Leading Better Care

Sharing Good Practice

NHS Board:NHSForthValley

Ward: Unit 1 FalkirkCommunityHospital

Details of Improvement:

What was the particular problem that this case study isabout?

The ward has been involved in dramatic changes which include amalgamating two teams of staff, moving to a new ward environment and a change in the model of care from acute care to community care.

How was this identified?

The above resulted in a big dip in staff morale. There was also a breakdown in the patients carejourney resulting in an increase in patients having to be transferred back to the acute care setting.

What were the implemented improvements (whattools/techniques did you use)?

The SCN facilitated a team approach to problem solve and minimise the risks to the patients due to the change in the model. Involving all levels of staff allowed the team to gel and feel back in control again. A custom made SBAR transfer form initially for brain injured patients was developed to facilitate appropriate patient transfer into the ward. This form also incorporated an escalation treatment plan. SBAR piloted end 2009.

What is the situation now?

Admitting appropriate patients who have a clear pathway with an anticipatory or a complex care plan assists nursing staff and GPs in the provision of seamless care and has reduced the number of transfers back to the acute setting thus improving the patient’s journey.

.

How is the change sustainable?

Nursing and GP staff have ownership and control of this process. The SBAR is now used for all patient transfers.

Measurable outcomes

What are the patient benefits?

Improved patient journey. Patient’s more involved in anticipatory care planning.

What are the staff benefits?

This problem solving process facilitated the amalgamation of the teams, staff feel back in control, happy in their environment and feel that safe patient care is being delivered.

Reduction in patient transfers. Decrease in sickness and absence in the ward

.

How did staff feel before the improvement/during theimprovement and after the improvement?

Pre – Disempowered stressed and worried re patient care.

During – Team spirit emerged, problem solving happened and stress levels began to reduce

Post – Happy cohesive team, proud and confident in the model of care they provide. Feel valued and able to participate in other ward based projects.

What are the lessons learnt and what would you dodifferently next time?

At and earlier stage I would make myself and the team aware of the proposed model of care thus allowing more time for problem solving. I would spend more time shadowing my colleagues working with the model.

What plans are there to spread the improvement?

SBAR now used for all patient transfer.

.

Contact information for case study

Craig Finlayson

Tel 01324 616124

e-mail