Be the Change (presentation)

Be The Change

A bottom-up approach to engaging staff in speaking out about patient

safety concerns and getting involved with quality improvement

Claire Matthews1

Rameez Rahman2

Abhinav Vepa2

Ashford and St. Peter’s Hospital (UK)1

King’s College London (UK)2

Why?

Why?

Why?

• The Francis report: need to overcome the “Somebody Else’s Problem” attitude

Why?

• The Keogh report: ambition to harness the energy and creativity of junior doctors

The Junior Doctor

The Junior Doctor

The Idea:

Engage ground-floor staff of all roles and

responsibilities in suggesting and initiating quality

improvements, whilst developing the clinical

leadership skills of the trust’s junior doctors.

The Idea:

Engage ground-floor staff of all roles and

responsibilities in suggesting and initiating quality

improvements, whilst developing the clinical

leadership skills of the trust’s junior doctors.

…create a junior doctor led movement

The Project

The Project

Change Champ

ion• HCA

Change Champ

ion

• Staff nurse

Change Champ

ion

• Ward clerk

Change

Champion

• Consultant

The Project

The Project

The Project

ClaireFY1

IzzyPlay specialist

NikkiNurse

SimonPorter

Children’s A&E:

Prioritised problems

The Project

Problem Solution Effect

Staff frustrated no feedback from

complaints

Monthly departmental newsletter with

managers response column

63% increase incomments submitted,

83% increase insatisfaction of response

PATHOLOGY

The Project

Problem Solution Effect

Average 3day delay on discharge for patients needing placement as

72hr care diary

Redesign of nursing documentation

Eliminated the need for separate 72hr diary;

approved by local RH/NH’s

MAPLE WARD (Medical)

The Project

Problem Solution Effect

55% porters English not first language

Language section in library and weekly

English lunchtime club Accredited language courses for all staff

PORTERS & SECURITY

The Project

Problem Solution Effect

Urgent need of child friendly redecoration DIY SOS funded by

donations from parents & local school

Family friendly oncology bay

OAK WARD (Paediatrics)

The Project

Problem Solution Effect

Low staff morale due to restructuring

Staff teambuilding away day – had to experience living with effects of a

stroke

Improved staff morale, better understanding of

care needs

CEDAR WARD (Stroke)

The Project

Problem Solution Effect

Frequent complaints from patients due to length of assessment

Patient journey mapped and an ECG machine procured to reduce

biggest rate limiting step

Average journey time reduced from 3hr 14min

to 2hr 5min

PRE-OP ASSESSMENT

The Project

Problem Solution Effect

Poor recycling in the trust due to poor visibility of

bins

All lids replaced with green lids and campaign

help

Recycling rates increased 42%; potential cost saving

£1,200

HOUSEKEEPING

The Project

The ResultsTotal number of areas: 40 (2 hospitals)

Total number of FY1 coordinators: 23Total number of Change Champions: 82 (18 roles)

Total number of problems raised: 253Total number of QI initiatives: 88Total number of patient / public votes: 1,677

The Results

The Results

Video

Thank youTo all of the FY1’s involved:

Kimmee KhanDan HaslamRandeep DhariwalAmar JesselDavid McCearRainu BawaKirsten ThomasHebah TaufikYize WanNiroshan NeminathanNoel MurphyTom BeaneyMatt HarcusJack RobertsDaniel CottamAmos MakAlexa DeanDana KhoriatiBawani SivagurunathanCarly ChuSangeetha Sathianandan