Anna Hinz

INNOVATION IN ALLOCATIONS

AIM OF SESSION• Why change what we’ve always done?

• Partnering with Consumers – Drs, Nurses, Patients

• Understanding demand modelling

• How are allocations developed

• Why are allocations so important to quality and safety?

• How much of a difference can changing my approach make?

• How this

project came

about?

ALLOCATIONS IN 2012

2012 ALLOCATION BOARDEach NIGHT arranging the allocation on the board took night duty

1.5 – 2 hours depending on interruptions (like patients!)

Along came the interactive board that revolutionised our world! After an initial period of general staff negativity and some teething problems -we had technology!

THEATRE ALLOCATIONS IN EARLY 2013

Although the interactive board added great value to the department it didn’t change the fact that we still entered new data each day

Theatre is like ground hog day – we follow a set schedule of sessions for surgeons. For the most part we know what’s coming!

TAKING THE NEXT STEP

• IN LATE 2012 WE STARTED A PROCESS OF DEVISING A MASTER ROSTER WITH THE IDEA THAT WE WORK ON A SET PLAN OF THE SURGEON TEMPLATE

• IF WE KNOW WHAT’S COMING – WHY DO WE REDO THE WORK EVERY DAY?

• WHY DON’T WE CREATE A MASTER ALLOCATION THAT IS PRELOADED TO CREATE THE MASTER ROSTER?

• ... GOOD IDEA – THAT SHOULD BE EASY!

NOW WE’RE THINKING

THE MASTER ALLOCATION IS BORN!

A WHOLE NEW PROJECT STARTED FOR COORDINATING STAFF AROUND ENSURING THAT THE RIGHT STAFF WERE IN THE RIGHT THEATRE AND MATCHING THE SKILL SETS BETWEEN INSTRUMENT/CIRCULATING, ANAESTHETICS, HOLDING BAY, ORDERLY AND TECHNICIAN STAFF – A BIG TASK!

PROJECT WORK

EACH STEP IN THE PROCESS IS SLOW AND PAINSTAKING

EVERY STAFF MEMBER HAS A SKILL SET TO A SPECIFIC SPECIALTY

OBVIOUSLY THEY HAVE A LIFE OUTSIDE OF WORK

PEOPLE HAVE PERSONALITIES AND DONT ALWAYS FIT TOGETHER AS A TEAM LET ALONE WITH THE SURGEON AND ANESTHETIST

MASTER ALLOCATION DEVELOPED

FOR INSTRUMENTS

AND CIRCULATING BY THEATRE

COORDINATOR

EACH DAY IN THE

CYCLE (28 DAYS) IS

VALIDATED WITH THE

SPECIALTY ANUMS FOR SKILLS MIX

ALLOCATIONS ARE

VALIDATED WITH STAFF

BASE

INNOVATIVE WORK TAKES TIME AND DEDICATION

WHAT’S THE BENEFIT TO THE STAFF/DEPARTMENT?

FOR THE STAFF

KNOWING WHAT YOUR ALLOCATION WILL BE FOR THE WEEK AHEAD OF TIME

HAVING A GOOD WORKING RELATIONSHIP WITH A REGULAR TEAM

KNOWING THE DOCTOR AND THEIR PREFERENCES

EFFICIENCY CREATED BY WORKING WITH PEOPLE YOU KNOW

KNOWING THE MEDICAL TEAM WELL ENOUGH TO SPEAK UP WHEN SOMETHING ISN’T RIGHT

FOR THE DOCTORS

HAVING A GOOD WORKING RELATIONSHIP WITH A REGULAR TEAM

EFFICIENCY CREATED BY WORKING WITH PEOPLE YOU KNOW

HAVING A TEAM THAT’S ACCOUNTABLE FOR YOUR REQUIREMENTS

KNOWING WHO TO TALK TO WHEN YOU KNOW THE CASE WILL BE DIFFICULT

CREATION OF A CALMER WORKING ENVIRONMENT

WHAT’S THE BENEFIT FOR THE PATIENT?

The Committee of Quality of Health Care in America (2000) noted that ‘...when team processes are planned and standardised, each member of the team knows the other team members’ functions, and errors may be noticed before they cause an incident.’

WHAT ELSE DID WE AIM TO ACHIEVE FROM THE PROJECT

HAPPY STAFF – HAPPY MANAGER!

• STAFF THAT ARE ENGAGED AND EMPOWERED TO HAVE A SAY IN THEIR ALLOCATIONS ON A DAILY BASIS

• THEY HAVE A STRONG RELATIONSHIP WITH THEIR DOCTORS AND ARE ABLE TO WORK WELL AS A TEAM

HAPPY DOCTOR HAPPY LIFE

• ONE OF THE BIGGEST GRIPES FROM DRS IS ‘WHY CAN’T I HAVE A REGULAR TEAM?’

WELL DOCTOR - YOU CAN AND WE WILL MAKE SURE IT HAPPENS!

BOTTOM LINE – WE’RE LISTENING!

WHAT HAVE WE LEARNT SO FAR?

VALIDATE ALL THE IDEAS AND TOOLS WITH THE ANUMS – THEY KNOW THEIR TEAMS BETTER THAN US AND WE VALUE THEIR INPUT

SELL THE IDEA TO THE ANUMS FIRST AND ENSURE THEY HAVE A STRONG UNDERSTANDING OF WHAT WE ARE TRYING TO ACHIEVE

THAT THE IDEA OF GETTING 200 + STAFF ONTO 28 DAYS OF ALLOCATIONS AND MATCHED TO 320 DIFFERENT SURGEONS AND ANAESTHETISTS IS HARD BUT NOT IMPOSSIBLE

THAT THE GAINS FAR OUT WIEGH THE PAIN OF THE WORK!

THE KNOWLEDGE THAT AS SOON AS WE THINK WE’VE GOT IT RIGHT SOMEONE WILL LEAVE – BUT THEN WE WILL KNOW EXACTLY WHAT SKILL SET WE NEED TO REPLACE THEM BECAUSE WE KNOW EXCATLY WHAT PEOPLE THEY WORK WITH!