Making Waves October 07 - James Paget University Hospitals

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Outpatients – making great progress Trust staff and regular Making Waves readers will know that outpatients has been a busy place over the last twelve months as the outpatient project has been rolled out. This has brought medical and surgical outpatients together as one department within Clinical Support Services. Here, Wendy Mitchell, Outpatients Manager, gives Making Waves an update on progress so far, and what still needs to be achieved. The outpatient review project had two key purposes: 1. To introduce more a much more flexible staffing structure in outpatients. This included developing the role of Outpatient Assistant (of which, more later) and more cross working across all our outpatient clinics 2. Modernising roles to make sure we’re ready to meet future challenges like 18 weeks and choose and book. So what have we achieved? Wendy says: ‘There’s no doubt this has been a difficult project at times, and it’s taken longer that we would have liked. But we’ve achieved a lot and I’m so proud of the staff working with me who have done this. Ultimately, we’re going to end up with outpatient clinics that are fit for purpose and that deliver excellent, flexible, integrated care to our patient, and that’s what really counts.’ Nursing team Whilst we’ve achieved some financial efficiencies, what’s really important is the integrated working that’s going on now between different nursing groups. We’ve implemented a new professional and personal development programme for our nurses in outpatients. We all recognised that in some areas there was a shortfall in management skills, so we’ve developed a management programme so that senior nurses can develop their management skills and become mentors for student nurses. This is a great step forward. We adopt a team approach to delivering this development; ensuring nurses gain a broad overview of the whole service both from the nursing and business side of things. 8 October 2007 Making Waves Outpatient bookings and performance We’ve also completed a detailed review of the admininistrative support to outpatients. From discussion with and listening to the views of our consultant users we recognised that some of the original systems in place across outpatients worked well, others required a different approach. We’ve re-structured it to change the role of our Outpatient Coordinators, so that rather than operating a call centre system we have now allocated all specialty areas with their own dedicated coordinator. Many of these staff possess a working knowledge of how clinics run and they are working as part of each specialty team directly with Consultants and secretaries, providing a clear link with outpatients. There is some training and development work still required in this area but what we aim to achieve is an Outpatient Coordinator team which provides information on waiting lists, make sure clinic slots are well used and monitors choose and book referrals. This structure is working very well in a number of specialties already and we hope that this will improve over the next 3 months. Top left: Wendy Mitchell, Outpatients Manager. Top right: The Outpatients Assistants with Jo London, Penny Cox and Teresa Norton. Right: Beverley Sharpe-Brash, Ophthalmology Nurse Practitioner. www.jpaget.nhs.uk
O/A’s! The Outpatient Assistants role was originally set up a few years back in Medicine. The role consists of healthcare assistant and administration duties. These team members undertake all the responsibilities usually expected in terms of clinic support but the multi skilling element provides greater flexibility and enhances the way we deliver care, especially in the face of staffing pressures caused by sickness or annual leave. This role does not replace the need for trained nurses in Outpatients but it does result in a shift to what we call our hub and spoke approach, that is our trained nurses are free to provide support suitable to their skills and to supervise the clinics whilst our O/A team provide the important role of supporting patients and consultants through the consultation and booking process. Whilst this sounds ideal I would emphasise that from the lessons we have learnt from the past this is not an “overnight” transformation, and special care has to be taken to ensure training and support are maintained for our team. In order to ensure this if offered our O/A’s have their own training and education programme which has been led by nurse managers Teresa Norton and Penny Cox. Particular thanks however need to go to Ophthalmology Nurse Practitioner Bev Sharpe-Brash who has driven the training forward and now regularly organises training sessions delivered by specialist nurses from a wide range of specialties. I’m really grateful for the work they’ve done on this with support from the Nurse education Department and our specialist nurse team. New lead nurse roles As part of the reorganisation we’ve also achieved the development of two lead nurse jobs within Ophthalmology (Bev again!) and the Colposcopy Nurse Practitioner in Gynaecology, Lesley Crisp. These new roles that have been in post six months now and form an important role in our strategy to develop nurse led clinics with a particular focus on reducing Consultant follow ups where appropriate. Changing the way we work…. A number of the Outpatient specialties have been involved with team sessions to map their work and to highlight some of the constraints (and irritations they experience!) which are inevitably faced across the service e.g. continuity of skill mix, accommodation pressures, improving communication with the wider organisation etc. We have tried to identify different way of working and introduce support roles to help in these areas where needed. So what’s ahead? The next phase is the refurbishment of main reception. You will see a lot more of our Outpatient Assistant team over the coming months working in this area. They wear a white uniform, and they will be meeting and greeting patients, booking appointments, dealing with enquiries, and providing a speedier validation system for car parking for our disabled patients. Although we are not investing any additional resource into our staffing at the current time we have been able to identify more innovative pathways in some areas. To support these improvements we have recruited a small cohort of trained nurses, mainly newly qualified staff to help us take forward our www.jpaget.nhs.uk plans by providing continuity to the clinics. In addition we recognise that there is a need to support the Outpatient training process for the next 12 months, and with this in mind, new O/A’s will be recruited in the near future. Breaking the boundaries… Again following the theme of integrated working, health records are now part of our service and we’re collaborating with them on new roles that provide outpatient administrative support for both health records and outpatients. This gives the team in health records exposure to the frontline delivery of outpatient services, and conversely, the staff in clinics learn about what goes on behind the scenes. We’re only just starting this, but I’m confident this will be an effective way of developing staff and ultimately providing a better service. So over the next sixth months, it’s a period of consolidation. At the end of this time, we’ll have 20 new Outpatients Assistants, fully conversant with their role and working flexibly. Our structure will be fully in place and we’ll be providing a much improved service to consultants and their secretaries. Thank you! ❝ I want to thank everyone in the team – we’ve achieved a waiting time of just 9 weeks for all new outpatient referrals at the end of June. This was with a momentous effort from all staff and it’s a fantastic achievement. ❞ The team are extremely supportive of each other in focussing on improving our wait times against all odds! Thank you finally to all the associated specialties and departments who have been patient during these changes. A few quotes from our O/A team ‘The last 8 weeks have been really hectic! Having been used to just doing the nursing side in our clinics we didn’t have a clue where to start when we were put on the reception desk but I think it was the best way for us to learn now. I’ve really enjoyed learning all the new work on the computer and what is involved when a patient arrives at the clinic reception desk. What I like about the new role is that it is very varied and interesting to see how other Outpatient areas work, plus it has given me a better understanding of the type of patients illnesses are treated and all the clerical work that goes on before each day’s clinic’. Beverly Tindall – Outpatient Assistant ‘When I was first approached about the O/A role I was more than a little apprehensive. I had been an HCA for more than 15 years in the Orthopaedic OPD and enjoyed my job. I had not considered trying anything new. Once I started my reception training I began to enjoy the challenge of learning something new. I did find it mentally exhausting but also felt a sense of achievement when I first made an appointment or booked transport for a patient without having to ask for help! It has been really interesting learning what goes on in other outpatient areas. The people that I have met have been friendly and helpful and have shown exceptional patience with me! All in all it has been a good experience’. Bridget Pratt – Outpatient Assistant October 2007 Making Waves 9
Page 1 and 2: October 2007 James Paget University
Page 3 and 4: Enhanced recovery after surgery (ER
Page 5 and 6: What about the Future? Developing t
Page 7: CSCA Bus Many staff will have met m
Page 11 and 12: Thank You! Another small sample of
Page 13 and 14: Excellent Service Awards On 4th Jul
Page 15 and 16: James Paget Hospital A celebration

Making Waves October 07 - James Paget University Hospitals

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