East Midlands Ambulance Service (EMAS) and University Hospitals of Leicester (UHL) have joined forces to focus on ambulance handover times in A&E at UHL, using Listening into Action (LiA) to connect people across the usual boundaries and come up with solutions together. Mark Dawn, LiA Lead at EMAS explains more about this new collaboration...
"At EMAS and UHL the pressure is mounting on both organisations to be proactive in reducing ambulance handover times at the Emergency Department (ED). One could say this has been a ticking bomb for years with ever increasing demands on both ED and the Ambulance Service. Public and stakeholder expectations are higher than ever. The sheer workload is relentless, the demands ever higher, and the targets unwavering. At times, demand outstrips supply. This is certainly the case at the Leicester Royal Infirmary Emergency Department.
The delays in ambulance handover times are very much under public scrutiny. No-one wants to see patients waiting in the back of ambulances, but sadly this has become a reality on occasion.
The appetite to work together to come up with solutions to this problem had already been started, with computer systems put in place that alert the ED staff to incoming patient volumes, managers regularly meeting to discuss issues, and operational managers performing a liaison function. UHL are building a bigger and better Emergency facility which will certainly help in the future, but it is the here and now that we need to address.
Both UHL and EMAS are Listening into Action (LiA) Trusts. This means that there is a common language around how to make change happen. Following initial discussions it was agreed that we would hold a joint LiA Conversation for the senior and line management teams from both sides to look at better joint working arrangements.
The event held was held in true LiA style, involving leaders and managers from both Trusts along with executive Sponsors - all with a great appetite to work together. The response to the event was truly amazing!
The conversation format is based around carefully crafted questions designed to engage everyone around the shared mission we were all there to 'crack'. Part of the process includes 5 minutes of personal, quiet reflection on each question before sharing thoughts and ideas with the table and then the wider group. This was embraced wholeheartedly with a working silence. Those of us on the periphery observing the show dare not breathe for fear of distracting the work in progress!
The wider discussion that followed was uplifting. Challenges were raised by both sides and the top three responses shared by each table following each question took active listening to a whole new level. There was not one person in the room who did not have a voice, not one person who was not engaged. Everyone had a part to play and the lively proactive debate was a joy to witness.
It all seems such a simple concept, and shows how two large NHS organisations can easily work together to find a common solution to what has become a hot topic of scrutiny from the public, Commissioners and the Trust Development Authority. The success of this first collaborative LiA Conversation means we been able to focus on solutions together. We have also arranged a second LiA Conversation to engage with our frontline colleagues from both Trusts.
We look forward to sharing the outcomes and the impact in due course."