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Autumn 2017
Co-ordination Centre Programme special t Find oPuage 4 more
02 Winter is Coming
03 Spotlight On‌ Mel Kynaston
07 The Countess Charity
Annual Members’ Meeting 18 October Page 10
08 Jr Docs switchover
09 Crash simulation
WINTER IS COMING
Welcome
FROM YOUR CHIEF EXECUTIVE
Contents
06 Model Hospital
With our new Co-ordination Centre Programme we are taking a huge step forwards with technology, but ultimately it’s about making improvements for patients. We always want to do everything we can to be as safe, kind and effective as possible. This innovation helps us in all those areas. You can read in the pages that follow how it will improve our patients’ journey by giving our staff more time to care for them. Let me take this opportunity to thank all those involved in getting us ready to launch. It’s taken a long time and a lot of hard work to get us to this point and I’m grateful for all their efforts. I’d also like to welcome our new Associate Director of Nursing Mel Kynaston, who has recently returned to the Countess. This magazine is always full of amazing work from our staff as they routinely go over and above to help patients. They have always been and will always be what makes the Countess a special hospital. We never lose sight of that.
The entire NHS is always put under the most pressure during the colder months. It’s a testing time, but it also gives healthcare professionals a chance to shine. As the long nights draw in new creative approaches are being put in place at the Countess to reduce waiting times by giving more people greater access to the care they need. While the Trust’s new Co-ordination Centre (find out more on page 4) should start to reduce lengths of stay for patients in the months ahead, there are other changes being made to improve how patients are admitted and discharged. These include a greater emphasis on early assessment, with a new Urgent Treatment Centre and acute physicians/geriatricians redirecting people sooner if they could be seen in the community instead. This will cut down unnecessary time spent in hospital, freeing up opportunities for those who do need to be in Accident and Emergency (A&E). Following the success of the Intermediate
Care Unit’s approach to 24-hour therapyled care, which was introduced at the Countess last year, the Bluebell Unit at Ellesmere Port Hospital will also now adopt this model going forward. This will see more people have rehabilitation focused on what they need to do to return home, with staff encouraged to drive the improvement in a patient’s quality of life every day. Underpinning this approach to winter is a closer collaboration between the different parts of the NHS in Chester and as part of it senior figures from across the local NHS will be meeting more regularly to find the best solution for patients with complex needs. “Everything we do is always driven by providing the best possible care for our patients,” Urgent Care Manager Karen Townsend said. “We’ll never stop reevaluating how we work and looking for ways to get even better. Winter is always a huge challenge across the NHS as more people attend A&E and we are certainly no different, but I’m excited by the difference our improvements can make this year.”
Spotlight on…
Associate Director of Nursing Corporate Mel Kynaston “It’s really good to be back. Obviously it’s completely different to what I was doing before but I’ve got a lot of exciting opportunities to develop in this role.”
Welcome back Mel! Can you explain your new role and how it will work? I’m one of three associate directors of nursing working with Director for Nursing and Quality Alison Kelly, along with an associate director of risk and patient safety. It’s still early days but it’s already working well. We’ve gelled together nicely and identified areas where we can make improvements. How does it feel to come back? I love it. It’s really good to be back. Obviously it’s completely different to what I was doing before but I’ve got a lot of exciting opportunities to develop in this role. What is the first thing you are going to focus on?
One of my biggest priorities is looking at patient experience. I want to strengthen how we use patient feedback to change our practice. We want to show that we have listened and made changes if necessary in response. As part of that I want to use patient engagement forums, which will give us a chance to discuss ideas and see how patients feel about the proposals. Patients can give you a different perspective and identify things we might not have picked up on as clinical staff. With things like the Co-ordination Centre, for example, it will be important to know how people feel about that going forward.
alongside our acuity and e-rostering data, we will be able to mobilise our workforce to meet the level of care our patients need and manage activity in all areas. We’ll be one of the first in the country using a real-time model in that way.
How exciting is it to be coming back to the Trust when we’re on the cusp of introducing the Co-ordination Centre programme? It’s really exciting, not just this new system but the whole Model Hospital initiative. What I think is great about the Model Hospital is whilst it’s about efficiencies, it’s been put together carefully to put patients first. The Co-ordination Centre is just mind blowing really. The benefits we’re going to get as a senior nursing team are immense. Using the information from the Co-ordination Centre,
How do you relax outside of work? I go to the gym. Going for a run really helps to clear my head. I also play squash, but generally I just like relaxing at home with my family: my partner Ciaran, my daughter Maisie and my dog Obie.
What’s your favourite part of the job? It’s really hard to answer that question. I love being a nurse. The most rewarding aspect of my current role is seeing the value for patients after being involved in a project to develop a new way of working. Hearing how we’re making a difference makes everything worthwhile.
What is your favourite book? The Bad Mother’s Handbook by Kate Long. It’s a tongue-in-cheek look at motherhood by an author who is from Whitchurch, which is where I grew up. I like it because, firstly it’s hilarious, but what I find difficult sometimes is juggling being a full-time worker and a mum as well. I like reading this because it reinforces that I’m not alone in facing those challenges.
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Mel Kynaston started her healthcare career as a domestic in a nursing home more than 20 years ago. During that time she has worked in several Trusts, including a spell as the Lead Nurse for critical care services when the Haygarth Building opened at the Countess a few years ago. She returns to Chester with improving patient experience at the heart of her ambitions.
BOLDLY BADGING UP FO
A new Co-ordination Centre Programme (CCP) is changing the way the Countess manage Using a system called TeleTracking, staff will have access to real-time data to better locate equipment and shape the workforce around patient need so that more people go to the right bed and are seen by the right specialists, first time. The only tangible difference for patients is a new badge that they will be asked to wear on their wrists, with everything else happening behind the scenes to streamline their journey from admission to discharge. “The Co-ordination Centre Programme will transform the way we work, making us more responsive and able to support our doctors and nurses caring for patients,” Clinical Lead for the CCP Chris Owen said. “We are at the forefront of what I see as the future of healthcare and it’s a really exciting time.”
“It gives our staff more time to do the work they trained for and improve patient outcomes.”
Digital revolution The CCP, which is part of The Model Hospital initiative, sees the Countess become the first hospital in the UK to adopt TeleTracking technology in this way. It will remove the need for nurses and doctors to spend significant chunks of time checking what beds are available, following the progress of a patient sent to another department and sourcing equipment. With 4,000 sensors around the site picking up that information automatically, it frees up more of their time to spend with patients.
“Having worked as a nurse in A&E and on the wards, I know how frustrating it can be to get bogged down in admin tasks,” Chris added. “With the CCP automating this information it gives our staff more time to do the work they trained for and improve patient outcomes.”
phone calls and gives them the chance to focus on one job at a time.
“We will be able to see everything with one look at a computer screen.”
Staff badges Co-ordination Centre Every employee at the Countess, including the executive team and office workers, will also wear new badges on their lanyards that will be picked up by the sensors in the same way as patients’ wristbands. These badges, which include an alert button for any member of staff to push if they need help, will show when staff are in patient areas and give the co-ordination team an easier, faster way to re-direct more support for a department that might be under increased pressure.
Porters using smartphones The CCP has also transformed the way porters work, with their job requests, including transporting patients and collecting equipment, now being transmitted via hand-held devices they carry with them. Ward staff input tasks into the CCP system, which sends an alert to these devices for porters to accept. This gives the porters all the information they need to know at a glance of the smartphone and removes the ad hoc nature of bleeps,
Information collected via TeleTracking will be collected and processed in the Coordination Centre, giving the clinical site co-ordinators and CCP team a virtual map of the entire hospital so they can easily spot blockages in the system and make decisions accordingly. Previously, they would spend hours walking from ward to ward to create that picture of the hospital environment but now they can do it at a glance. Clinical Site Co-ordinator Del Aldous believes it could make a huge difference. “We’re still going to be doing the same jobs we do now, but we’ll be in one place in the Co-ordination Centre,” Del said. “We will be able to see everything with one look at a computer screen without having to run around to find that information. As soon as a patient leaves it will flag up to us that their bed is now empty so it should increase patient flow.”
Bed turnaround team When a bed is flagged up as being empty on the system, a new Bed Turnaround Team will be automatically alerted so that they can go straight on to the ward and clean it ready for the next patient.
OR BETTER CARE
es patients through the hospital.
Governor’s view:
Peter Folwell
The Co-ordination Centre Programme (CCP) is just one of the many tools that will be used to improve the way patients are cared for. As a Governor for Ellesmere Port and Neston, I was pleased to meet with project lead Rob Howorth to be shown it in action. An enormous amount of work has been put into getting this right. When the CCP is rolled-out it will enable the live monitoring of where patients are, which staff are looking after them and where vital equipment is. It’s an impressive innovation that puts the Countess at the forefront of patient and hospital management in the country. At the heart of the programme is the desire to make the patients’ stay the very best it can be. This means getting them to the right bed, first time and will enable the bed management team to see exactly which beds are available or will soon become available.
“We’ve never had a dedicated bed turnaround team like this before,” Chris
said. “They will give our nursing staff more time to spend with patients by reducing the number of beds they will have to clean. Their introduction is an example of what the entire CCP is all about.”
This is all just designed to make things easier for staff and improve care for patients. If it sounds like ‘Big Brother’, it certainly is not. This is a key innovation in the hospital’s constant drive to become even more safe, kind and effective in everything they do.
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This team has been designed to take the pressure of nursing staff during peak times, operating seven days a week.
One of the first areas to go live on the new system was the porters. In the past sometimes porters have arrived to move a patient only to have to wait until they are ready, or alternatively patients have had to wait for a porter. Such delays also impact other services, such as radiology etc. Now, a porter is only called through the CCP system via hand-held devices when a patient is ready. If they are they then accept a task and go and collect the patient.
journey so far… Model Hospital Programme Director Ian Bett reflects on the progress made so far… Almost 18 months ago we accepted the challenge of becoming The Model Hospital. We’ve always known we have one of the most dedicated and caring workforces in the NHS, but we wanted to find new ways to support and channel their efforts more effectively. We wanted to remove as many unnecessary processes, red tape or dated methods as possible that stood in the way of them getting the most from the long hours they spend caring for patients. It’s no secret that the last few years have been tough for the NHS. Money and resources have been tight amid evergrowing needs and expectations. Instead of burying our heads down, we chose to meet those difficult challenges head on. Great innovation can spring out of adversity and I’m proud of the foundations we have now put in place for our future as The Model Hospital. The launch of our Co-ordination Centre
Programme (CCP) is the most eye-catching transformation, but there have been many other projects behind the scenes that may not be as headline-grabbing but are equally important. At the start of the initiative, which was inspired by Lord Carter’s Review of Operational Productivity in NHS Providers, one of the first projects was the introduction of ‘Bureaucracy Busters’. These experienced volunteers spoke to colleagues across the hospital, finding out what improvements they would like to see for staff and patients. These were possibly ideas that had been tried in the past, but proved frustratingly hard to realise, such as the creation of a new prep room for bowel surgery patients on ward 44 to provide increased privacy and dignity. We have also introduced an e-rostering programme across the hospital, which gives details at a glance of staffing levels on every ward at any time. This is a valuable tool for matching staffing to patient need, giving us the ability to provide extra cover if any ward is under
Ian Bett more pressure than others. By doing this we have also been able to significantly reduce our spending on bank and agency staff. The CCP itself, as you will have read in other parts of this magazine, is making huge changes behind the scenes. Although the only tangible difference for patients is a simple wristband, it has been a huge undertaking for our project team. With 4,000 sensors being installed across the Trust, all equipment being badged and all staff needing new badges they have done amazingly well to oversee something that impacts everything we do. I’m really proud of all their efforts and I know they will get great satisfaction when it starts to make a difference to patient waiting times and length of stays. What has really made our journey towards being The Model Hospital so rewarding up to this point is the support we’ve had from our community within the Countess. I want to thank our staff for embracing this period of change and sharing our vision for improving in any way we can for everyone coming through the door. We have made great strides towards achieving our ambitions and we are once again setting a fine example for other Trusts to follow. Model Hospital Programme Director Ian Bett
The Co-ordination Centre Programme team
Slippers not slips! The Countess Charity is delighted to be supporting a new initiative for the provision of safe and comfortable slippers for those patients who arrive without them, perhaps because they have been admitted in an emergency or have no one to bring some in.
“Wearing safe footwear not only helps to prevent falls when in hospital, but also helps patients to feel more confident
when they move around.” This initiative fits well with the #endpjparalysis campaign, which aims to get patients wearing their own clothes as soon as possible.
26th October – Fashion Show at The Countess for Bosom Buddies 17 – 19th November – Chester Arts Fair at The Racecourse for Babygrow Thursday 30th November – Afternoon Tea at The Town Hall for the Ultra Sound Scanner Appeal Friday 1 December – Trees of Life at The Countess of Chester Hospital Sunday 3 December – Santa Dash Monday 4 December – Trees of Life at Ellesmere Port Hospital
Jennifer Brownley, Specialist Occupational Therapist, explains why: “The ‘End Pyjama Paralysis’ movement aims to encourage patients to get up, dressed and out of bed as soon as possible. “Correct footwear is essential to reducing the risk of falls when moving around the wards. This will give our patients the confidence to remain active and independent, which will aid recovery and reduce future care needs.” Head of Fundraising Lesley Woodhead explains how best to support the slipper appeal: “To contribute to the slipper project please call into the fundraising office in the main reception or make a donation online at www.justgiving. com/campaigns/charity/countesscharity/ slippersnotslips. “We are also currently fundraising for an Ultra Sound Breast Scanner, Bosom Buddies, Dialysis Machines, Memory Lane – to improve facilities for patients on wards 50 and 51, Babygrow Appeal, all of our wards and to improve our spiritual care centre. “To find out more about how The Countess Charity is providing more for our patients please call us on 01244 366240. We are looking for groups and individuals who want to make a difference in their local community by supporting their local hospital. We look forward to hearing from you.”
Trees of Life Illuminate a light in one of our trees in memory or celebration of a loved one. Loved ones names are celebrated in a book on display in the Spiritual Care Centre. Please call 01244 364341 for more details or go to www.justgiving.com/fundraising/ chestertreesoflife Or pop in to the office in the main reception at The Countess
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Anna Rees, Clinical Lead for Frailty Rapid Response Team says “When people come into hospital they can tend to spend too much time in bed. This can delay their recovery. We are keen to help patients get moving as soon as possible. In order to move safely, people need to be wearing well-fitted shoes or slippers. Sometimes people have come into hospital without safe footwear, and it is important that we are able to provide the correct ones.
Diary Dates
Hello and goodbye… Early August is always a time of bittersweet change at the Countess, with many doctors including foundation year two doctors moving on and the newest cohort of trainees coming in to replace them. This switchover gives the medical education team a chance to reflect on the last 12 months, celebrate the many successes and show the incoming junior doctors how education in Chester will lay the foundations for a great career. Every year around this time the medical education team host a Foundation Doctor
Awards ceremony, handing out various prizes such as ‘Doctor of the Year’ and ‘Player’s Player’.
Dr Ian Benton
“We’re very proud of our training programmes at the Countess,” Director for Medical Education Dr Ian Benton said. “We take our role in developing our foundation doctors very seriously and it is always a pleasure to see how far they can go in a relatively short space of time.” He added: “The awards are something we always look forward to and it’s also an opportunity to show our new trainees how we will value and celebrate their achievements over the next few years.”
FOAMdation for success A trainee doctor has set up a new online resource for foundation doctors called FOAMdation, profiling different areas of medicine and offering advice about best practice in a variety of scenarios.
As an idea FOAM (Free Open Access Medical Education) has been around for quite a while, but Gareth observed that most of the resources were geared towards senior trainees in areas such as critical care and emergency medicine.
Dr Gareth Thomas, who recently left the Countess having finished his rotation as a junior specialist trainee in emergency medicine, spotted an opportunity to provide additional help for newlyqualified doctors as they move on to the wards for the first time.
He wanted to plug a gap by offering the same informal learning opportunities, recently using his own experiences to publish a two-part podcast ‘How to be a Junior Doctor’.
“I kept thinking about it and how it could make a real difference. I thought if I don’t do it someone else will and I’d rather it was put together properly the way I think it should be,” Gareth said.
“The feedback I get from most of the foundation doctors is that it’s a great idea,” Gareth added. “It’s still early days and this kind of education is very new for junior doctors, but as more and more discover it they are finding it useful.”
Despite leaving the Countess, the medical education team at the Trust will continue to support Gareth with FOAMdation and he is delighted to retain an affiliation with Chester. “I’ve really enjoyed working at the Countess,” he said. “It’s a very pleasant place to be with a strong team and it’s somewhere I can see myself working at a later date when I’m looking for a permanent post.” :: You can access the podcasts at www.foamdation.com
CAR CRASH SIMULATION TESTS MEDICS’ METTLE Doctors have to be ready to spring into action at a moment’s notice, whether they’re in the hospital environment or not.
“We wanted to do something a bit different for our F1s,” Clinical Education Staff Nurse Kat Chadwick said. “We worked really hard on it for months and managed to keep it a closely-guarded secret, which was vital to our F1s getting the most out of the exercise.” While the unsuspecting F1s had lunch, a scene was set in which a driver had a cardiac arrest behind the wheel, causing him to lose control, go off road and hit a couple walking their dog. An area of the car park and grass to the side of the Education and Training Centre was cordoned off for the purposes of the exercise, with willing volunteers lying on the grass playing the injured couple, while
a dummy ‘Sim Man’ – dubbed Steve – took on the role of the driver. “As soon as we stepped out onto the grass it felt very real. I lost awareness of the people looking on immediately as we tried to get to grips with what was happening in front of us,” Dr Jack Keogan said.
“WE’VE HAD GREAT FEEDBACK AND IT’S GREAT TO KNOW AFTER SO MUCH PLANNING IT WAS A USEFUL EXERCISE FOR THEM. I’M SO PROUD OF EVERYONE INVOLVED.” The junior doctors raced over to the casualties, tending to head and pelvic injuries for the couple, as well as launching attempts to resuscitate the driver. They impressed onlookers by responding swiftly, efficiently and liaising well with
paramedics, who were provided by Jigsaw Medical Services along with a rapid response vehicle and an ambulance. “We were impressed by both the scale involved and the attention to detail that made everything run so smoothly. This made sure it was a valuable learning opportunity, as well as an exciting afternoon,” Dr Keogan added. “Opportunities like this are unbelievably rare. I’ve not heard of anything similar outside of specific pre-hospital training courses, and my university colleagues I’ve spoken with have all been very envious.” Kat, who came up with the original idea for the simulation, was very satisfied to see it all come together and she is already planning the next one. “We’ve had great feedback and it’s great to know after so much planning it was a useful exercise for them,” Kat added. “I’m so proud of everyone involved.”
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In a bid to prepare the Trust’s foundation year one doctors (F1s) for this, the education team set up an elaborate car crash simulation to put them under pressure in unfamiliar surroundings.
GOVERNORS NEWS
An invitation to members This year’s Annual Members’ Meeting and Marketplace event will take place on 18 October in the Education and Training Centre from 12.30pm. It is an opportunity to learn more about the hospital and share highlights from our year. Refreshments will be provided and parking will be free for those in attendance. Places are limited so please book by contacting the Countess Membership Office on 01244 365284 or email claire.raggett@nhs.net or jessica.chambers12@nhs.net.
ORGAN DONATION CLINICAL LEAD STEPS DOWN Dr Richard Nelson has stepped down from his lead role on the Organ Donation Committee to focus on working as a Consultant Anaesthetist. Dr Nelson has been the clinical lead on the committee since 2009, working closely with specialist nurse and transplant coordinator Tracy Rhodes and Pat Clare, publicly elected governor for Ellesmere Port and Neston, who chairs the committee. Their combined efforts last year saw the installation of the ‘Circle of Light’ window and plaque near intensive care, which act as a permanent reminder of the importance of organ donation. “Richard has been a superb advocate of organ donation at the Countess for the last eight years,” Pat said. “We are
sorry to see him step down, but know his dedication and tireless work will make it easy for a new lead to come in and pick up where he left off.” Below are some questions to consider when thinking about organ donation: •H ave members of your family ever talked about what you would do if you needed a heart, liver, kidney or other organ to live? •W ould you accept a life-saving organ from a donor? • I f you would take an organ, would you be prepared to donate yours to save lives when you die?
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