Huntsman 4 is a 32 bedded in patient Geriatric ward at the Northern general Hospital. Flow of patients through the Northern General hospital directly links with several elements of the Excellent Emergency Care workstream.
Key drivers for this work include ensuring that patients receive the right assessment, at the right time, with the right people. Patient experience is integral to this work as is clear and regular communication. The team have been involved in a collaborative approach to the design and standardisation of board round and as a result of this involvement requested support from the service improvement team to provide coaching support to a regular improvement meeting.
The work involves the Huntsman 4 Microsystem and those involved include all key stakeholders including Housekeeper, ward clerk, Nursing team, Therapy team and consultant teams who all regularly attend.
The team are also supported by the directorate management team to ensure that work links in with the wider directorate work streams
The team have focused on an assessment of the current state of the Ward Process and patient feedback regarding the current state of the system. Completion of this assessment highlighted several opportunities for improvement in communication (both between members of the ward team and also between patients, relatives and carers.
The teams key aims for improvement work are therefore focused on these key issues. The team aim to:
- Improve communication
- Reduce delays
- Improve patient experience and understand this experience more clearly.
At this stage in the improvement work measures used have reflected the scale of testing being carried out. The team have collected:
- Individual patient feedback
- Primary data on the location of buzzers
- Process data on the number of request for services completed by the ward
The team have tested a system to support increased patient feedback in addition to the Friends and Family Test. This involves a short conversation with patients to inform the focus of improvements.
The team have also tested ways to ensure patients have access to their call buzzer, an initial audit showed that on some occasions on 60% of patients had access to their buzzer.
The team are also testing ways to ensure the request for service is completed in a timely way by completing the request for service immediately after the board round.
What we achieved
The testing of different methods of securing / maintaining the location of the buzzer has been successful and recent data collection showed that all patients had their buzzer. The non-slip mats ensure that buzzers do not slip off the table
The team successfully tested at small scale using a new process to enable nurses to complete the request for service immediately after the board round
Increased patient feedback has been routinely collected for discharged patients using the test outlined above
The team continue to test and develop ways to maintain a focus on the buzzer and are currently exploring ways to standardise the look and use of the buzzer. This includes liaising with Dycem the company who provide the non-slip matting to explore custom designs. In addition the team are planning on standardising the location of other key items including the location of walking aids in the bed space.
The team continue to develop approaches to the completion of actions following the board round and are currently on PDSA #2 of this work, in addition to the immediate completion of the request for service form the team are testing recording of the action on the E-Whiteboard system and standardising an approach to this work. The team are also discussing how safety huddles could support a consistent approach to care and may develop these in the future.
All members of the Huntsman 4 Nursing team and also members of the wider MDT have been engaged and involved in the ongoing improvement work
The weekly improvement meetings are held as open meetings and have been supported at multiple levels within Sheffield Teaching Hospitals.
For more information Contact: Kevin.Firth@sth.nhs.uk 0114 2265059