps LiA empowers the team and makes them feel part of the journey to improvement instead of being forced on the journey. Next Steps. Have a big build plan (finished in November) Focus on flow into assessment units LiA shouldn't be a 4 month project but rather a change in philosophy Continue with suggestions box: Continue with VIS board re improvements.

  24. THANK YOU!Any Questions? For further Information on this work please contact Names: Mark Buchanan / Chris Oliver/ Tommy Fitzharris Department: Acute Care Ext: 2208 email markbuchanan@nhs.net, chrisoliver@nhs.net

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