Staff Publication

Reducing medication (TTOs) delays when patients are ready to leave hospital (2016)

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Type of publication:
Post on the Academy of Fab NHS Stuff website

Author(s):
Nick Holding

Citation:
Academy of Fab NHS Stuff (www.fabnhsstuff.net/), February 2016

Abstract:
It’s a commonly held belief that patient discharge medication and discharge summaries are a cause of delays to patients leaving hospital.

Last year we tested to what extent this was a problem, confirm or dispel myths, and work with teams to find ways to improve turnaround times of medication.

We found that the process could be broken down into 4 key cycles of work:

1. Pharmacist generating the medication request (average 1.5hrs)

2. Prescription in queue waiting to be picked (average 1hr)

3. Prescription collection in Pharmacy Dept (average 50 mins)

4. Delivery of medication back to the patient (average 1hr)

Overall lead time to turnaround medication was therefore 4hrs 40mins. One of our roles in this was to help the teams that carry out the work, improve the work. So with this in mind we presented our findings to ward and pharmacy teams and ran a workshop to identify a number of improvement ideas which we would test and measure their effectiveness using Plan, Do, Study, Act (PDSA) cycles.

The teams came up with 3 simple ideas that they wanted to try out.

1. Pharmacist on daily ward round to improve communication and reduce delays in generating prescription

2. Separate work line in pharmacy for outpatient and inpatient activity to reduce delays in the picking queue

3. Introduce a direct delivery service to wards from pharmacy to reduce delivery times of medication

Testing the concepts and ideas Using PDSA cycles we planned a series of improvement weeks where we tested out the various concepts and measured the impact. Our aim was to develop a proof of concept which could then be explored further and introduced appropriately. By doing a number of simple steps we found that in after the first improvement week we reduced the turnaround time from 4hrs 40mins to 2hrs 30mins. By retesting, refining and introducing the other ideas in the second improvement week, the teams reduced the turnaround time further down to 1hr 30mins

Therefore, in conclusion, by truly understanding the current state, allowing the teams that carry out the work to improve the work, and giving them the space and time to test out their ideas, we showed that we can significantly reduce delays that patient experience when they are ready to leave hospital.

Link to more details or full-text: http://www.fabnhsstuff.net/2016/02/24/reducing-medication-ttos-delays-patients-ready-leave-hospital/

Taking Board Meetings outside the room (2016)

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Type of publication:
Post on the Academy of Fab NHS Stuff website

Author(s):
Adrian Osborne

Citation:
Academy of Fab NHS Stuff (www.fabnhsstuff.net/), March 2016

Abstract:
Trust Board meetings sometimes aren’t the most engaging or interactive of experiences, and any meeting that takes place in one place in one town will be limited in the number of people it can reach.

At The Shrewsbury and Telford Hospital NHS Trust (SATH) we’re on a journey, using social media to take our meetings outside the room and bring communities (real and virtual) into the room.

Link to more details or full-text: http://www.fabnhsstuff.net/2016/03/16/taking-board-meetings-outside-room/

Consultant-led, collaborative service for people suffering from respiratory conditions (2016)

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Type of publication:
Post on the Academy of Fab NHS Stuff website

Author(s):
Nawaid Ahmad

Citation:
Academy of Fab NHS Stuff (www.fabnhsstuff.net/), January 2016

Abstract:
This Future Hospital Programme case study from The Shrewsbury and Telford Hospital NHS Trust outlines the benefits of having a consultant- led service for respiratory medicine.

Key recommendations:

Establish a series of multidisciplinary team (MDT) meetings to discuss the needs of patients with long-term conditions. The MDT should incorporate primary care physicians, mental health, social services and palliative care services to provide a collaborative and exceptional level of care.
Run community-based clinics to reduce hospital admissions as well as help with accurate diagnosis
Propose a long-term management plan for more patients with more complicated health needs and to help with advanced care planning for those patients who are especially ill.

Link to more details or full-text: http://www.fabnhsstuff.net/2016/01/25/your-story-consultant-led-collaborative-service-for-people-suffering-from-respiratory-conditions/

Revision guide part 1 MRCOG (2016)

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Type of publication:
Book chapter

Author(s):
*Andrew Sizer, Mary Ann Lumsden

Citation:
In: Fiander, A. and Thilaganathan, B. (2016) MRCOG part one: your essential revision guide: the official companion to the Royal College of Obstetricians and Gynaecologists revision course. 2nd edn. London: Royal College of Obstetricians and Gynaecologists.

Link to library catalogue

Making a difference to End of Life and Bereavement Care (2016)

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Type of publication:
Post on the Academy of Fab NHS Stuff website

Author(s):
Jules Lewis

Citation:
Academy of Fab NHS Stuff (fabnhsstuff.net), February 2016

Abstract:
Death and dying is very difficult to deal with, even for staff who work in hospitals, but helping patients and their families at their time of greatest need is hugely important to us. It is a privilege to care for people at end of life and support their relatives/friends; we only have one chance to get it right.

The Trust has implemented the Swan Scheme to represent end of life and bereavement care. Following advice, support and permission from Fiona Murphy at the Royal Alliance Bereavement and Donor Service, a nurse-led innovation transforming practice across 3 large acute hospital trusts in the North West of England with the purpose of providing excellent end of life care for all.

Link to full-text

Understanding The Needs of People with Dementia and Family Carers (2015)

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Type of publication:
Journal article

Author(s):
Bray, J., Evans, S., Thompson, R., Bruce, M., Carter, C., Brooker, D., Milosevic, S., *Coleman, H., *McSherry, W.

Citation:
Nursing Older People 27 (7) p.18-23

Abstract:
This is the first in a short series that presents case study examples of the positive work achieved by trusts who participated in the Royal College of Nursing's development programme to improve dementia care in acute hospitals. When a person with dementia is in hospital, poor understanding of individual needs and preferences can contribute to a lack of person-centred care. Similarly, the needs of family carers can often be overlooked and staff do not always appreciate these needs at such a stressful time. This article illustrates how three NHS trusts have addressed these issues. To help staff get to know patients with dementia, Salford Royal NHS Foundation Trust has implemented a patient passport. Similarly, The Shrewsbury and Telford Hospital NHS Trust has implemented a carer passport that overcomes the restrictions imposed by hospital visiting hours. Royal Devon and Exeter NHS Foundation Trust also focused on carers, holding a workshop to elicit feedback on what was important to them. This was a useful means of engaging with carers and helped staff to realise that even simple changes can have a significant effect.