Type of publication:Service improvement case study
Author(s):*Hannah Pope *Rebecca Houlston *Dr Aruna Maharaj *Madeleine Oliver
Citation:SaTH Improvement Hub, July 2023
Abstract:The introduction of the acute medical floor (AMF) will enable ward 22 short stay to achieve a length of stay of 3 days (4320 minutes) by 31st July 2023.
Type of publication:Service improvement case study
Author(s):*Hannah Pope *Rebecca Houlston *Dr Aruna Maharaj *Madeleine Oliver
Citation:SaTH Improvement Hub, August 2023
Abstract:The Acute Medical Floor (AMF) will reduce ambulance handover delays <60 mins at RSH by 35% by 31st July 2023.
Type of publication:
Service improvement case study
Author(s):
*Shelbey Fenton-Cook
Citation:
SaTH Improvement Hub, May 2023
Abstract:
To increase overall transfers of patients from the inpatient bed base to the discharge lounge by 10 am, focusing on a target of transferring 2 patients by 8am by 10th May 2023.
Link to PDF poster [no password required]
Type of publication:
Service improvement case study
Author(s):
*Sharon Huckerby, *Nathan Picken, *Nicola Roach, *Emily Weston, *Donna Moxan, *Liam Allman-Evitts, *Kevin Lloyd, *Cath Tranter, *Aaron Evans, *Becky Bromley
Citation:
SaTH Improvement Hub, 2022
Abstract:
The Medicine Division need to understand if the introduction of the Medical Flow Coordinators has improved the volume of cancelled discharges impacting on flow out of the hospital.
Link to PDF poster [no password required]
Type of publication:
Service improvement case study
Author(s):
*Sarah Brown (Radiology), *Ali Beshir & *Russell Williams (Portering)
Citation:
SaTH Improvement Hub, 2022
Abstract:
It had been identified that scanners were not being utilised fully with downtime noted due to delays in our inpatients arriving for their scheduled appointments. To overcome this problem, the Radiology and Portering teams agreed to partner with the aim of trialling a Coordinator role. Using volunteers from portering, the pilot took place initially on AMU & SAU and increased to other wards as the trial progressed. The coordinators were provided with training from Radiology and a robust communication plan was delivered to stakeholders to share the process being trialled. The results did not conclusively demonstrate any significant change to the outcome measures, but feedback from the wards and Radiology team showed that patient safety and experience had been positively impacted upon.
Link to PDF poster [no password required]
Type of publication:
Conference abstract
Author(s):
Singh M.; *Annadurai S.
Citation:
Anaesthesia; Jul 2019; vol. 74 ; p. 90
Abstract:
Surgical case cancellation has significant impacts on operating theatre efficiency and the UK loses a substantial amount of money on these cases [1]. A recent prospective study over a 1-week period in an NHS hospital suggested a adult surgical case cancellation rate between 10% and 14% and the majority of these cases were due to non-clinical reasons [2]. It is distressing for the patient and affects outcomes. We undertook an audit regarding cancellation of paediatric surgical cases on the day of surgery at a district general hospital (DGH) to look for various reasons for the cancellations and to evaluate the services. Methods We collected prospective data from the hospital's database regarding cancelled paediatric surgical procedures over a 6-month period from February 2018 to July 2018 in our DGH. Results We found that a total of 70 paediatric surgical cases were cancelled on the day of surgery out of total of 653 paediatric surgical cases, which is an approximately 10% cancellation rate over the 6-month period with a range of cancellations from 7% in May and June to 18% in February. We observed that 76% of the cancellations were of elective cases. We subdivided the reasons for cancellations into organisational, patient, surgical and anaesthetic factors. Among the organisational factors, 23% of cancellations were due to 'unavailable beds'. We observed that 11% of cancellations occurred because patients 'did not attend', 7% of patients were reported as 'sick' and 3% of patients did not follow preoperative fasting instructions. Surgeons cancelled 15% of cases for the reason 'procedure no longer required', whereas anaesthetist 'sickness' was the reason for cancellation in 9% of cases. Discussion Cancellations prolong the waiting list and worsens patient experiences and clinical outcomes. In our audit, we found that the main reasons for cancellations were non-clinical. To improve the surgical reasons for cancellation, we suggest timely rereview of the need for surgery. Although staff allocation is looked at regularly, some cases were cancelled due to the unavailability of staff, which can be improved on. We discussed the idea of seasonal planning of cases. We plan to re-audit with the aim of investigating cancellation rates in elective cases over a 1-year period to also review the cancellation rate during the winter months.
Link to full-text [no password required]
Type of publication:
Journal article
Author(s):
Pitas, A.
Citation:
Physiotherapy; Dec 2017; vol. 103, Supplement 1, Page e68
Type of publication:
Conference abstract
Author(s):
*Allos B.; *Redgrave R.; *Davies W.; *Chatterjee A.
Citation:
Lung Cancer; Jan 2017; vol. 103, Supplement 1, Page S47
Abstract:
Introduction: Waiting time targets in England and Wales state cancer treatment must commence within 31 days of the treatment plan being agreed. Often, pressures on chemotherapy units, such as low staffing levels and capacity, delays starting chemotherapy. This may impact outcomes. To improve capacity and waiting times we have implemented group pre-assessment (GPAC) for all prospective chemotherapy patients at our trust. Methods: Previously each patient received a 1-hour pre-assessment appointment with a dedicated nurse. For non-urgent patients we have established GPAC clinics since January 2014. These are run three times a week by volunteers in conjunction with one chemotherapy nurse and accommodate 6 patients per session. Patients watch a 25-minute DVD providing general information on chemotherapy in addition to introducing the unit, nurses and general treatment procedures. A unit tour follows this. Each patient receives a diagnosis-specific tumour pack and the session concludes with a 10-minute one-to-one meeting with a nurse to discuss their personal treatment regime. Results: We pre-assess up to 18 patients a week via GPAC. Since implementation we have reduced nursing hours needed for this service to a maximum of 6 hours per week. From September 2015 to August 2016 a total of 667 patients attended GPAC clinic with 312 nursing hours required. Our unit has consequently saved 355 nursing hours over that time period (Figure 1). Patient satisfaction with the service remains high with 24/25 (96%) of patients surveyed rating the service as good to excellent across five categories. With GPAC initiation, our average chemotherapy waiting time has reduced to 13 days from over 20 days. Conclusion: By initiating GPAC our department has significantly saved nursing hours allowing us to reallocate these to chemotherapy delivery and service development. With increased capacity to treat patients waiting times have been significantly reduced. This has not been to the detriment of patient satisfaction. (Table Presented).
Shrewsbury and Telford Hospital NHS Trust has an active Research and Innovation Department.
Find out more by visiting either the R&I Intranet pages (only available on a Trust PC) or the R&I pages on the SaTH website.
Shrewsbury and Telford Hospital NHS Trust has an active Improvement Hub.
Find out more by visiting either the Improvement Hub Intranet pages (only available on a Trust PC) or the Improvement Hub page on the SaTH website.