Seamless Surgery Awards
The first ever Seamless Surgery Awards took place on the evening of Thursday 13th July and were attended by over 130 STHFT staff from a range of professions who work on surgical pathways. The awards were a celebration of the many improvements that have taken place as part of the Seamless Surgery Programme. There were many fantastic nominations and these were independently judged and the six winners and highly commended teams are below.
The Awards Newletter can be found here.
Scheduling and Planning
This award was presented to a scheduling team who make the best use of resources to schedule effectively for theatre lists, on a consistent basis. Including all members of the Multidisciplinary Team to do this.
Winners: Julie Smart (General Surgery) and Angela Nicholls (MSK)
Highly Commended: Neurosurgery Scheduling and Planning Team & Lower Limb Artroplasty Planning Team
Ange Nicholls has a managerial role within MSK and Julie Smart leads the General Surgery waiting list team. In the last 12 months Julie and Ange identified a need to help improve scheduling and planning processes to reduce the variation in the way Lorenzo is used. They decided to work together to find the time to undertake the significant task of writing a standard operating procedure (SOP) to give clear guidance for existing and any new staff who list patients for elective surgery. They are now training teams in using the SOP. Sharing a strong belief in making sure the that patients and staff have the right information at the right time, that stress for staff is reduced and that the patient experience is the best it can be, first time.
Many teams make huge efforts to reduce cancellations. This award was presented to a team who have gone the extra mile to reduce cancellations for patients.
Winners: Orthopaedic LiA Team
Highly Commended: Ophthalmology Seamless Surgery and Theatre Team & Plastic Surgery, RHH
The Orthopaedic LiA team set out to reduce on-the-day cancellations for elective surgery in their area in April 2016. The rate had traditionally been around 6.7% cancellations per week and the team worked hard to address the root causes, try new and different ways of working and all of this enabled a reduction in on day cancellations to a rate of around 3.5%, through all this work. By July 2016 the average rate of on the day cancellations had dropped to 2.8% per week.
Theatre Flow (On the Day)
This award was given to a theatre team who enables patients to flow through the system on the day of surgery. Systems and processes will be well designed to help things run smoothly. The team were able to demonstrate improvements for example in roles and responsibilities, minimum gap times, start times or readiness of equipment.
Winners: Cataract Microsystem Team
Highly Commended: Plastic Surgery, RHH & Burns Theatre Team
A big success within Ophthalmology has been the Cataract Microsystems process from which the Sheffield cataract pathway has been developed. This has led to the Trust investing in a brand new, state of the art Cataract Unit due to open at NGH in 2018. Patients are assessed and consented for surgery in a one-stop outpatient appointment. The new pathway involves each patient being allocated a dedicated nurse who remains with them through the whole surgery pathway. The flow through theatres is so much improved that 8 cataract patients can now be completed on the microsystem theatre lists where previously only 6 patients could be listed. This is a 33.3% increase in throughput and has been achieved whilst retaining the training element for the junior doctors.
Best Elective Patient Experience
Some changes lead to improvements that really make a direct difference to the experience patients have with their surgery. This award was presented to a team who have made such improvements and can proudly show the difference they have made for patients, however big or small.
Winners: The Plastic Surgery See and Treat Team
Highly Commended: Ophthalmology Seamless Surgery and Theatre Team & Pre-operative Assessment, RHH
Over several years the Plastic Surgery Directorate has piloted a See and Treat Clinic, where once a patient has been referred they are seen by a Consultant, prepared for a procedure, walk into the Theatre/Procedure Room and have definitive treatment there and then. To deliver requires teamwork with coordination between Admin and Clerical Outpatient Staff and Theatre Staff. There have been numerous PDSA cycles undertaken and evaluated in a variety of environments. At each step the process has been evaluated and improved. The patient has been placed at the centre of this pathway and every member strives to make the journey enjoyable and effective. Waiting times before, during and after have been reduced to a minimum. Throughput and efficiency has been maximised and the service has been evaluated to show cost benefit.
Overall Seamless Surgery Team
This award was presented to a team who provide a seamless patient journey from the moment of decision to operate to treatment and discharge. Evidence was provided of good communication between clinical and non-clinical staff, and work on all parts of the process with efficient use of resources.
Winners: Ophthalmology Seamless Surgery and Theatre Team
Highly Commended: Orthopaedic LiA Team & Plastic Surgery, RHH
The Ophthalmology Seamless Surgery and Theatre Team worked hard to improve theatre utilisation and reduce cancellations Their actions have seen on day elective cancellations reduce significantly from over 6% for Q1-Q3 in 2016/17 to 4.9% for Q4 and 3.9% for the first 6 weeks of 2017/18.
Some of the more specific actions the team have taken include;
- Implemented new Blood Pressure and Diabetic policies to help avoid on day cancellations.
- Implementation of Alturos minutes across the Directorate
- Developed electronic theatre planning
- Developed a cataract patient information video that provides a helpful explanation to reassures patients and helps avoids on day anxiety
Seamless Surgery Superstar
In this first year of Seamless Surgery awards, this category gave a chance for us to hear about those individuals who go above and beyond to embrace the improvement ethos and make an outstanding contribution to improving the elective surgical pathway.
Winner: Deborah Brodie (Neurosurgery)
Highly Commended: Beth Walker (ENT Theatres, RHH) & Mandy Shaw (General Theatres, NGH)
Deborah works as operational manager for Neurosurgery and has led the Neurosurgery team in taking the Seamless Surgery work forward. The team used the idea of planning "Perfect Lists" to achieve a number of the Seamless Surgery aims and as a way to bring many different members of the MDT together with a shared goal. The lists were very successful in improving touch time and increasing the number of patients on these lists. The ideals from these lists have been translated in the overall planning of all lists and in the way theatre flow on the day is managed. This has translated in an improvement in cases per list, with a gradual increase from an average of 1.27 in November 2016 to 1.40 in May 2017. Deborah has engaged staff by writing newsletters and continues to hold Neurosurgery planning meetings each Tuesday. Deborah leads these meetings which are very focused on looking back and learning from previous lists as well as looking forward to ensure future lists are well utilised.