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Challenges in POA. Mrs Jane Jackson SRN MPhil MCGI Consultant Nurse Honorary Fellow University of Hertfordshire [email protected] 1930’s Consultant led service only for complex surgery. Early beginnings – but were they patient centred?. How has POA developed?. Day Surgery

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Challenges in poa

Challenges in POA

Mrs Jane Jackson SRN MPhil MCGI

Consultant Nurse

Honorary Fellow University of Hertfordshire

[email protected]


Early beginnings but were they patient centred

1930’s

Consultant led service only for complex surgery

Early beginnings – but were they patient centred?


How has poa developed
How has POA developed?

  • Day Surgery

  • 1993 - POA for all patients

  • Worldwide delivery of care / sharing of knowledge and experience

  • From Nurse led to Patient Led care

    possibly as a Nurse run service


Shaping of the poa service
Shaping of the POA service

  • Healthcare professionals

  • Delivery of service, audit, patient survey

  • e-mail and Internet and networking exchange of POA procedures / delivery of care

  • www.pre-op.org

  • Demands for efficiency, lean thinking, lean working

  • Advances in Day Surgery


Life expectancy at age 65 yrs.Life expectancy Source: Office for National Statistics; Government Actuary’s Department

Life expectancy at age 65, United Kingdom


The most common causes of death in England and WalesAge-standardised mortality rates for selected broad disease groups, England & Wales


Department of health cno
Department of Health / CNO

  • Health of the Nation – 1998;

  • The NHS Plan 2000;

  • Creating a patient led NHS Delivering the NHS Improvement Plan 2005;

  • Healthcare Associated Infections 2006 -reduction in the rates of MRSA / C.Diff;

  • 18-week patient pathway 2006;

  • Patient Choice 2007;

  • Healthy weight, healthy lives 2008.


Clinical practice
Clinical practice

  • NICE clinical guidelines

  • European working times directive

  • For nursing staff, Advanced practice Modernising nursing careers


18 week pathway
18 week pathway

  • 85% compliant in England and Wales by March 2008

  • 90+% compliant by Dec 2008

    Key words

    Patient led care

    Clock starts – referral

    Clock stops - treatment


Poa at decision to treat
POA at decision to treat

Referral

CATS /OPD

dtt

+/- investigations

POA

ffs

W/L

not ffs


Challenges of 18 week delivery through one stop poa
Challenges of 18 week delivery through one stop POA

  • Re-organisation of the OPD / POA / admission process

  • Involves changes for all the surgical division – Consultant, secretary, POA, records.

  • Primary and Secondary care cohesion

  • Key – clarity for patient of the 18 week process


Benefits of 18 week
Benefits of 18 week

  • Short journey for patient

  • Lean thinking and lean working

  • “…the patient receives the right care, at the right time and of the right quality without unnecessary delays.”Delivering the 18 week patient pathway DOH 2007

  • Effective use of resources - notes

  • Appropriate referrals


Patient led care through inter professional teamwork

Patient led care through Inter professional teamwork


Annual Conference –

“A Risky Business”

6th November 2008

at

Royal Court Hotel, Coventry

Registration: £190 (members of the POA)

£225 (non-members)

For further details including registration forms, please visit www.pre-op.org or contact [email protected]


Pre operative assessment 2008
Pre Operative Assessment 2008

  • Providing a service for the user

  • Effective assessment

  • Location – convenient to the patient


A practical guide to developing and running effective pre assessment

Legal aspects

Career developments

Team leadership

IT support

Audit

Predicting and explaining risk of surgery

Developing a POA – face to face and telephone

How to set up POA

The role of POA in meeting the 18-week pathway

A practical guide to developing and running effective pre assessment


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