The story so far

Productive Endoscopy at the Royal

Liverpool .

Nicola Taggart

Endoscopy Services Manager

Productive Endoscopy workshop

October 2013

During the presentation I will give brief over view of :-

• Who we are.

• How we became involved.

• How we got started in the project.

• What we have achieved.

• Communication issues.

• Training and personal development of staff.

• Review of what we have learnt along the way.

• Key issues and challenges ahead.

Overview of Presentation

Introduction

• Many interesting changes locally and Nationally

• Workload.

• Workforce.

• Standards in practice.

• JAG accreditation.

• National training centre

• Productive Endoscopy.

.

12997 13122

1441514805 14996

15904

6000

8000

10000

12000

14000

16000

Yr06 Yr08 Yr09 Yr10 Yr11 yr12

How we got started

• Began end of May 2013

• NHSIQ- approach & support

• Trust board level support

• Establish Module leads.

Why did we need to do this?

Three main

areas of focus

Activity issues

workforceissues

Patientissues

Patient Issues • Lists running over

• Long waits in department

• Identified waits in patient survey

• Communication issues

• Patient experience not standardised

• Poor compliance with enema prep

• Good safety record

Activity Issues

• Yearly increased activity

• Already a high performing department

• Inpatient liaison nurse running duty lists

• Pressure to maintain cancer targets

• Plans for fifth room

• Maintaining a quality service

Workforce issues

• Three large teams working together

• .

• Staff survey in 2012 identified issues

• Areas of poor communication

•

• High levels of union involvement

• Previous experience of Lean was unsuccessful

Sort and Shine store room BEFORE AFTER

Sort and Shine Endoscopy roomsBEFORE

AFTER

Sort and Shine Key Benefits

.Environmental improvements.

• Cleaner and tidier

• Less time wasted

• Everything to hand.

Sort and shine key benefits

Benefits for patients

• Impacts on patient safety

• Staff care more about equipment

• Availability of equipment

• Procedures are quicker and slicker

Sort and Shine Key Benefits

Financial benefits

• Much less waste daily

• No longer routinely over ordering.

• Data collection for service improvement

IMPROVED COMMUNICATION

• Data collection.

• Collaborative working

• Better understanding of departmental pressures

• Regular meetings

• Quarterly newsletter publication, CQC compliant

• Daily feedback at team brief

• Knowing how you are doing board

• Support for Sisters and senior nurses

Education and staff development

• Managing change.

• Staff are motivated in new project work

• Staff feel confident to share their opinions and help to make the

changes

• A culture shift

• More enthusiasm and ideas generated.

Highs and lows

• Visible evidence of success with sort and shine

• Staff understanding each others pressures

• Utilising tools and techniques

• Generation of ideas

• HCA developing and implementing a discharge system

• On-going projects moving forward.

• Time is always an issue

• Some staff will never get on board

Where do we go from here

• Further action post diagnostic phase.

• Maintain enthusiasm.

• Sustaining changes.

• Key projects ahead.

• Improve waiting times

• Improve discharge processes

• Fifth endoscopy room

• New hospital (2017)