Ugochi Agbasimelo

Hannah Bowman

Lucie Butler

Gayle Elder

Barts health NHS Trust

The Royal London

Birthing Centres at: Barkantine

Barking

Barts Health overview

2

Many work streams of independent activity requiring

action

Another initiative!!!!

AAU Independence

project- We will help you to

Leading change adding value

Privacy and Dignity

compassionate care work stream-

Ambulatory care

T&O nursing and therapies silo working

ED

EM CARE

Dementia and Delirium action

plan

Red to Green

Without recourse to

public funding

Aging population-

RLH and NUH buck the trend

Some the highest levels of

deprivation

Lengths of stay

Expectations- Carer, Patient and staff

External and regulatory pressures

Patient choice and safe discharge

Journey to #EndPJParalysis

Maintaining Patient’s Privacy &

Dignity

Teach us to live that we may dread

unnecessary time in bed.

Get people up and we may save

patients from an early grave

• spending 10 days in bed ages your muscles by 10 years!

80 years of age?

• reduces muscle power by 2.5% and not just in the arms and legs but also in the heart and lungs

Just 24hrs of bed rest

Pre-Launch Steps

• Collaborative working and meeting with #endPJParalysis

working group (patient panel members, therapists, nursing staff

– all grades – on the flagship wards, communication team)

• Flagship wards cut across all disciplines – surgery, OPS,

medicine

• Baseline audit – literally to count

– How many patients sat out at lunch time

– How many patients in own clothes

Launch

Pledges

Post Launch Window in the Atrium

Creating stimulating environments

Background

Therapies

Therapy team working on 12C ward- Trauma, Ortho and plastics

Difficulties with communication between Therapy team and Nursing

staff

Established using mobility charts above beds to facilitate better

communication

Involvement in the end PJ paralysis working group with Ugochi-

Matron

Mobility board

Therapies

Goal setting booklet

Looking at 4 elements • Washing and dressing

• Transferring to the chair

• Toileting

• Eating meals

Poster

Therapies

Highlighting for patients, relatives and staff

reasons why to get up and get moving

Reiterating what will be discussed with patients in

their goal setting booklet

What we gave to the wards to make things easier

Resources to help discharges

• Discharge Folder – a central source of information to

make things easier for busy ward staff.

• Patient acceptance form for patients moving ward to

ward amended to include discharge planning as a

prompt.

• Ward induction packs for new start HCAs, band 5s and

band 6s – covering discharge planning, SAFER etc

A guide for all disciplines

SAFER Flash Cards

• Designed to be a quick and easy guide on

SAFER, red to green and discharge planning.

• To incorporate all disciplines to be involved in

flow and early discharges – not just nurses and

doctors.

• To make all staff feel included in new processes

• Pocket sized to allow staff to carry around as a

prompt.

Independence project AAU

Staff poster

? By Default

Fit to sit

ED initiative to move to an ambulatory majors

Patient who need hospital admission or further

investigations are dressed and sit in a separate

part of the department being taken into cubicles

for examination.

Keeping Moving…. forwards

• Embed practice – Make endPJParalysis the norm

• Communication (including visuals) for the flag ship wards

• Measure achievement on a daily basis – create data to

show improvements

• Senior leadership support in rewarding/encouraging areas

that have worked hard made great strides

• Roll out to all other wards in the Hospital and Trust

• Publicity- blogs, meetings, demos

• Rolling out mobility charts, posters and goal setting

booklets across the hospital

• Incorporating this into the Surgery Enhanced Recovery

Programme

• Work on a fit circuit for our staff and patients