InFocus Magazine 2007 - Hampshire Hospitals NHS Foundation Trust

06
Productive ward
releasing time to care
The premise is simple:
To review working practices and give
nursing staff more time to spend with
patients. Using knowledge from the
commercial and business worlds, we can
tighten efficiency to release more time.
In conjunction with the NHS Institute
for Innovation and Improvement, our
hospital has embarked on a project
designed to conserve the time of
nursing staff.
Our nursing team on C3 are closely
involved in the project, helping to
determine areas of need. For example,
the nurses are frequently interrupted
by visitors who are looking for patients.
These interruptions can take nurses’
attention away from important or
urgent tasks. Nurses, medical staff
and patients discussed this problem
and came up with the ‘patient location
board’. This displays the ward layout
with each patient’s name in their
allocated bed space. It enables visitors
to see at a glance where the patient
is and therefore nurses are not
interrupted as frequently.
Stock cupboards on each ward
have also been reorganised. These
cupboards – one per ward – contain
all the frequently-used items that
may be needed when patients
suddenly feel unwell. They were not
regularly stocked and were mostly
in disarray, making it difficult to
quickly access equipment. There was
no consistency in their layout or
contents. Nursing staff agreed to
rationalise the contents, stick to one
layout and designate someone to
top up stock on a daily basis. Now a
cupboard in bay 3 and a cupboard
in bay 5 are arranged in the same
orderly fashion, making them quicker
for nurses to access.
Plenty of other measures have been
identified to free up time: a redesign
of the nurses’ station, rationalisation
of stock in the sub-pharmacy area
(saving almost £1,000), an information
leaflet for patients on the ward
routine and the trial of equipment
that will automate the management
of supplies.
This ongoing project has already
brought many positive outcomes.
Staff members have embraced the
opportunity to foster a culture of
change, nurses and patients have
engaged in decisions affecting their
environment and visitor feedback
has also been positive. As a result of
this project’s success, it will soon be
adapted by other departments in the
Trust, freeing up time and improving
patient care right across the hospital.
Two Week Rule and the Breast Symptomatic Service
When cancer is suspected, early diagnosis and swift treatment
are vital. The government has installed a number of targets to
make sure this happens, and the ‘Two Week Rule’ (TWR)
is one of these. Current guidelines say that patients
referred with suspected breast cancer should be offered
an appointment within two weeks; and all cancer patients
should be offered treatment within 31 days of referral.
To reach these targets this year, our breast cancer team
has continued to make some great improvements to their
service. Patients with suspected breast cancer can take
advantage of our one-stop service, where they will have a
clinical consultation, mammogram, ultrasound and/or needle
and core biopsy at one appointment. As well as being far
more convenient for patients, this speeds up the diagnosis
process. It’s also enabled us to meet all cancer-related targets
This year we have seen:
374 TWR referrals
168 new patients with primary breast cancer
And we have recorded the following average times:
Time from TWR referral to treatment: 35 days
Time from ‘Decision to Treat’ to treatment: 14 days
These figures meet all of our targets, ensuring that all
cancer TWR patients are treated within 62 days of referral
and that all cancer patients receive their first treatment
within 31 days of deciding which treatment is appropriate.
This is down to a dedicated multi-disciplinary team working
hard to ensure all cancer patients receive the best possible
care in a timely manner.