Annual Report and Accounts 2012/13 - Royal Devon & Exeter Hospital

2. Progress on our
2012/13 Priorities
Royal Devon and Exeter NHS Foundation Trust
Quality Report 2012/13
13
As CQAT provides real time patient
feedback, it enables our clinical teams
to work on those areas that patients
and staff have identified as needing
improvement as quickly as possible.
Results are with the clinical teams
within 48 hours of an audit taking
place, allowing real and tangible
changes to be introduced rapidly. The
results of CQATs are also reported
to the Board as part of the regular
reporting schedule.
3. Strengthen nursing
leadership at ward
level
Last year we said that we would
strengthen leadership at ward level by
ensuring that ward matrons are given
the time to lead and opportunities to
develop their skills.
We know that if we are to maintain
high standards of care, it is essential
that Ward Matrons have the right
skills and sufficient time to provide
leadership. During the last year we
worked with Plymouth University
to design and develop a bespoke
leadership programme for Ward
Matrons. This programme aims to build
on and enhance our Ward Matrons’
existing excellent leadership skills and
will be delivered from April 2013.
The Trust has also taken steps to
increase support for Matrons on wards
to ensure that they have dedicated
time to lead their teams and monitor
standards of care. This increases their
visibility and makes them more available
to patients, relatives and carers.
Staffing at a ward level is complex as
there are a wide range of factors which
influence how many staff are required
to deliver safe and appropriate care.
In order to ensure that we fully
appreciate this complexity, during the
last year we have undertaken a review
of our clinical teams at ward level. This
review used three criteria:
1. Professional Judgement
Ward Matrons assessed the staff
they required to provide optimal
care on their individual wards. This
information was then reviewed by
a senior team (made up of Senior
Matrons or Lead Nurses, and the
Deputy Director of Nursing).
2. Dependency Review
Clearly not all patients require the
same amount of nursing time in
order to receive a high standard
of care. Factors such as the nature
of a person’s illness, their age and
other disabilities can impact upon
how dependent a patient is.
We use a number of tools to
calculate the dependency of
patients within hospital wards.
All of these have their limitations
so we commissioned an expert
with extensive experience in the
development of dependency tools,
to develop a bespoke dependency
tool for our needs. This tool has
been used to provide us with
detailed data relating to the
occupancy and dependency of
each ward in the Trust.
3. Benchmarking
Current ward staffing levels
have been compared to national
benchmarks.
The result of all of this work is that
we now have a comprehensive
understanding of our ward
staffing levels and are confident
that we have the right numbers
and mix of staff on different wards
to meet the differing needs of
their patients.