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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 Champion • HCA
Change Champion • Staff nurse
Change Champion • Ward clerk
Change Champion • Consultant
The Project
The Project
Claire FY1
Izzy Play specialist
Nikki Nurse
Simon Porter
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 in comments submitted,
83% increase in satisfaction 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
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 Results
Total number of areas: 40 (2 hospitals)
Total number of FY1 coordinators: 23 Total number of Change Champions: 82 (18 roles)
Total number of problems raised: 253 Total number of QI initiatives: 88
Total number of patient / public votes: 1,677
The Results
Video
Thank you To all of the FY1’s involved: Kimmee Khan Dan Haslam Randeep Dhariwal Amar Jessel David McCear Rainu Bawa Kirsten Thomas Hebah Taufik Yize Wan Niroshan Neminathan Noel Murphy Tom Beaney Matt Harcus Jack Roberts Daniel Cottam Amos Mak Alexa Dean Dana Khoriati Bawani Sivagurunathan Carly Chu Sangeetha Sathianandan
