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'LiA on steroids' at Bridgewater

Thu 7th May, 2015
'LiA on steroids' at Bridgewater

Newton Community Hospital, which belongs to Bridgewater Community Healthcare NHS Foundation Trust is a small hospital comprised of an outpatient department and a 30 bed intermediate care ward.

When Jayne Gore became ward manager at the hospital 18 months ago, she inherited a very dispirited team of staff. Despite the fact this small hospital was only 5 years old she felt it was "stuck in the dark ages".

There has been a lot of reorganisation and change within this nurse-led hospital since then, this has helped to restore staff morale and has created a more “buzzing team - who are raring to go”. 

When the Trust adopted LiA in September 2014 Jayne joined the Sponsor Group and a small number of staff from the ward attended an LiA Big Conversation. They were really fired up by the Quick Win concept and brought this energy and enthusiasm back to the ward. Since then for the first time staff at all levels in the ward feel that their ideas (and there have been many) have been listened to and they have been empowered to initiate the changes themselves.

In a very short space of time they have acheived an incredible number of Quick Wins, making the ward a better, safer place for patients and staff. Actions so far have included:

• Enhancing the activities programme
• Developing a post-fall pathway
• Changing the care of the deceased pathway
• Reviewing continence care
• Reorganising trolleys and cabinets to help staff work more efficiently
• Creating a community matron referral form
• Replacing subcut cannulas to improve patient comfort
• Introducing a tray service for refreshments and meals
• Introducing a night rotation list
• Restarting staff team building events
• Changing the night routine 
• Creating comp slips/contact numbers for social workers and therapy staff

Quick Wins have also been used to tackle some of the bigger issues on the ward. The changes that have been made have had a huge impact on patient care and staff morale.

Review of intentional rounding – The intentional rounding tool was a huge unwieldy document which was difficult and time consuming to use. Incredibly in the space of just 2 days, the tool was reviewed, redesigned and put into immediate use. This pared down version of the tool has saved a staggering 320 minutes of nursing time per day shift and 480 minutes per night shift - releasing valuable time to care. Patients on the ward were surveyed and the results have been overwhelming positive. At the same time there has been a marked drop in falls and clinical incidents on the ward.

Introduction of an early morning tea round – One HCA felt it was unreasonable for patients to wait from the last tea round at 11pm until 9am the following morning for a cup of tea. She suggested that if one HCA per morning shift adjusted their work time to start 45 minutes earlier, patients could be served tea at 7am. Despite some initial resistance, this simple change in routine has now been adopted by all the HCAs. It has motivated patients to be up, dressed, and moving sooner. This has also meant that therapy staff arriving on the ward can provide care in a more timely manner, helping to speed up patient recovery.

Changes to staff recruitment - Junior staff are now involved in the interview process for staff of the same grade. Having an active role in recruiting team members makes them feel listened to and valued.

This is only the beginning for this energetic team, there are more changes in the pipeline. The ward has recently held staff conversations to decide on specific teams and focus areas for their service. A member of the Trust Sponsor Group recently said "Newton is like LiA on steroids" - can't wait to see what they do next!

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