[T]he latest improvement project at the Cumberland Infirmary has improved care for stroke patients by increasing the amount of time the nursing staff spend with their patients.
The team on Elm B ward were selected to take part in a Rapid Process Improvement Workshop (RPIW) supported by the Cumbria Learning and Improvement Collaborative (CLIC) which focusses on positive transformations in health and care.
The workshop provided a very intensive five-day improvement plan and an opportunity for staff working on the ward to take time out to discuss the main obstacles they face within their day-to-day roles. They looked at how the obstacles could be reduced to provide staff with more time for face-to-face patient care.
The team, including medical, nursing, allied health professional staff and a patient representative, quickly identified and implemented a number of improvements including:
- A ‘PEP’ talk (Patient Engagement Programme) that will not only include patients in the planning of their care and help to improve mood but also improve communication between teams leading to savings of over 400 hours a year.
- The opening of a dedicated Stroke Assessment Cubicle which will free up almost 500 hours annually of staff time and ensure a much larger percentage of stroke patients go through the correct pathway, improving outcomes and generating funding through the Best Practice Tariff.
- A review of case notes will lead to a saving of 1400 hours a year.
- Plans have been developed to reconfigure and optimise room use on the ward. This will free up 1400 hours of the team’s time, allowing staff to spend more time with patients and reduce incidences of falls. Additionally, a dedicated room for therapy will enhance patient experience and outcomes as well as allowing staff and patients valuable confidential space.
- Work on the discharge pathway (1 discharge checklist completed as part of the board round) will facilitate the discharge co-ordination process, improve patient experience and develop more collaboration between hospital and community teams, as well as saving up to 520 hours.
- Arrangements for the Early Supported Stroke Discharge Team to visit the ward three times a week to co-ordinate discharges; will save time and reduce failed discharges through better communication and getting it right first time.
Julie Little, ward manager on Elm B, said: “It was a very exciting week for our team with the aim of keeping patients at the centre of our attention and improving their experiences. As part of this work, we’ve reduced the number of falls on the ward by 25 percent, which is a great reduction and a real boost for patient safety.”
Dr Paul Davies, consultant in stroke medicine said: “The RPIW week has been excellent and has enthused and empowered the staff that work on the ward. They have brought their ideas on how the working environment can be improved and how they can work more efficiently and that will allow more time for working with the patients. This in turn leads to better quality rehabilitation and care for our patients”
Further to this week, the team will hold 30, 60 and 90 day reviews to ensure all improvements identified are continuing to be implemented.