Patients and Visitors

The Newcastle Upon Tyne NHS Foundation Trust

Jobs

Jobs

Current projects

Contact: (0191) 213 9414 - Mrs Suzanne Medows, Senior Nurse, Practice Development

We have the following initiatives in place to improve patient care throughout the Trust:

Energise for excellence

Energise for Excellence (E4E) is a national initiative which provides an overarching framework to support nurses and midwives in delivering improved quality and safety while making the best use of resources. Under the five domains in the E4E umbrella, a significant amount of work is ongoing within the Trust, this includes ‘The Productive Ward’, ‘Essence of Care’ and the ‘Clinical Assurance Tool’.

Energise for Excellence in Care (E4E) is a quality framework for nurses, midwives and health visitors which aims to support the delivery of safe and effective care, creating positive patient and staff experiences that build-in momentum and sustainability.

The framework brings together numerous tools, techniques and policies from both a national and local level which you can see on the Department of Health website.

In a ‘Call to Action’, nurses and midwives are asked to commit to the following five actions;

Commit to take a specific action to make a specific change within a specific timescale
Use the most relevant tools
Measure it
Celebrate success
Tell your story to others

Within E4E there are five domains, each with a number of supporting workstreams

Get staffing right, current work includes rollout of the Electronic Roster, evaluation of core Nursing and Midwifery job descriptions and development of the Clinical Assurance Tool (CAT) resource scorecard.
Deliver care, current work includes measurement of our care delivery using Essence of Care.pdf benchmark audits and CAT which incorporates Saving Lives; future work will include measurement using the Safety Express
Measure impact, current work includes measurement of our effectiveness using CAT and workstreams which include Productive Ward and Essence of Care.pdf. Future work will include measurement using the Safety Express
Patient experience, current work includes realtime patient surveys in our Outpatient Department, regular inpatient surveys facilitated by PALs and participation in the National Patient Survey programme
Staff experience, current work includes Senior Team walkabouts, Staff engagement forums, Nursing and Midwifery newsletter

For further information about this initiative please contact Mrs Suzanne Medows, Senior Nurse Practice Development, 0191 213 9414.

The Productive Ward

The Productive Ward Programme is about ‘releasing time to care’ that helps staff organize their ward using improvement techniques from industry, and is aimed at maximising time spent in direct contact caring for patients.

The ‘Releasing Time to Care’ Productive Ward Programme has been developed by the NHS Institute for Innovation and Improvement (NHS II&I) to show nurses how to apply improvement techniques to their work on wards. The basis of this work shows that ward based nurses spend less than 40% of their time on direct patient care with the rest spent on activities such as paper work and administration, handovers, discussion with other staff and seeking equipment.

Project Plan

This 1 year programme will build upon previous productive ward work around the well organised ward, including patient observations, and meals. The previous work formed the foundations to further build upon, with the basis of the more recent work planning to introduce to the ward areas:

Knowing how we are doing boards: these are boards that will be visible to anyone attending the ward areas, and will inform visitors of how ward areas are performing in relation to certain aspects of care.

Patient status at a glance boards: these are white boards within the ward areas that show patient information, so that at a glance staff will be able to use the information to ensure the patients’ journey from admission to discharge runs smoothly. (The boards may use symbols to maintain confidentiality of patient information.)

Ward Processes

The NHS II&I have in their pilot sites examined a number of ward processes where ‘knowing how we are doing’ and ‘patient status at a glance’ modules have been implemented and found an increase in safety and reliability of care as well as improved patient experience.

Measuring success

Specific key measures will be examined as a baseline, throughout the project and again once roll out has completed. These include: MRSA/Clostridium Difficile infections, pressure ulcers, falls, absenteeism, patient satisfaction, staff satisfaction, bank and agency spend and length of stay.

Strengthening the role of the Sister/Charge Nurse

The Sister/Charge nurse role has been described as 'the guardian of care' yet many feel that new management responsibilities has diverted their attention away from clinical quality. This evolution of the role over the years has raised problems of workload capacity, which has in turn affected their recruitment and retention. Moreover, the responsibility of twenty four hour accountability discourages less junior nurses from applying for these senior roles. Within the Trust work has already begun to examine the Sister/Charge nurse role and initiatives have been implemented to strengthen this role, including an induction portfolio.

Learning Disabilities News

Nearly ten years ago two main National Reports for learning disabilities, “Signposts For Success” (DH 1998) and “Once a Day" (DH 1999) identified basic changes that secondary care and General Practitioners practices needed to make to improve services for people with learning disabilities. This included early detection of illness and fair and equal access to treatment. This was again reinforced in 2001 in the Valuing People Report (DH 2001) which also identified that there was a lack of clear, accessible plans and support systems for people with learning disabilities to navigate through the health system. Over the last two years there have been many publications to suggest that the health service is still not meeting people’s needs that have learning disabilities. More recommendations have been published in light of reports of poor practice which the Newcastle Hospitals have reviewed and examined recommendations.

A review of the number of patients admitted to the trust with learning disabilities was undertaken from January 2007 until the 22nd February 2008. Conditions incorporated as being associated with learning disability were included after consulting the MENCAP definition. These included the following conditions: cerebral palsy, downs syndrome, attention deficit, autism, fragile X and asperger’s. Dyspraxia, dyslexia, epilepsy, Rett Syndrome and fetal alcohol were not included. A total of 1288 patients were admitted to the Trust with a recognised learning disability. Of these 727 were elective and 561 non-elective patients with 52% under the age of 21 years.

Treat me right (Mencap 2004) called for more learning disability training for all staff. One particular initiative within the Trust is a learning disabilities guide that has “Ten Top Tips” to assist nurses when caring for patients with learning disabilities (appendix three). This has been developed in collaboration with the local learning disability partnership in Newcastle and includes a website - www.easyhealth.org.uk - offering education and links that staff can access regarding learning disabilities and information on where staff in the Trust can get support and advice.