Question 4 : Are they responsive?

1. Question 4 : Are they responsive? • Reporting Adverse Incidents • Nutrition and hydration • Intentional rounding • Productive ward

2. Reporting adverse incidents Management • Attend to injured person • Inform appropriate people • Make the environment safe • Remove (but retain) faulty medical device or equipment from service • Apologise • Document incident • Report Adverse Incident onto Datix If Serious Incident or RIDDOR, call the Risk or Health and safety team Further information via the intranet: • Adverse Incident Reporting • Risk Management • Health and Safety • Key contact numbers: • Corporate risk and assurance team Ext 2166 - 4966, 4054 – 4050 • Health and safety team Ext 3309 – 4043

3. Reporting adverse incidents Datix – adverse incident monitoring system Datix can be accessed via SGH intranet under Applications; Non Clinical Applications

4. Effective Hydration • A red lid on the water jugs and a red tumbler signal to staff that these particular patients need help with drinks and fluids • Nutrition boards will need to identify which patients require jugs with red lids/red tumblers – magnets will be available soon. • All patients or fluid charts require close monitoring and documentation of fluid intake and output, use red tumblers/jugs with red lids • Always check they may be restricted on fluids.

5. Intentional Rounding (comfort or hourly rounding) • A simple check - is everything ok? • Many staff do already but not always - patients say they often don’t see staff • Regularly checking on patients comfort needs • Reduces harms (falls, pressure ulcers) complaints, and use of call bells • Patients reassured as know they will see us regularly • Ensure a patients know who is caring for them • Sometimes hourly but should be frequent • Pain, drink, comfort, help with toilet, have their call bell? • Being present in bay doesn’t mean you are available to all patients • Gives patients “permission” to ask us things as often think we are too busy • Should be documented but kept simple

6. Productive ward • This national initiative aims to help frontline staff release more of their time to care for patients directly • Each area undertakes a baseline assessment of how they are doing. It helps to identify how much time is spent on direct patient care as well as identifying the non value adding activities and areas of waste • Staff are taught the LEAN service improvement methodology of Sort, Set, Shine, Standardize and Sustain • Teams identify their key performance indicators for their area and devise an action plan for improvement • The aim is for the ward to become well organised – this will include organising store rooms so that you are able to find what you are looking for within 5 seconds of going in there, identifying space for equipment (all reduces the time wasted looking for nursing equipment) • A ward vision is created which provides clarity on what staff should be delivering and what patients can expect • Direct care time audits are undertaken to identify the percentage of time staff are spending on direct care with their patient group,. The audit identifies areas of waste and areas for improvement • There are a variety of guided modules, set over 16 weeks, for wards to follow in order to improve the area of waste identified • Just completing a ten minute module contributes to your professional development • The Productive Ward is currently under review and will be relaunched in 2014