The Fabbest of the Fab (Part 2)
Deborah Glover MBE, Editor PCNR
BSc (Joint Hons), Dip. Care Policy & Management, RGN
Hartley Larkin Award
NHS Emergency Care Intensive Support Team
On the night of May 7th 1765 Hartly Larkin, a dockyard foreman at Chatham marine docks was deeply troubled. HMS Victory was to be launched the next morning and was 9.5 inches wider than the dock exit. Acting entirely on initiative, he convened a gathering of shipwrights and carpenters who set to work cutting away the docks timbers. Larkin and his team, quite simply, had done what needed to be done. This award is for a team who has echoed this concept in a project.
The SAFER patient flow bundle
The SAFER patient flow bundle is similar to a clinical care bundle. It’s a set of simple rules that if followed routinely will help improve patient flow, patient experience and reduce length of stay across adult inpatient wards (in acute hospitals).
It consists of 5 key elements:
- S – Senior Review; all patients will have a senior review (preferably by a Consultant) before midday
- A – All patients will have, and be aware of an Expected Discharge Date based on the medically suitable for discharge status agreed by clinical teams. Patients and their loved ones need to know the answer to simple questions such as what is going to happen to me today, what is going to happen to me tomorrow and what do I need to do to leave hospital?
- F – Flow of patients from assessment units to inpatient wards starts at the earliest opportunity. Wards which routinely have patients transferred from assessment units are expected to ‘pull’ the first (and correct) patient to their ward before 10am.
- E – Early discharge; 33% of patients will be discharged from base inpatient wards before midday. Where possible, take-home medication for planned discharges should be prescribed and in pharmacy by 3pm the day prior to discharge. If not, they should be prepared in real time rather than leaving them to later in the day which results in unnecessary waiting for patients
- R – Review; a weekly systematic review of ‘extended lengths of stay ( 14 days)’ patients will identify the issues and actions required to facilitate discharge. This is led by clinical leaders with support from health and social care colleagues and operational managers who will help remove constraints that lead to unnecessary patient delays
Follow this link for more details: http://www.england.nhs.uk/wp-content/uploads/2015/03/breaking-the-cycle-safer-flow.pdf
The 4 candles Award
South Glasgow University Hospital
The Two Ronnies, featuring Ronnie Corbett and Ronnie Barker, first broadcast their ‘4 Candles’ sketch in 1976. This award is for a team whose project has relied on an ability to listen and respond to feedback from any source.
The team at the Langlands Unit, South Glasgow University Hospital decided that they needed to get to know the people in their ward better. Stories and feedback from a range of sources had reminded them of the importance of understanding who a person is in the context of their own life, not just as a ‘patient’ in a bed.
Inspired by an example from a children’s service that used a graphics to determine what really mattered to children, they used a simple mind map on an A3 sheet to find out the things that were really important to the people in their ward.
Initially, Activities Coordinators completed the poster. With consent, the posters are displayed on the whiteboard above the person’s bed and serve as both a reminder of the importance of these things and as a prompt for anyone supporting the person to personalise their interaction (Figure 1).
Just one example of the impact this great intervention had can be seen in the story of a lady with advanced dementia. After admission to the ward, she became increasingly agitated, kept trying to move around unsupported, and had fallen. Soon after admission, with the family in attendance, the team completed a “What’s important to you?” poster. During this process the family said that “she always has her rosary beads in her hand”. This prompted the staff to find the rosary that had been efficiently tidied away into the locker! They gave her the rosary beads and very quickly she settled down.
Boroughs Partnership NHS Foundation Trust
Absolutely committed. Fiercely determined. Brim-full of self-belief. Refusing to compromise. Dedicated to perfection. The winner of the 5127 award will have demonstrated all of these attributes. 5127 refers to the number of prototypes that Sir James Dyson developed before finally marketing his first Dyson ‘Cyclone’ vacuum cleaner.
This scheme, which prevents people who are having a mental health crisis being detained in police custody, is led by Jane Murphy. This street triage scheme in which a supports police officers on emergency call outs where a person might have mental health issues, ensures that patients benefit from the immediate joint response; they are quickly put on the right pathway rather than being detained as a precaution.
In the 11 months to March 2015, the street triage team attended 734 incidents during 278 shifts. The team intervened at 89 incidents where officers were considering using a Section 136 and advised arresting only 10; this represents an 89% reduction.
Jane and her team have helped reduce the number of patients being arrested under section 136 Mental Health Act or being unnecessarily taken to hospital for treatment.
You can read more about this fabulous partnership working here: http://bit.ly/1Qmguit