14 minute read
Improvement Plan makes significant progress
OUR PLAN TO IMPROVE FOR OUR PATIENTS
Across the next four pages you can read about some of the work we are doing to improve our services to ensure our patients get the best and safest care in our hospitals. The Trust has developed an Improvement Plan focusing on seven key themes to ensure it continues to improve the lives of the people it serves – local communities, patients and their loved ones. Jackie Davies, Associate Director of Improvement said: “Our aim is to improve the care we provide to our patients and to be a better place to work for the people who work here. We want to ensure we learn and continuously improve our services. Our Improvement Plan is built on feedback from patients, our staff and the people and organisations we work with and it is focused on patient care, patient experience and supporting our staff.”
An artist’s impression of what the new building might look like.
The Trust has submitted its proposals and planning application to redevelop its Women and Children’s Building, which will play a vital role in enhancing the quality of its care and treatment for the local community and wider region.
The proposed redevelopment of the Women and Children’s Building reflects the Trust’s ambition to provide the local community with effective and safe treatment and care to patients and their families. Joan Carter, Project Manager leading on the new build project said: “It’s a really exciting time as we see the plans coming together. The existing Women and Children’s Building was one of the earliest parts of the modern Countess Hospital and has supported countless patients and their families over the past fifty years.
“The proposed new building will enable a step-change in how we provide families with the highest levels of care and treatment, while supporting our wider ambition to tackle health inequalities in our region.” A series of engagement sessions have already been held to ensure patients and staff are involved from the very early stages of the project. Joan added: “The engagement sessions are an important part of the planning work for the new building. They will ensure that the views and experiences of patients and staff are heard and will help us to make sure that we create a building for our services that meets the needs of our patients and their families. The new facility will enhance the experience of patients and strengthen the Trust’s clinical effectiveness across its services. It will also be fully integrated with community and primary care services promoting an increasingly joined up approach to patient care across the region. The Trust has been successful in gaining £110 million funding from NHS England for the new building. It is expected that construction on site will begin in summer 2023 with the building completed in early 2025.
Community Diagnostic Centre opens its doors
Patients are now benefitting from earlier diagnostic tests closer to home thanks to the new Community Diagnostic Centre (CDC) at Ellesmere Port Hospital which opened in August.
The CDC at Ellesmere Port Hospital gives patients direct access to diagnostic services without the need to attend acute hospital sites like the Countess Hospital or be transferred to other locations.
Richard Baird, Divisional Director for Diagnostics and Infrastructure said: “The CDC is part of a wider national initiative that will see over 100 community diagnostic centres open across England. The CDCs will make accessing diagnostic services more convenient for patients and they will help to ensure patients have shorter waiting times.” The Community Diagnostics Centre is a one-stop shop for diagnostic testing, with Magnetic Resonance Imaging (MRI), Computed Tomography (CT) and Ultrasounds (US) taking place. These imaging tests are all used to map out what is happening inside patients’ bodies and are used to diagnose a wide range of issues, including many types of cancer. Jayne Beedles, MRI Team Lead shared her excitement about the arrival of the new MRI scanner which was craned into position at Ellesmere Port Hospital over the summer: “It’s making a huge difference having the scanner over here at Ellesmere Port. It’s gives us a lot of extra capacity for patients. Along with the technology of the newest type of scanner, there are faster scanning times so the number of patients we can scan will increase, and we can continue to bring the waiting list down. We’ve got a great team and we’re really hopeful for the future.” In the four months since the Community Diagnostic Centre opened, it has already seen an additional 5,642 patients who have received life-saving checks, scans and tests closer to their homes.
Making a difference in Maternity
Staff leading the way to improve care
Delivering the safest possible care to expectant and new mothers is the driving force behind the Maternity team’s focus on post-partum haemorrhage.
The team have come to work together to develop collaborative working across the service as well as with other connected clinical services at the Trust.
Natasha Macdonald, Director of Midwifery commented “I’m very proud of how the whole multi-disciplinary team (MDT) have worked together. It’s important that we always work to further develop our services. The Care Quality Commission visited the Trust in the Spring of 2022 and since then the team have worked tirelessly to take on board recommendations and implement changes to improve. I would like to thank the team and the wider MDT for their commitment to our patients and their families and for their constant hard work.”
Additional training for staff
The entire Maternity team have now completed PROMPT training for PPH and unplanned hysterectomies.
PROMPT is an evidence-based multiprofessional training package for obstetric emergencies which uses live scenarios to support learning. Staff have found the scenario training sessions extremely beneficial, with a full range of personnel present. Caroline Edwards, Senior Midwife said “In addition to the obvious advantages The Maternity team showed the new regarding patient safety, I have found ROTEM machine to members of the the experience such a positive one, with Board and explained its effectiveness the joint working, collaboration and new in December. Pictured L-R is Ros Fallon, working relationships a highlight. I am Non-Executive Director and Maternity very proud to have been a part of this Safety Champion; Natasha MacDonald, implementation.” Director of Midwifery; Caroline Edwards, Senior Midwife; Melanie Kynaston, Deputy Director of Nursing & Quality and Faye Bruce, Non-Executive Director. Enhancing round the Post-partum haemorrhage: supporting patients
The Maternity team have implemented a new pathway – the route or path a patient will take through hospital services once they are referred for treatment, making sure they adhere to the latest clinical guidance. The pathway will help them to improve monitoring and escalation of post-partum haemorrhage (PPH) - excessive bleeding at any time after a baby is born (up to six weeks).
The team’s aim was to ensure effective collaboration to lessen the harm caused by possible post-partum haemorrhage. There are four key pillars to the new pathway implemented by the team: 1. Risk assessments performed for every patient 2. Early detection practices 3. Multidisciplinary teamwork 4. Use of ROTEM point of care testing. A ROTEM is a globally recognised test, carried out using a special piece of equipment, to measure bleeding and the body’s ability to stop the bleeding and begin to heal. The Maternity team’s new ROTEM machine was installed in September 2022. David Castillo, Consultant Anaesthetist, who led on this part of the project said: “Having a ROTEM on the labour ward is an integral part of the quality improvement project. It allows a measurement of coagulation function to be performed quickly and near to the patient. Coupled with fibrinogen concentrate stored on the labour ward, this means we can rapidly respond to coagulation defects acquired during a postpartum haemorrhage and stop them progressing.”
clock care
A new standard operating procedure, written by a multidisciplinary team to support maternity procedures has provided access to additional twenty-four seven emergency surgical intervention.
By working with the blood transfusion service, the team could modify the major haemorrhage protocol to ensure that women at risk of PPH were screened for blood antibodies in the event that an emergency blood transfusion was required. Emma Kirkham, from the Transfusion Team commented: “It has been such a positive experience working with the different teams involved in implementing the PPH pathway. It has allowed for a greater understanding and appreciation of the hard work and dedication from all the departments involved, all with the aim of providing safe and efficient care for our patients.”
Same Day Emergency Care Unit getting ready to open
Soon, patients who need emergency medical care will be seen and treated on the same day rather than being admitted to hospital for an overnight stay thanks to the Countess’ new £15 million Same Day Emergency Care Unit (SDEC).
Opening in a phased way over the winter, patients will be referred to the new SDEC directly from the Emergency Department, by NHS111, their local GP or by the North West Ambulance Service.
The Unit will provide joined up, quicker assessment of patients who may require hospital care or a same day intervention. Patients will be rapidly assessed, diagnosed and treated by healthcare teams across medicine, surgery and geriatrics. Cathy Chadwick, Chief Operating Officer said: “The SDEC is one of the many ways the Trust is working to provide right care, in right place, at right time for patients. The SDEC will reduce delays for our patients and ensure they receive the care they need quickly and wherever possible, on the same day so that they can get back home to recover in familiar and more comfortable surroundings.” Whilst construction of the unit was still in progress, interested volunteers and lived experience advocates were invited for a tour to offer their insight into the functionality of the space and offer their feedback on areas where they felt the internal functionality could be improved. Their feedback was very positive, with comments on the expansive room sizes, the recognition of the privacy and dignity of patients and the way that teams will work within the building were all mentioned. Cat Witkiss Acute Medicine Matron at the SDEC, said: “It’s important to realise that hospital isn’t always the best place for every patient to recover from their illness. Rather than being admitted to hospital, if patients require further treatment but are well enough, they can now receive their treatment at the SDEC and then return to their own home to recover. This is a much better option for them and frees up beds for other patients who need them.”
Patients took a tour of the building to see how accessibility and patient experience could be improved.
Supporting our people
Focusing on how staff are supported, listened to and involved in the Trust’s future plans is key to the Improvement Plan.
Nicola Price, Head of HR and Organisation Development said: “Setting out our plans for how we better listen to and support our staff is essential if we are to ensure we can consistently deliver the best and safest care for our patients. Alongside that, we want to become an employer of choice to retain our existing staff and attract other highquality people to work in our hospitals.” The Trust’s priorities are: Improve staff engagement: Making sure staff have a voice, are listened to and that they see the results of their feedback and contributions in action is key. Nicola added: “Our focus extends beyond the more traditional methods of engagement – we’re working on how we retain staff, how we recognise their achievements and how we ensure their wellbeing and welfare is central to the way we operate.” Embedding equality, diversity and inclusion more visibly: Creating an inclusive environment is fundamental. A new Equality, Diversity and Inclusion Strategy is in development. Getting the right resources in place: The People and Organisation Development team is being increased in size to better support delivery of the People Strategy. Kathy Cofax, Wellbeing Practitioner has been substantiated in post, and two organisation development practitioners, one focusing on equality, diversity and inclusion and the other on culture and engagement will join Fleur Flanagan, Head of Organisation Development. Andy Morris, Strategic Workforce Planner will support a more strategic approach to developing our staffing, recruitment and retention.
Fleur Flanagan, Head of Organisation Development said: “Our staff are our most important and valuable asset and these new posts will help us to support them better. It’s imperative that our people feel that they have a voice, feel supported and believe that the Trust cares about them. We want them to feel that they can share their thoughts, worries and ideas freely – it’s one of the best ways we can learn as an organisation and that we can embed safety at a fundamental level.”
Kathy Cofax, Wellbeing Practitioner, Mark Dale, Head of HR and Andy Morris, Strategic Workforce Planner have all recently joined the Trust
Raising the bar of Corporate Governance
Corporate governance is a vital component of our Improvement Plan and significant progress has been made already.
Paul Edwards, Director of Corporate Affairs explains: “Corporate governance sets out how we will manage ourselves as an organisation. It provides the clear and transparent rules and controls that determine how we operate and how we make decisions based on clear priorities and strategic objectives.” Within the Trust’s Improvement Plan, there are three key elements:
Developing our Board A development programme for all Board members will increase the effectiveness of our Unitary Board and provide more targeted activity to support executive and nonexecutive directors. Roles and responsibilities have been re-evaluated and decision-making processes have been reviewed. Strengthening our Board Assurance Framework The Board Assurance Framework (BAF) is used to log and manage strategic risks and work to make it more visual with clearer timescales will make it easier for everyone to understand – including the public.
Governance training Face-to-face governance training is in place for the Senior Leadership Group with a second phase to support wider knowledge and understanding of governance rolling out to all staff in early 2023. Paul added: “We want to demonstrate to patients, the local communities served by the Trust and members of staff that their healthcare is in safe hands and that this is supported by open and transparent processes. Strong governance can help us to do this. We will embed more open and rigorous procedures so that people and other organisations can have trust in us and the way that we work.”
Bringing Board Rounds to our wards: making a difference to patients
Working with the Emergency Care Improvement Support Team (ECIST), the Trust has successfully implemented Board Rounds to improve patient care and communication among staff.
Most people are familiar with ward rounds – a group of clinical staff, led by a consultant which moves from patient to patient to discuss their care and progress with their treatment. We wanted to improve this process and Board Rounds are proving a success on our wards. They differ because typically they do not take place near a patient’s bed. Instead, a multi-disciplinary team of staff gather around a visual management board which has all the data, test results, care management plan and other information they need to see for each individual patient. The aim of the Board Round is to keep up the momentum toward patient discharge. Non-medical tasks, such as communication with family members and community or social care services required for discharge, can be discussed with a clear plan of action to ensure a patient’s care plan and planned discharge date stays on track. One of the primary benefits of the Board Round is making sure everyone involved in a patient’s care knows exactly where their care and treatment is up to. Teams can better identify potential issues, take early action and keep discharge planning on track. has been well-received by both staff and patients. Staff have reported feeling more supported and valued, and patients have told us that they have seen an improvement in communication and care which is exactly what we hoped would happen.
Board Rounds take place every day with a multi-disciplinary team
