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Releasing Time to Care: Implementation with the Southern HSC Trust

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Title: Releasing Time to Care: Implementation with the Southern HSC Trust


1
Releasing Time to CareImplementation with the
Southern HSC Trust
  • Kay Carroll
  • Lead Nurse , Southern HSC Trust
  • Sharon Kennedy
  • Ward Manager, Southern HSC Trust

2
Implementation stages
  • Regional Launch 1 October 2008
  • All 5 Trusts participating in the pilot stage
  • Project Leads training 29/30 October
  • Familiarisation event in each Pilot Trust
  • Ward based staff training
  • 28th Nov,26th Jan, 12th Feb, 12th March 2009
  • Evaluation of pilots March 09
  • Rollout to other ward?

3
Releasing Time To care The Productive Ward
  • Releasing time to care - is a systematic and
    inclusive approach to improving the reliability,
    safety and efficiency of the care that you
    deliver.

4
Releasing Time To care The Productive Ward
  • Executive Lead
  • Joy Youart
  • Acting Director
  • Acute Services Directorate

5
Project Leads
  • Jacqueline Morton
  • Head of Reform
  • Glynis Henry
  • Assistant Director
  • Nursing Workforce Development Training Nursing
    Governance

6
Key roles
  • Senior management team and Trust Board
  • Steering Group
  • Executive Leader
  • Project leads
  • Ward Leader
  • Ward team
  • Support from other areas e.g. Finance,
    Information and Estates

7
Expectations of Executive leader
  • To influence and work with staff on the wards and
    to influence and communicate with senior
    management team colleagues and Trusts Board
    members
  • Ensuring there is senior management team / Board
    sign up and understanding of the Productive Ward
  • Selling the benefits of PW to the organisation
  • Clarifying the challenges for the organisation
  • Ensuring the Board understands that PW is focused
    on improving the quality of care, not an
    opportunity to reduce costs
  • Ensuring that senior colleagues understand the
    need to be visible on wards, supporting the staff

8
Expectations of Project Leader
  • Responsible for the successful planning and
    implementation of the Productive Ward
  • Project management overseeing implementation
  • Managing expectations
  • Support to Executive Leader and Ward Manager
  • Stakeholder management
  • Communication and visible involvement
  • Tracking progress
  • Enabling ward staff
  • Securing resource
  • Reflection and learning from the process
  • Being enthusiastic, credible empathic

9
Expectations of Ward leader
  • Understanding the basic principles of PW
  • Understanding the benefits PW can bring to your
    ward
  • Ensuring staff attendance at all training
    sessions
  • Leading your staff in the implementation of PW in
    your ward
  • Addressing emerging issues
  • Working closely with your Project leader
  • Regular communications with all ward staff
    including shift staff
  • Being a point of contact for other interested
    wards

10
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11
Introduction to Releasing time to care
  • Two information sessions for staff.
  • Meeting with Medical staff.
  • Dissemination of information to other members of
    MDT.
  • Communication Board in MDT room.

12
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13
LEAN PHILOSOPHIES
  • Elimination of Waste.
  • Respect for people.

14
Lean Methodologies .
  • 6S
  • Visual Management.
  • Process Flow analysis.
  • SMED.
  • Standard Operating Procedures.

15
Releasing Time To care The Productive Ward
  • Knowing How Your Doing
  • Developing Ward based measures to help your team
    make informed decisions

16
ONLY 33 OF NURSES TIME WAS SPENT ON DIRECT
NURSING CARE N.H.S INSTITUTE FOR INNOVATION
IMPROVEMENT AVERAGE 40
17
Measures Board
  • Infection control issues.
  • Hand Hygiene audits.
  • Commode Audits.
  • Environmental audits.
  • C Difficile
  • MRSA / MSSA bacteraemia.

18
Measures Board
  • Complaints.
  • No of complaints.
  • Reason for complaint.
  • Profession indicated.
  • Length of stay.
  • EDD recorded.

19
Measures Board
  • HUMAN RESOURCE ISSUES
  • Sickness and Absenteeism rates.
  • Nurse Bank and agency use and costs.

20
  • Display of a nursing dashboard in public area
    including Infection control, ALOS, complaints,
    sickness and absenteeism. Measures include the C
    DIFF infection rate which is supported by the
    hand hygiene audits scores. This allows the team
    track progress and to identify areas that may
    require a focus and improvement

21
Releasing Time To care The Productive Ward
  • Well organised ward.
  • Making Ward areas work for your team instead of
    hindering them in the delivery of care

22
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23
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24
Ward 1 South
  • REORGANISATION OF STOCK
  • 76 reduction in the number
  • of steps taken to set up a catheterisation
    trolley
  • 234 steps reduced to 61 steps
  • 446 minutes reduced to 216 minutes

25
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27
Cash Savings
  • CASH SAVINGS
  • 2080
  • Excess pharmacy
  • returned
  • 1200
  • Excess TSSU
  • returned
  • 880

28
Releasing Time To care The Productive Ward
  • Patient Status at a Glance
  • The ward team develops visual patient information
    that improves communication, patient experience
    and patient flow

29
PATIENT STATUS AT A GLANCE
  • Patients name
  • Name of consultant.
  • EDD.
  • Infection control status.
  • Outliers.
  • MDT Referral.
  • Dietary options.

30
Releasing Time To care The Productive Ward
  • Meals
  • The ward team reduce the time spent physically
    delivering meals and allow more to assist with
    feeding and ensuring proactive nutritional
    assessment for ward patients

31
Releasing Time To care The Productive Ward
  • Meals
  • Establish new membership.
  • Engage with
  • catering,
  • Portering
  • domestic
  • dieteticians and
  • communication team.
  • Baseline data.
  • Audio video meals
  • Patient survey.
  • Implement 10 a day

32
Roll out
  • Feedback to SMT.
  • Develop Roll out programme.
  • Ward Managers
  • Half day workshop May 09.
  • Two day residential June/ Sept.
  • LEAN methodology/ Releasing time to care.
  • Training Programme for Trainers for Southern
    Trust commenced Sept 09.

33
CHALLENGES
  • C --- Complex
  • H --- Huge.
  • A --- Achieved.
  • L ---Learning.
  • L --- Longevity
  • E --- Engagement.
  • N --- Negotiation.
  • G --- Gains
  • E ---- Evidence
  • S --- Success/ support.

34
The Way Forward
  • Releasing Time to Care is not a project it
    focuses on improving ward processes and
    environments to help nurses and therapists spend
    more time on patient care thereby improving
    safety and efficiency.

35
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