hospital e f li
Pain relief:
Staff magazine
Spring 2013
Pain team celebrates UK first
The story of K&C’s ECC
7 reasons to brave the dragons
Outstanding contribution
hospital people
Outstanding Contribution Award The last ‘Outstanding Contribution Award’ of 2012 went to Nina Lee, New Media Development Manager. Nina is the technical guru of the Trust's communications team - usually found working magic at her PC within the press and communications office at Kent & Canterbury Hospital and coming to the rescue on all sorts of IT issues from Sharepoint to Powerpoint. In October this year, an unexpected prolonged absence of one of the team members just two weeks before one of the biggest events in the team's year - the annual Trust Awards evening - threatened the smooth running of the event. Determined to put on a good show for the award finalists, Nina stepped up to the challenge and took over the organisation of the event on her own initiative - which meant
Nina receives her award from Chief Executive Stuart Bain at the Chief Executive’s Forum doing all sorts of tasks and using all sorts of skills that she doesn't normally have to as part of her everyday role. This meant spending many extra hours at work, which she did without complaint. Those of you who were there that night will know that the event was a great success and a great 'thank you' to staff for the hard work they had done. n To nominate a colleague for an Outstanding Contribution Award simply go to www.ekhuft.nhs.uk/awards
This man wants your bright ideas! Planning offices in Canterbury. Henry Quinn is the Head of Strategic Intelligence, based in the Strategic Development and Capital
Henry is a man passionate about innovation and has taken on the job of collating all the ideas submitted by EKHUFT staff through
the Trust’s ‘Bright Ideas’ scheme, presenting them to the Executive Directors, sending them to the relevant department to implement, and telling the person who submitted the idea what’s happening with it.
What’s your story? Hospital life celebrates the best of EKHUFT. If you have a story you would like to see printed in it, get in touch! Contact Gemma Shillito, Communications Manager, on ext 73843 or e-mail gemmashillito@nhs.net
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Putting patients first
The ideas are discussed every three months by the Executive Directors, who decide which ideas are able to be implemented or which they want to be investigated further. In the first six months of Henry taking on this role, 25 ideas were submitted and 14 were approved. n If you have a bright idea, tell Henry by completing the online form at www. ekhuft.nhs.uk/brightideas
hospital people
pain
Pain Team celebrates its three-year journey from relaunch to UK first
relief
EKHUFT’s Spinal Cord Stimulation service relaunched three years ago and the Pain Team is busy making it one of the country’s pioneering centres.
Spinal Cord Stimulation is used to help people suffering the effects of chronic pain. A consultant implants a permanent stimulator alongside the spinal cord. The stimulator relieves symptoms by generating electrical pulses that change the sensation the brain feels. Patients experience a tingling sensation instead of pain, and can control their level of relief using a remote control device. EKHUFT’s service is the only one of its kind in Kent. It is a dramatic step that is only offered to people suffering chronic limb pain who have already gone through the numerous other treatments available. While it hugely improves quality of life, it isn’t a complete cure and involves having a foreign body permanently implanted. So
The team from left: Dr Raju Bhadresha, Tina Elliott, Jamie Kirkham, Helly Langley, Elizabeth Quinn, Dr Neil Collighan, Elizabeth Mount, Val Gawler the team have developed a series of assessments, including a psychological assessment carried out by a consultant psychologist, before the decision to implant is taken by the multi-disciplinary team. It takes around a year from starting this pathway to get to surgery. Before surgery is planned, a two-week trial of a temporary stimulator is used to guage how much difference the implant will make to the patient’s pain. “A successful procedure makes about a 50% improvement in quality
of life, with increased mobility,” said Chronic Pain Consultant Dr Neil Collighan. The procedure is carried out as day surgery by Dr Collighan or Dr Raju Bhadresha, and the patient benefits from regular follow-up from the chronic pain specialist nurses. A maintenance contract with the manufacturer means patients can have the stimulator’s programme tweaked if required in an outpatient clinic. At the end of 2012, the team was the first in the UK
to implant a revolutionary new stimulator which has double the stimulation capacity of older models making it far more effective than anything previously on the market. The team promotes the services and support available to chronic pain sufferers at Trust roadshows and events. “One in seven of the population experience chronic pain at some point in their lives,” explains Dr Collighan. “This is a disabling condition for many, so intervention is hugely important.”
Putting patients first
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hospital life
7 reasons
to brave the dragons
The launch of the Trust’s ‘After Dragon’s Den’ scheme in 2011 threw away the red tape and gave you the chance to have an immediate ‘yes’ or ‘no’ to your dreams to develop your service. Staff all over the Trust have grabbed the opportunity with both hands and 18 months on, here are just some of the projects that have taken off as a result... The beauty of ‘After Dragon’s Den’ is all projects are considered - be they sexy clinical services, innovations in nursing care or better systems behind the scenes - but they all have two things in common: they lead to better patient care and help the Trust save money. Red mats The red mats used on patients’ tables in wards to alert all staff 24/7 that a patient needs help or monitoring with food or drink were funded through a successful pitch to the dragons by Deputy Matron for Quality & Nutrition Angus King. The mats are an extension to the successful ‘red tray’ scheme and help ensure that all information that staff need to care for a patient effectively is visible within three seconds. Central catheter positioning system Three ECG systems that
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Putting patients first
Red mats are now on every ward to alert staff to a patient’s nutritional needs allow accurate placing of Peripherally Inserted Central Catheters were funded by the dragons, who were so won over by Consultant Anaesthetist Dr Matt Jones and Matron Gemma Oliver that they funded three rather than the one being asked for! “The systems are up and running on all three sites and they are fantastic,” said Dr Matt Jones. “We can now treat patients in all locations without using radiology and we can 100% confirm accurate line placement at the bedside, so patients can get their treatment immediately. “It really has made a difference to our patients,
allowing us to provide a safe, speedy and efficient service.” Digital dictation A successful bid for digital dictation for Urology by Vikki Hughes has meant that clinicians can now give GPs urgent clinical information in as little as half an hour - saving crucial time. And routine clinics that could take up to four weeks to be transcribed are now taking 72 hours or less. Capsule endoscopy In Spring this year Dr Carlo Nunes showed the dragons that starting a capsule endoscopy service (giving patients a pill-sized camera
to swallow that films its way through the small bowel) made financial sense for the Trust as well as offering an improved service for patients who previously had to travel to London for this investigation. “I wasn’t sure whether the dragons would go for it,” said Dr Nunes. “I would encourage anyone to try. It’s worth it.” Patient support The Urology Nurse Specialists used funds granted by the dragons to buy teaching aids for men undergoing surgery for prostate cancer. The nurses use them during patient group meetings
hospital life to help their patients understand what to expect and to be better prepared for quick discharge from hospital after the procedure. Staff physio service The Occupational Health team persuaded the dragons that it makes financial sense for the Trust to fund a self-referral staff physio service, so injuries and potential problems can be sorted out early, making staff less likely to need time
Above: the ECG system allows immediate accurate placement of Peripherally Inserted Central Catheters Left: The pill that sees inside you
off work due to ill-health. Staff can now self-refer to Physiotherapy without
having to go through their GP, for quick access to a dedicated physio service.
iPads for kids Yvonne Norley, Service Manager for the Learning Disabilities and Challenging Behaviour Team, got the goahead for three learning disability assessment kits for children with communication difficulties
Ready to hear your idea! The dragons are always looking for people with new ideas to come forward - no matter how big or small the idea. If you are passionate about improving patient care or services we want to hear from you!
that include iPads and specialist communication software for the children’s use. This equipment allows the children to be better assessed, which has always been extremely difficult to achieve.
Top tips for pitching at ‘After Dragon’s Den’
The dragons enjoying the props in October’s den Help and guidance on preparing bids and
presenting to the dragons is available if you want it.
• Make sure you can prove your project will improve patient care and either save money or generate income • Do your research - make sure you can show your figures add up • Keep it simple - what problem will your project solve? Why is it so important? n For more information contact mandy.carliell@ nhs.net
Putting patients first
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hospital life
redefining
emergency care
The Emergency Care Centre at Kent & Canterbury Hospital provides a pioneering model of emergency care that the rest of the UK looks to emulate, writes Acute Physician Dr Memon Illahi. The Emergency Care Centre (ECC) was established in February 2005 as a result of reconfiguration of acute hospital services within east Kent. The Trust’s plans were considered to be controversial when they were proposed, both within the clinical discipline at the hospital and by local pressure groups who believed that losing the trauma element of their local A&E would lead to loss of life and a reduction in both patient service and patient safety. However, with over eight years’ experience in the current model we know that the ECC has proven to be highly successful in many different ways. There are, for example, significantly less patient incidents and complaints now. Patients are assessed much more quickly. The ECC takes acute admissions for medicine, vascular surgery and urology. Acute medical admissions account for about one third of the total EKHUFT medical workload and the ECC has over 90% of the patient load it had as an A&E. Patients are referred by ambulance, primary care and inter-hospital transfers as well as ‘walk-in’ patients. The facilities, which were developed
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with full clinical input, include a four-bed resuscitation area, 12 bed majors bay, an 18 bed short stay ward; a DVT assessment area; and a minor injuries unit staffed primarily by Emergency Nurse Practitioners.
on-call consultant physicians for medicine and care of the elderly; six Foundation Year 2 doctors; on-call specialist registrar; medical SHOs or F2 doctors; and the nursing and technical staff.
So what’s different? The major difference between the previous A&E and current ECC is that staff (medical and nursing) is medically orientated.
There is a separate dedicated team for looking after patients with urological or vascular disorders who also provide surgical opinion for the medical team and acute surgical cases can be transferred to Ashford or Margate.
The majors team comprises a consultant acute physician on duty (currently Monday to Friday 9-5);
hospital life Meeting emergency care standards In 2005 The Royal College of Physicians and The Royal College of Surgeons published a joint document: The Emergency Department: Medicine and Surgery Interface Problems and Solutions. It highlighted key issues for emergency departments to overcome to deliver speedy but safe care, including: • waiting for results • waiting for medical teams to respond to referrals from the emergency department • junior members of specialist teams being the first point of contact, who then have to wait for a more senior member of the team to make decisions • experienced emergency physicians and nurses having to refer obvious admissions through a specialty team. The ECC has successfully implemented solutions to these issues, including: • prioritisation of ECC requests for X-ray; CT, MRI, ultrasound and VQ scans done on the same day • senior doctors available on the floor to admit patients directly on clinically appropriate beds in the unit and in some cases, specialty wards • senior leadership on the floor allows decision makers to be available at every step of the patients’ pathway • established nurse-delivered protocols for common conditions like DVT (Deep Venous Thrombosis), Cellulitis and selected cases of Pulmonary Embolism • multi-professional agreed care pathways for more complex conditions, eg, cerebro-vascular accidents, including admission. The medical staffing of the ECC by two Consultant Acute Physicians with specialty interests is in line with recommendations from the Royal College of Physicians. Consultant
“We intend to continually review the services we provide and make any changes which we believe will improve both patient care and staff morale” reviews avoid unnecessary delays in managing very sick patients and facilitate earlier discharge of other patients directly from the unit. The ECC is greatly supported by medical and elderly consultants, each of whom conduct three ward rounds in a 24 hour period. This model also provides training for Foundation Year 2 doctors that is focused on the development of a flexible workforce of doctors who are both competent at dealing with acutely ill patients and effective at communicating with patients and colleagues alike. The ECC at Kent & Canterbury Hospital is new, exciting, innovative and effective and has attracted widespread attention and visits from
clinicians and managers across the NHS, and similar models are likely to be implemented across the country. We believe that we have established a good team and this has been reflected in delivering high standards of care for our patients. We intend to continually review the services we provide and make any changes which we believe will improve both patient care and staff morale. Our aim is to continue to deliver world-class medical care speedily, expertly and efficiently for both our local population and the millions of tourists who visit Canterbury every year.
Putting patients first
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hospital staff
New Year... New you?
If one of your New Year’s resolutions was to get fit, healthy and trim, you’ll be pleased to know that Occupational Health has launched a fantastic new staff service which has all the benefits of personal trainers and none of the cost!
Being fit and healthy helps to combat feelings of tiredness, stress and depression and has been linked to improved performance, better sleep and overall wellbeing...
The first session will be based around ‘knowing your numbers’ – BMI, BP, etc - and identifying lifestyle improvements and A BMI check at goals. Follow up sessions Occupational Health can be arranged to review progress and the wellbeing advisors will be happy to e-mail or call you with updates and motivations to help keep things on track. The goals can be tailor made for your current level of fitness – therefore the service works for everyone.
For those who would like a lifestyle overhaul we can also offer the take 5 five week well-being challenge! This helps to motivate change around five key lifestyle areas: diet, exercise, stimulants, stress and ways to well-being. This can be undertaken by individuals or teams who would like to embrace the New Year on a positive! Interested? if you work for EKHUFT and you would like see one of the wellbeing advisors please call and book an appointment on: K&C - 01227 864206 WHH – 01233 616059 QEQM – 01843 234478 ext 62301 Or e-mail a request for an appointment to occupationalhealth.kch@nhs.net
“I have regular meetings to look at progress and discuss changes to my plan. I have lost 13kg and 4cm from my waist. I still have a long way to go but have noticed great improvements in my fitness.”
hospital life Hospital life is produced by East Kent Hospitals University NHS Foundation Trust Communications Department tel: 01227 866384 e-mail: ekh-tr.communications@nhs. net Editor Gemma Shillito ext 73843 DL 01227 866384 e-mail: gemmashillito@nhs.net Unless otherwise indicated, views expressed in Hospital life are those of its contributors and are not necessarily the views of the Trust.
If you would like a large print copy of this magazine, please contact the Trust’s Communications Department on 01227 866384. ÿivot v nemocnici je dostupný vo väÿšine jazykov. Pre výtlaÿok zavolajte prosím na 01227 866384 alebo pošlite e-mail na ekh-tr.communications@ nhs.net “Hospital life” je k dispozici ve vÿtšinÿ jazykÿ. Výtisk si mÿÿete objednat buÿ na ÿísle 01227 866384 nebo emailem na: ekh-tr. communications@nhs.net Broszura “Hospital life” dostÿpna jest w wiÿkszoÿci jÿzyków. Jeÿli chcieliby Paÿstwo otrzymaÿ jej kopiÿ, prosimy o kontakt telefoniczny na numer 01227 866384 lub e-mailowy na adres ekh-tr. communications@nhs.net