An internationally acclaimed programme that frees nurses up to spend more time on direct patient care is being implemented at Timaru Hospital.
The Releasing Time to Care – Productive Ward programme was developed by the UK’s National Health Service (NHS) Institute for Innovation and Improvement in England.
“The programme helps nurses streamline the set-up and activities on their ward so processes take less time and nurses can spend the time saved on direct patient care,” says Carol Murphy, Timaru Hospital's general manager of quality and risk.
Carol says this leads to greater reliability, safety and efficiency of patient care, and an improved, less stressful working environment for staff.
The programme is initially being rolled out in the Assessment, Treatment and Rehabilitation Ward (AT&R Ward) at Timaru Hospital, but other wards are set to follow suit.
Results of the programme in the UK have been dramatic, including an increase in the proportion of time nurses spend on direct patient care from 20 per cent to 60 per cent.
Other results have included a 63 per cent decrease in the time spent on medicine rounds, and work interruptions reducing by half per nurse shift.
AT&R Ward clinical nurse manager Tracey Worthington attended the first ever international summer school held by the NHS Institute for Innovation and Improvement at the University of Warwick last September. She learned about the Productive Ward programme, saw it in action, and will now manage the programme at Timaru Hospital.
“The model empowers frontline staff to provide quality, patient-centered care,” Tracey says.
“Releasing Time to Care - The Productive Ward will provide transparency for patients, staff and families, allowing more open communication and visibility of patient progress.
“This is not a project. It’s a culture change. By doing the hard work and foundation modules efficiently, a sustainable culture change will develop.”
South Canterbury DHB chief executive Chris Fleming says he fully supports the new initiative.
“Timaru Hospital’s frontline staff have always done a fantastic job but this will give them more time to care for the needs of individual patients, and at the end of the day the patient is the most important person in the health system.”
Questions and Answers
What is the Releasing Time to Care – Productive Ward programme?
• It is a programme that frees nurses up to spend more time on direct patient care in an improved nursing environment.
• Practical modules are applied to improve and streamline hospital ward processes, thereby releasing nurses’ time to care.
• The flow-on effect is enhanced reliability, safety and efficiency of patient care – and an improved working environment for staff.
• In essence, it is a way of working smarter rather than harder.
Who designed the Releasing Time to Care – Productive Ward programme?
The modules have been developed by the National Health Service (NHS) Institute for Innovation and Improvement at the University of Warwick in Coventry, England.
Visit www.institute.nhs.uk for more information.
How does the Releasing Time to Care – Productive Ward programme work?
It works by implementing techniques that are simple, yet effective, and which offer dramatic time and money-saving results in healthcare settings.
Wards firstly implement three foundation modules that gather information about what currently happens on the ward, reorganise where things are kept, and redesign the patient whiteboard. These are called:
• Knowing how we are doing
• Well organised ward
• Patient status at a glance
Wards then implement modules that help streamline key ward processes such as:
• Meals
• Medicines
• Shift Handovers
• Patient Observation
An example of such streamlining might be reducing the time spent physically delivering meals so more time can be spent helping patients with their meals and performing proactive nutritional assessments.
Where is the programme being implemented at Timaru Hospital?
The programme is being rolled out first in the AT&R Ward but will subsequently
be implemented in the Medical and Surgical Wards.
When does the programme begin at Timaru Hospital?
A launch will be held at 2.30pm on Tuesday, February 17, at the Education Centre. All staff are invited.
Why did South Canterbury DHB choose to implement the programme?
Because it has proven an effective way to improve not only patient care and safety, but also
staff satisfaction by giving them greater control over their work environment and reducing stress. Waste is also reduced.
How long does the programme take to implement?
Because the aim of the programme is to create permanent change, a lot of time is spent gathering base data, analysing what currently happens in the ward and identifying where changes can be made.
It is expected to take around six to 12 months before changes are fully embedded and
improvements are seen.
How will the Releasing Time to Care – Productive Ward programme be evaluated?
Audits are carried out regularly until the desired change is embedded. ‘Regular’ could mean every day.
The programme also involves posting data about efficiency and reliability of care, patient safety, staff wellbeing, and the patient experience in a prominent place on the ward. This enables both staff and patients to see the current situation on the ward, current action areas for improvement, and achievements.
If the techniques used in the Releasing Time to Care – Productive Ward programme are so simple, why haven’t they been implemented before?
Some of the changes have been attempted before but have lacked the sustainability component that ensures the change is permanent.
Who else is implementing this programme?
Representatives from the Ministry of Health and Waitemata, Waikato, Bay of Plenty, Hutt Valley, Wairarapa, West Coast and South Canterbury DHBs have undergone programme training at the Institute for Innovation and Improvement in the UK.
A similar ‘lean methodology’ approach has also been adopted by Counties Manukau DHB.