Smith, J., Jarman, M., Osborn, M., 1999. Doinginterpretive phenomenological analysis. In: Mur-ray, M., Chamberlain, K. (Eds.), Qualitative HealthPsychology. Sage, London.

doi:10.1016/j.joon.2009.07.024

Use of the Productive Ward principle to improveworking conditions and service delivery(concurrent)Karen Bowley, Rebecca Delpino

Solihull Hospital, UK

Aim: To explain and share how the principles of‘Releasing Time to Care’ have been used in prac-tice to develop services with documented evidenceof improvements in standards of care and staffsatisfaction.

Abstract:Ward15provides a ‘cando’ patient cen-tred service, in a busy hectic ward constantly underall kinds of pressures. Although staff work hard tomaintain standards of care, this project has enabledus to stand back, evaluate what we do and how weare doing it, using a variety of new methods.

The main reason we have been able to achieveso much is that we have taken time to involveand move forward the whole team, giving themthe permission to come up with the ideas.

So far the project has enabled us to:

� Reduce waste and organise workspace, allowingstaff to spend more time with the patientinstead of looking for the necessary equipment.� Analyse how our Ward is performing. Graphs andaudit scores are displayed for all staff, patientsand visitors to see, staff are comfortable withresults displayed in a public place and the pridein our ward has measurably increased.� Identify areas for improvement to submit intelli-gent and informed business cases.� Take forward initiatives that will be rolled outTrust wide.

We are streamlining care delivery with the back-ing of the project and making a difference to thequality of care that the patient receives.

This structure is assisting us in our long termplan to deliver the service we aspire to and thatis required by the health service of the future.

Intended learning outcomes:

� Awareness of principles behind ‘Releasing Timeto Care’.

� Knowledge of methods used to organise servicesand measure improvement.� Provide a useful guide to tools that can be used toimprove user satisfaction and staff well being.

Recommended reading:Allen, D., Kingdon, M., Murrin, K., Rudkin, D.,

1999. What If? – How to Start a Creative Revolutionat Work. Clapstone, Oxford.

NHS Institute for Innovation and Improvement,2007. Releasing Time to Care. The Productive Wardwww.institute.nhs.uk/productiveward.

Silversin, J., Kornacki, M.J., 2003. Implementingchange: from ideas to reality. Family Practice Man-agement 10(1), 57–62.

doi:10.1016/j.joon.2009.07.025

From person centered to person driven(concurrent)Claire Bailey, Joe Bolger

Royal Bolton Hospital NHS Foundation Trust, UK

Abstract: The orthopaedic team had success inreducing mortality but recognised they needed towork in partnership with patients to improve theirexperiences.

Planning and preparation: The Trust has manyestablished methods for collecting patient’s com-ments/feedback. However, there is no formalstructure for working in partnership with patientsto improve their experience. We do not always in-clude them in designing a service. A programme ofwork was initiated within Orthopaedics to under-stand and improve our patients’ experience andwe decided upon an adaptation of experiencebased design.

Involvement and Partnership: The key stake-holders were our patients. For the purpose of theprogramme, 50 elective orthopaedic inpatientswere asked to complete a patient diary. Ten elec-tive joint replacement patients were selected atrandom to take part in the video and patient/staffsession approach.

Implementation: Seven patients agreed to befilmed- either in their own home or the hospital.Patients were simply invited to tell their story.The films were edited and shown to staff over fourstructured interactive sessions. Staff reactionswere filmed using a ‘Big Brother’-style ‘diary room’format. A number of improvement ideas were dis-cussed between patients and staff.

Selected abstracts from the 23rd Royal College of Nursing Society 143

Challenges: There were some initial challengesto take the programme forward. At the time, therewere not many examples or case studies in healthcare to refer to. Also how to edit the four hoursof video footage – and then structure the staff ses-sions. We remembered an article written by DonBerwick, (MD, MPP, FRCP, President and CEO, Insti-tute for Healthcare Improvement (IHI)) in which hetalked about what the specific dimensions of ‘‘totalquality’’ that he had considered for a patientrequiring knee surgery.

‘‘Don’t kill me, don’t hurt me, don’t make mefeel helpless, don’t keep me waiting’’.

Results and benefits: The sessions allowed us towork with staff to understand the impact of theirinteractions with patients. There were some exam-ples of good practice and some where we could dobetter. This is not about being patient centered –this is about becoming patient driven and the teamwas proud to give a voice to our patients and havethe privilege of participating in listening to andproviding a methodology which brings our patientsand staff together to improve services.

Intended learning outcomes:

� Understand how patients experience our ser-vice, enable us to move from a service that doesthing to, to works with patients as partners,material to teach, challenge and improve.

Recommended reading:Berwick, Donald M., MD, MPP, Request for Pro-

posals: Replacing Don’s Right Knee, Institute forHealthcare Improvement/Boston, Massachusetts,USA. www.ihm.org.uk/.

doi:10.1016/j.joon.2009.07.026

Keeping orthopaedic and Trauma nursing alivefor the student (concurrent)Jean Rogers

Stockport NHS Foundation Trust, UK

Aim: To develop strategies to educate studentsinnovatively in the Orthopaedic and Trauma area.

Abstract: Developing quality placements fornursing students requires good collaboration be-tween clinical practice and higher education insti-tutions (DoH, 1999). Increasing acuity, patientturnover and increasing numbers of students inthe clinical area has sometimes compromised thequality of learning and education in the Orthopae-dic and Trauma area.Education of students is not

‘one size fits all’ and many initiatives have beentried in the past to ensure quality education inthe clinical setting with varying success. StockportNHS Foundation Trust has taken this on board andhas developed the post of professional develop-ment lead in the Trauma and Orthopaedic unit toaddress this issue.

This presentation will describe some of theimportant initiatives that have been developed toenhance students’ practical and theoretical learn-ing in the Trauma and Orthopaedic area by the pro-fessional development lead in consultation with theTrust’s practice educator. The initiatives includequizzes, board games, workshops, practical sessionsand games to encourage a variety of learning. AsPetty (2004) states ‘this encourages competitionbetween groups and is a popularmeans of enliveningrevision’. The students enjoy the experience and itenhances their learning as can be seen from the stu-dent evaluations and we believe any initiatives thathelp the student learn can only be good.

Intended learning outcomes:

� Understand the strategies used for developingstudents in the Orthopaedic and Trauma area.� Discuss the role of the professional developmentlead in Orthopaedics and Trauma.� Review the student evaluations.

Recommended reading:Department of Health, 2008. Framing the Nurs-

ing and Midwifery Contribution: Driving up theQuality of Care. DoH. London.

Petty, G., 2004. Teaching today: a practicalguide, third ed. Nelson Thornes. Department ofHealth, 1999. Making a difference: strengtheningthe nursing, midwifery and health visiting contribu-tion to health and healthcare, DoH, London.

doi:10.1016/j.joon.2009.07.027

Make no bones about it, students are important(Concurrent)Alyson Burton, Rachel Ahmad

Whipps Cross University Hospital, UK

Aim: To highlight the importance of support andpreparation for students coming onto placementson orthopaedic wards.

Abstract: The presentation reports on the rein-troduction of pre registration nursing students toan elective orthopaedic ward following a two yearabsence. It demonstrates the collaboration of the

144 Abstracts