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15,000 staff getting on board with LiA at Barts Health

Thu 19th November, 2015
15,000 staff getting on board with LiA at Barts Health


Something special is going on at Barts Health.

This is the largest NHS Trust in England, serving a population of 2.5 million, with more than 15,000 staff providing care across five hospital sites: Mile End Hospital, The Royal London Hospital, Newham University Hospital, St Bartholomew's Hospital and Whipps Cross University Hospital.

The positive signs - in the tough context of the Trust being put into Special Measures earlier this year - include: a palpable uplift in the energy and engagement of staff, a sense that there is 'something in the air' that feels different and exciting, clinicians stepping forward in their droves to lead change for the benefit of patients, a sense of 'hope' and 'optimism', and enthusiasm for a new site-based leadership structure that enables a sense of belonging and local pride.

In August Alwen Williams, CEO, committed to Listening into Action (LiA) as the main vehicle for getting a fundamental shift in the culture, leadership style and ways of working across the Trust, linking this directly to delivery of 'Safe and Compassionate' - their Quality Improvement Plan. Notably, the number of clinicians - doctors, nurses, therapists and other health professionals - who have already come on board is unprecedented at this early stage in the journey - an incredibly positive sign.

This early momentum is very promising. In the past 12 weeks:

  • Each site has established its own LiA Sponsor Group led by the Managing Director and comprising 'movers and shakers' from a variety of roles and levels to navigate the journey and bring colleagues on board
  • They have a network of dedicated LiA Leads - combining clinical and improvement experience - to coordinate day-to-day activity on the ground, in support of the LiA Sponsor Group
  • 40 pioneering LiA Clinical Teams have already been launched to engage around 'big ticket' priority improvements to patient care through working 'the LiA way' over an initial 20 weeks (see lists below)
  • 20 LiA Big Conversations with more than 1,000 staff from all roles and levels are being hosted by the CEO, Managing Directors and Clinical Leaders to connect around 'What gets in the way of great patient care?' and 'What changes - that we can make between us - would make the biggest difference?'
  • 20 LiA Enabler Teams focused on the biggest issues raised by staff at the LiA Big Conversations will engage 100s of staff to pool ideas and deliver step-changes within an initial 20 weeks   
  • 100s of Quick Wins led by leaders and managers at all levels will help to unblock the way
  • Stories and results will be highly visible, 'fuelling' the spread to more and more teams, supporting sustainable change, and embedding LiA as 'the way we do things around here'.

The 40 pioneering LiA Clinical Teams

Newham University Hospital:

  1. Early identification of our patients with deteriorating health, and timely intervention to reduce patient harm
  2. Prioritising the fundamentals of care, to enhance the quality and safety of care for our patients
  3. Improving patient experience of maternity care
  4. Improving care for critically ill patients by ensuring timely admission to and discharge from our high dependency areas
  5. Ensuring that elective work starts and ends on time
  6. Developing and implementing a suite of day surgery pathways
  7. Optimising safe and effective discharge through nurse-led discharge, multi-professional board rounds and use of the discharge lounge
  8. Optimising scheduling of patients for all elective pathways
  9. Developing one-stop clinics 
  10. Improving patient experience by increasing uptake of the #hellomynameis and #beNice campaigns

The Royal London Hospital and Mile End Hospital:

  1. Introducing same day surgery for Max Fax patients to speed treatment and avoid overnight stays
  2. Implementing 'Home for Lunch' for short stay patients
  3. Working with Health Partners to deliver 'Discharge to Assess' for Older Adults
  4. Reporting and learning from incidents with Simulation Centre to improve the quality of care for our patients
  5. Enhancing the quality of care and improving end of care life for our most vulnerable patients with good DNR protocols and training
  6. Securing staffer staffing levels through effective recruitment for our theatres and neurosciences wards
  7. Ensuring fundamentals of care on our Older Peoples wards
  8. Improving patient flow on 10E and 13th floor through criteria-led discharge
  9. Using patient stories to improve care in Trauma and Orthopaedics
  10. Improving patient flow and reducing waiting times in Head and Neck clinics
  11. Enhancing the quality of patient health records to aid effective clinical decision making

St Bartholomew's Hospital:

  1. Improving patient experience in chemotherapy
  2. Improving outpatient flow and experience
  3. Operating theatres and Cath labs - 'No patients cancelled for non-clinical reasons‘
  4. Reducing cardio-thoracic surgical site infections
  5. Enhancing patient experience, to include PREMS, patient WIFI, and an enhanced complaints procedure
  6. Improving inpatient flow
  7. Increasing 7 day working - 'every patient seen every day by a consultant‘
  8. Optimising patient pathways
  9. Looking after our staff
  10. Recruiting every willing patient to a trial

Whipps Cross University Hospital:

  1. Early identification of our patients with deteriorating health, and timely intervention to reduce patient harm - Implementing Sepsis 6
  2. Implementing the sign up to safety on wards (Sage and Sycamore)
  3. Right patient, right time, right person in the emergency pathways
  4. Implementing Criteria Led Discharge on the respiratory wards
  5. Improving the availability of medical records
  6. Implementing the WHO check list in every theatre, including maternity and Plane Tree
  7. Introducing a one stop Breast Clinic
  8. Introducing sustainable ambulatory care including care of the elderly (FAU)
  9. Implementing compassionate care plans for End of Life Care
  10. 'Closing the loop' on all incident reporting, with an initial focus on maternity and gynaecology

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