It may be summer but there is still plenty going on! Here are a few current issues and initiatives from the last couple of weeks
Focusing on the patient
We have made a number of changes to our senior management team in recent months. A new approach to create much closer working between directors and day to day delivery of care, more clinicians involved at senior level, and some new people too
Our new Medical Director Dr Andrew Catto, who has taken over Board leadership of quality and safety, has put an introductory podcast together to talk through our vision moving forward. In it, he talks to our staff and you can see it on our Trust website here
In times of significant turbulence and change, such as we are currently experiencing, it is helpful to have this reminder of what is really important
SAFER care and shifting our focus from ‘back door’ to ‘front door’
Regular readers will know we have been working hard on improving discharge in our hospitals over the last year, because without timely discharge we cannot achieve timely admission from our Emergency Departments
Our ‘front door’ attendances, and emergency admissions, have increased significantly over recent months, so we have been re-emphasising our SAFER bundle just lately
We know that in order to keep our wards functioning effectively and our patients flowing through the hospital smoothly, we must achieve compliance with the bundle, which is made up of the following:
All patients will have a planned discharge date (PDD) on admission.
Flow of patients will commence at the earlier opportunity from assessment units (AMU & SAU) to inpatient wards.
Early discharge – ideally from base inpatient wards before midday.
Review of all patients with extended lengths of stay >14 days on a weekly basis, identifying the issues and actions required to facilitate discharge.
Despite the increased pressure, it is pleasing that our 20% reduction in length of stay over the last year is continuing. As you can see from the graph below, one area we continue to improve on is reducing the number of patients with a length of stay of more than 14 days:
We are currently looking at what we can do for our short stay patients to speed up processes such as diagnostic results, transport arrangements and arranging TTOs earlier which will allow us to make discharges earlier in the day, improving our flow further
A discharge in time really does stop another patient waiting in-line, but in the coming months the focus will be on creating alternatives to admission for those patients who can be appropriately cared for outside of an acute ward
Clinical leadership is crucial
Our clinical leaders are central to this transformational work, and we were delighted to appoint Dr Govindan Raghuraman as Associate Medical Director for Heartlands Hospital. He has changes in mind already – 14 directorates report to him and these are, as is traditional, specialty rather than patient pathway based. To help make improvement easier he is planning to align these into three Groups:
- Emergency Care
Each Group will be led by a senior team comprising of a doctor, a manager and a nurse who will work to create more joined up planning and service delivery
We will be recruiting to these roles very soon and look forward to working with these teams to bring about the pathway improvements that are part of our 5 year strategy
Staff training: Equality and Diversity, and Health and Safety
Our Staff Survey results suggest that we could usefully augment our mandatory training programme. Awareness training is one way to do this
We have introduced a new paper based awareness training package to cover these two key areas. It consists of two workbooks, one for each topic, and both really do raise awareness in areas that are a very important part of caring for our patients and our staff and keeping everyone safe
It is important that all staff complete this awareness training and we will be issuing the workbooks over the coming weeks
Good Hope Hospital fete
It was great to see so many of our local community attend the Good Hope Hospital fete a couple of weeks ago. It is a great day out and an opportunity to open our doors to the local community
The annual event, opened by Rt Hon Andrew Mitchell MP, the Member of Parliament for Sutton Coldfield, raised nearly £1,000 towards equipment for the hospital’s elderly care wards
There was something for everyone to enjoy including a teddy bears’ hospital, a home-made cake stall and an afternoon tea party, which meant the day was a great success with the local community, staff, patients and supporters
As we’ve not had any further cases in the hospital or the community since 19 June, we declared the outbreak officially closed on 22 July
We have now started on the Root Cause Analysis to understand how we managed the outbreak and to learn any lessons. Professor Eric Bolton of the Health Protection Agency will work with us on this – he has particular expertise in food and water-borne gastrointestinal infections
Interestingly, it now seems the outbreak we experienced is part of a wider problem caused by the same strain of organism?
Managing this has been an intensive undertaking for us, coming as it did at a very busy time in Heartlands Hospital. We remain vigilant and are still advising relatives and visitors not to bring in food for patients
Staff Recognition Awards 2014
Each year, we hold our Staff Recognition Awards ceremony, giving patients, community and staff a chance to nominate those who have touched their hearts
I really enjoy attending and hosting this event (sharing the limelight with Michael Collie, our local BBC television personality) and seeing our staff and volunteers from across our Hospitals and the Community rewarded and recognised for the brilliant work they do each and every day
This year, for my award, I will be receiving nominations from our Patient Services team as well as from individual staff members and teams. This will ensure we don’t overlook the many compliments that we receive in writing and by email, and also the mentions that patients make as part of our Family and Friends Test returns
Preparations are well under way for this year’s event on October 22, and there is lots of information about award categories and previous winners here
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Our Health Blog Round Up collates a variety of health and healthcare-related blogs and it is updated every week – you can read it here