Wood Hill House Intermediate Care Beds
Wood Hill House provides rehabilitation in collaboration between Sheffield Teaching Hospitals medical and therapeutic staff, and Horizon, who are the setting owners and take responsibility for daily care provision and hotel services. The home had recently celebrated its first year of operation when a clinical Microsystem Improvement team was formed in October 2014.
The lead improvement team is currently made up of two Occupational Therapists, a Physiotherapist, the Consultant Geriatrician, a Mental Health Nurse, a Pharmacy Technician, the Operational Manager for Intermediate Care Beds, an administrator, the Clinical Team Leader and a Carer.
By undertaking a 5Ps analysis, two major themes were identified: communication and boredom.
Communication was selected as the first area on which to focus as the team members recognised that the different disciplines’ patient assessment overlapped greatly which was frustrating for patients who found that they were repeating themselves a number of times. Although there are shared patient records, the observation was made that members of each discipline generally stayed in their own sections and it was unlikely that professionals would be able to navigate the full file; staff were not confident that they could easily find the information they were looking for.
The team agreed to focus on improving patient records, predicting that with standardisation and an improved layout, the document would serve more easily as a tool for communication between the professionals delivering care:
GLOBAL AIM STATEMENT
We aim to improve communication in Woodhill House.
The process begins with the patient arriving.
The process ends with a multidisciplinary, joint organisation treatment plan.
By working on the process we expect to improve efficiency, patient satisfaction and consistency, and to reduce duplication of work.
The work commenced with reducing variation between patient records by providing a structured format which was clearly labelled. A new contents page was tested in the records of three patients, one on each floor of the home. A satisfaction questionnaire was put in place on each of these, with simultaneous baseline measurement in three sets of unchanged notes – this measured ease of access to the information sought on any one occasion.
It took a couple of attempts to find a solution which seemed to fit, but satisfaction did increase rapidly. The workload involved in changing all patient records was prohibitive, so instead it was decided to use the new system for patient admissions only, with the expectation that by the end of one month all patient records would take the new format