The magazine of Great Ormond Street Hospital for Children and the UCL Institute of Child Health
May 2011
Young volunteers make an imp act See page 16
Satisfaction survey A four-page special on patient and parent feedback, see page 8
A note from Jane Collins Chief Executive
Contents
Young volunteers bring fun and games to GOSH. See page 16.
Regulars
Features
A note from Jane Collins
3
In the news
4
A note from Professor Andrew Copp
7
Faith in practice
22
Charity pages
24
Word on the ward Island Day Unit
26
Five minutes with Terry Durack
27
Social Out and about
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Free film show
21
Sports update
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Patient Satisfaction Survey We find out what patients and families think of GOSH
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The whys and wherefores of hospital tours 14 Why donor visits are so important for our fundraising Young volunteers at GOSH Young people craete a stir with our patients
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The Clinical Document Database A project which is making a big impact at GOSH
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Hopefully all staff know that as well as aiming to achieve Zero Harm for our patients, we also want to achieve outcomes for them that are within the top five in the world. I believe that children coming from Britain or further afield deserve this, and all of us would want and expect it for our child or brother or sister. Outcomes are made up of different elements, with Zero Harm arguably the absolute starting point. Clinical outcomes, patient reported outcomes (children and young people and parents sometimes have a different view of a good outcome to their clinical team) and experience of coming to the hospital are all part of outcomes. This is why all staff in the hospital will directly or indirectly play a part in us achieving our aims. So where are we now? We are making progress on reducing harm in the areas we have focused on, so thanks to all those involved. However, we know from conversations, reports and reviews there is still lots to be done. I was delighted we ended March with more clinical outcomes on the hospital website. If we aren’t transparent about these we can’t possibly be in the top five children’s hospitals in the world. We also have some excellent feedback from children, young people and families again in this year’s Ipsos MORI survey (see page 8), so there is lots to be proud of.
A new international assessment, which our Imaging department put themselves through, adds another measure not only to the quality of services we provide in diagnostic terms but also focuses on the experience patients have when they visit the department. The Imaging Services Accreditation Scheme (ISAS) measures many things including clinical service users’ views, team work within the department, and how patients and families are cared for while they are being investigated. Demonstrating what we do, as with these assessments, is a huge amount of work and thanks to the whole team who were involved over a number of years (Great Ormond Street Hospital was a pilot site when the scheme was being developed) for doing all the work. The really important result is that we have been accredited – the first children’s hospital and the first hospital in London. Actually number four in the UK! So external accreditation, which everyone in Laboratory Services knows about already as they have had similar assessments for many years, is another way we can judge whether we are continuing to get closer to our aims. These schemes are focused on outcomes rather than processes, which is just what patients and families want to know about.
The copy deadline for June’s edition is Monday 9 May. However, to ensure space can be allocated you are advised to submit article proposals no later than Wednesday 4 May. Please note that submitting articles does not guarantee a place in the next issue. Submissions should be sent to Sally Mavin at sally.mavin@gosh.org Any articles submitted after this date will not in included in the June edition. Cover image: Four-year-old oncology patient, Milan and his mum. Editor Sally Mavin, ext *643042 Email: sally.mavin@gosh.org Designer Kirsty Seidler, ext *643168 Editorial board Jo Barber, Communications • Helen Cooke, Workforce Planning • Anna Ferrant, Executive Office • Amanda Macbeth, Brand Marketing • Anthony Higgins, Transformation • Andrée Hughes, Nursing and Workforce Development • Adam Levy, Chair of Staff Side • Seth Edwards, Brand Marketing • Lesley Miles, Marketing Communications and Community Fundraising. Printer: Jigsaw Colour, www.jigsawcolour.co.uk Charity logo ©2007 Great Ormond Street Hospital Children’s Charity. Registered charity no 235825.
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There’s still time for you to have your say on the future of children’s cardiac surgery. Log on to www.ipsos-mori.com/safeandsustainable to complete the survey. The closing date is 1 July 2011. 3
Managers’ Toolkit Your questions answered Continuing our monthly tip from the online toolkit for managers, Roundabout brings you another much-asked question. Don’t forget to visit the site for many more useful bits of advice. You can find it by scrolling down the Commonly Used Links on our intranet, GOS Web. How do I report electrical, plumbing or carpentry problems? Contact the Works department helpdesk on ext 5412 to report a problem, making sure you have the following information to hand: • The name of the building in which the problem exists • The floor level of the fault/job • The name of the department • The room number • The name of the person reporting the fault • A contact telephone number • As much information about the fault/job as possible. Departments who would like to update or include information about the services they provide in the toolkit should contact Sarah Wimhurst on ext 8301 or email wimhus@gosh.nhs.uk
In the news A study, published in the British Journal of Psychiatry and led by Dr Dasha Nicholls of the UCL Institute of Child Health (ICH), found that early onset eating disorders affect around three in every 100,000 children under the age of 13. The Guardian, The Times, the Daily Telegraph, The Independent and BBC News all reported the findings. The London Evening Standard and Mail Online covered the launch of a new study led by Professor Russell Viner of the ICH. The PROMISE programme comprises five linked studies that aim to significantly improve the experience and care of obese children in the UK and help alleviate growing pressure on the NHS. The Evening Standard reported the story of cardiac patient Larkin Wares. Larkin’s dad, theatre choreographer Leon Baugh, received an award at this year’s Olivier Awards ceremony and used his acceptance speech as a chance to thank the Cardiac team at the hospital for the care they had given his daughter. The Irish Post reported that patient Ciaran Finn-Lynch was celebrating one year after his stem cell trachea transplant. Last March, Ciaran became the first child in the world to undergo this pioneering procedure and he celebrated alongside the Tracheal team who saved his life. Ciaran’s parents used the opportunity to encourage people to join the organ donor register.
Staff Psychological and Welfare Service A reminder to all staff that a number of seminars are being run by the Staff Psychological and Welfare Service in May: • Application forms and CVs 4 May • Interview skills 4 May and 18 May • Career planning 9 May • Managing stress 11 May 4
To book a place on any of the seminars call 0845 155 5000 ext 9800 or email staffpsychologicalwelfareservice@uclh.nhs.uk The Staff Psychological and Welfare Service is funded by Great Ormond Street Hospital Children’s Charity.
Foundation Trust In March, Great Ormond Street Hospital (GOSH) staff were invited to meet colleagues from other Foundation Trusts to find out how being a staff governor on the Members’ Council can make a difference. Liz Dunn – Guy’s and St Thomas’ Hospital Liz Dunn, a haematology Matron from Guy’s and St Thomas’ Hospitals has served on the Members’ Council for five years. Liz became involved with partners and academics to get a broader understanding of the whole strategy of her trust. She also worked with patient representatives to draw up toolkits on key issues such as nutrition to directly improve the patient experience. For Liz, governors from outside her trust had been very valuable. Through training and supervision, they had provided an independent way to survey patients on the wards. She had also been involved with communications and membership, including health promotion.
Staff governors at GOSH Realistically, being a staff governor means investing your spare time. So what do you get in return? Both Alex and Liz feel they’ve gained a broader understanding of their hospitals, personal development and rewarding links to other staff outside their day job. Staff representation also involves the voice of staff in key governance issues such as selecting Non-Executive Directors and helping set the strategic direction of the Trust. What next? Roundabout goes to press before we hear from the Department of Health about the timetable. Updates will come through the hospital’s email newsletter. We hope to issue a call for nominations in May, close nominations in June, send ballot papers out in July for a result in the first week of August. However, this depends on the Department of Health, and staff will be kept updated in due course.
Alex Edwards – Moorfields Eye Hospital Alex Edwards, Officer Supervisor for Estates and Facilities at Moorfields Eye Hospital, has served on the Members’ Council for two years. Her involvement in the council has taught her a lot about how decisions are made, extended her knowledge of the Trust’s work and has brought her into contact with staff and issues she would otherwise not have known about. The role requires responsibility, sometimes dealing with confidential issues. By offering drop-in sessions to staff, Alex feels she is able to keep in touch with the electorate.
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Staff awards 2011 Final call for staff awards 2011 nominations Time is running out to nominate colleagues for this year’s staff recognition awards. All forms must be submitted by Monday 6 May. The categories are: • No waste champion Reducing waste and wasteful practice within their department or throughout the Trust. • Transformation award A team whose transformation project has led to a significant improvement. • Colleague of the year For a special individual who improves the working lives of the people around them. • Team of the year Working together well to make a real difference to patients, families and staff.
You can pick up a nomination form from: • HR Department, York House • One of the ballot boxes around the Trust • GOS Web (Click on Commonly Used Links and scroll down to Staff Recognition – Nomination Form) The staff awards 2011 ceremony will take place on Wednesday 25 May at 5pm in the Kennedy Lecture Hall, UCL Institute of Child Health. The staff awards are funded by Great Ormond Street Hospital Children’s Charity.
Closing date for nominations is Friday 6 May 2011
Bethan Nancy Mount Awards Joint winners of the second Bethan Nancy Mount Award Lecture Series were announced on Monday 4 April. Palliative Care Registrars Dr Michael Wacks and Dr Michelle Hills, and Endocrinology Trust Doctor Dr Sarra Ahmed shared first place, with Ophthalmology Registrar Dr Samantha Harding taking the runner-up spot. A 12-week lecture series ran between January and March, giving junior doctors the opportunity to present their work and case studies. The series included a broad range of topics, from hearing loss and cutting-edge surgical research work to blue rubber bleb nevus syndrome and an introduction to human factors. The Bethan Nancy Mount Award was set up by the Postgraduate Medical Education 6
A note from Professor Andrew Copp Director, UCL Institute of Child Health (ICH)
• Manager of the year For an exceptional manager, who listens, motivates, empowers and helps the team to achieve their goals. • Child and family award For a special individual or team nominated by a patient, parent or carer.
(PGME) department following a donation from the greatgrandparents of Bethan, a former patient at Great Ormond Street Hospital. On receiving the award Michael and Michelle said, “This was a fantastic opportunity. We would like to thank our whole team for their useful feedback. We really enjoyed presenting and the audience seemed really interested. It’s a lovely surprise to win.” PGME would like to thank all the doctors who participated.
Identifying the genes that cause childhood disease has many clinical benefits. For some families, finding the genetic cause of their child’s illness is the end of a long journey and provides the explanation they have been seeking. For genetic counsellors, understanding the nature of a genetic disease and its pattern of inheritance allows patients and families to be informed about the risk of recurrence in later pregnancies. For clinical genetics laboratories, new tests can be designed that allow improved diagnosis across the health service, and may permit prenatal testing to be developed. Finally, for scientists, gene identification can mark the beginning of a research programme to better understand how the disease develops and to test possible new ways of developing therapies in the future. The close relationship between genetics research at the ICH and clinical genetics at Great Ormond Street Hospital (GOSH) has enabled a long series of landmark studies to identify the genetic basis of childhood disease. Going back to the early 1990s, the ICH and GOSH led the way in discovering alterations in the genes for fibroblast growth factor receptors (FGFRs) that cause many cases of craniosynostosis, in which the skull sutures fuse prematurely. This genetics progress has continued to the present, with several new gene discoveries in the last few years. Professor Phil Beales and colleagues pinpointed the genetic basis of 3MC syndrome, in which patients have a characteristic facial appearance together with cleft lip or
palate, learning disability and genital, limb and urinary tract defects. Dr Detlef Böckenhauer and Professor Robert Kleta have identified genes that give rise to kidney tubule disease: specifically EAST syndrome in which patients also have epilepsy, balance problems and deafness, and idiopathic membranous nephropathy, an important cause of salt-losing nephrotic syndrome. While people sometimes criticise such studies for being relevant only to rare disease, we invariably gain new information from the research that improves knowledge in a much more widespread way. For example, our understanding of how the skull sutures stay open in normal children, to give the growing brain room for expansion, has been advanced in a major way as a result of the FGFR disease discoveries more than 15 years ago. An exciting new initiative that will help bring about even more of these gene discoveries is GOSgene. Funded by the Biomedical Research Centre and led by Phil Beales and colleagues, this service allows clinicians who see patients with likely inherited disorders to quickly and efficiently start research that may lead to the discovery of new genes. Combined with the technical expertise of UCL Genomics, led by Dr Mike Hubank, GOSgene now provides a comprehensive service from clinical samples to target gene identification (see www.ucl.ac.uk/ich/ services/lab-services/gosgene). We look forward to further exciting research progress as this technology helps us understand the conditions of more and more patients who attend GOSH.
Above: Palliative Care Registrars Dr Michael Wacks and Dr Michelle Hills.
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Patient and family satisfaction survey 2010/11 Providing a world-class service to patients and their families is a key priority at Great Ormond Street Hospital (GOSH). To find out how we’re doing, we asked leading research company Ipsos MORI to undertake some independent research. Ipsos MORI conducted 750 telephone interviews with patients aged 10 to 16 years and their parents. Some of the results are shown on the following pages but the full results are available on the Trust website.
to a friend or relative if their child needed treatment. But there were many more highlights.
This year, the survey showed that 96 per cent of patients and their parents were either ‘very’ or ‘fairly’ satisfied with their last visit to GOSH, compared to 94 per cent in 2009. The majority (98 per cent) of those questioned had confidence and trust in the doctors, and 96 per cent said they would be likely to recommend the hospital
The patient and family survey is funded by Great Ormond Street Hospital Children’s Charity.
Log on to www.gosh.nhs.uk/patient_family_ surveys to download the full results
Four-year-old oncology patient, Milan and his mum.
Advocacy Parent wording: How likely or unlikely would you be to recommend Great Ormond Street Hospital to a friend or relative if their child needed treatment? Combined child wording: If a friend or relative of yours needed treatment, how likely or unlikely would you be to recommend Great Ormond Street Hospital (say Great Ormond Street Hospital is a good place to receive care)? Overall (750 responses)
Very likely 87%
9%
Fairly likely 2%1% 1% 1%
Overall, how satisfied or dissatisfied were you with your last visit to Great Ormond Street Hospital?
Fairly unlikely
Child patient (138 responses) 76%
18% 3% 1% 1%1%
Parent of patient (612 responses) 89%
7% 1% 1% 1%
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Neither/nor
Satisfaction with visit
Very unlikely
Very satisfied
74%
Don’t know
Fairly satisfied
22%
Neither/nor
2%
Fairly dissatisfied
1%
Very dissatisfied
1%
Turn over for more results 9
Treatment and service
Communication and service
I would like you to tell me whether you agree or disagree with these statements.
Last time you saw a doctor or nurse at the hospital, how good were they at...?
Strongly agree
Tend to agree
Neither/nor
Tend to disagree
Strongly disagree
Don’t know
I had confidence and trust in the doctors treating my child
Very good
Good
Neither/nor
Poor
Very poor
Don’t know
Explaining what would happen in the treatment or tests 10%
88%
19%
76%
2% 1% 1%
1% 1% 1%
Staff were polite to us at all times
Explaining why your child needed treatement or tests 83%
12%
20%
75%
2% 2% 1% 1%
3% 1% 2%
I had confidence and trust in the nurses treating my child
Involving you in decisions about your child’s care
80%
21%
73%
15%
3% 1% 1% 1%
1% 1% 2%
Staff introduced themselves to us
Answering you or your child’s questions 77%
17%
23%
72%
2% 1% 1%
2% 3% 1% 1%
Staff explained their role to me
Taking you and your child’s concerns seriously 71%
22%
23%
70%
3% 2% 1% 1%
2% 3% 2%
My experience as a parent was valued by staff (Parents only - base 612) 71%
Spending enough time with you and your child 19%
29%
63%
4% 3% 1%
3% 2% 3%
I felt I could complain and it would be taken seriously
Asking you questions about how you and your child were feeling
62%
30%
59%
20%
6% 3% 2%1%
6% 2% 4% 6%
Alleviating fears
Cleanliness
Parent wording: How well do you think the staff dealt with your child’s fears?
How clean, if at all, did you think the following areas were?
Combined child wording: How well do you think the staff dealt with your fears? By dealt with, I mean helped you feel less scared?
The place where your child was treated 80%
Very well
61%
Fairly well
28%
Not very well
1%1% 2%
The ward where your child stayed 72%
5%
Not at all well
5%
Don’t know
2%
Very clean
15%
Fairly clean Not very clean Not clean at all
22% 1% 1% 4%
on’t know/ D no answer
The bathrooms and toilets 61%
34% 2% 1% 1%
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Breakthrough guides win two science communication awards Seeing off competition from the UK’s leading medical research charities, the Breakthroughs in Children’s Medicine guides, produced by Great Ormond Street Hospital Children’s Charity, scooped double awards at the Association of Medical Research Charities biannual Science Communication Awards in March.
Envirolump returns to Roundabout Last month we introduced you to our eco-friendly elephant, Envirolump. Patients from the Children’s Hospital School at Great Ormond Street and UCL have been busy designing posters with the Joint Environmental Committee (JEC), encouraging staff to stay green. If wards or departments want a laminated copy to hang on their noticeboards please contact Sarah Lewis on ext 5509 or on lewiss2@gosh.nhs.uk You may even get a visit from Envirolump himself!
The guides won their category of best example of writing for a lay audience, and were singled out for a special prize from across all entries for outstanding design. Copies of the first two guides can be viewed on www.gosh.org/breakthroughs The next guide, tracking the leading work of our neurosciences team, is now in production, due out in August.
Walk to Work Week (9–13 May) Put your best foot forward this May with the nationwide campaign aiming to get everyone enjoying the benefits of walking to and from work. If you don’t live close enough to walk the whole way to work, why not jump off the bus or tube one or two stops early? You could even organise to meet colleagues en route and make it a social event. The Health 4 Life team will be celebrating Walk to Work Week from 9–13 May, so please get involved. To find out more, visit our lunchtime event on 12 May at 1pm in the Orangery, and feel the health benefits that walking can bring you. Chief Executive Jane Collins says: “The easiest way I find to make sure I get some exercise is to walk as much as possible during the day. It may take a bit longer but not as long as going to the gym.”
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The Breakthroughs in Children’s Medicine guides are funded by Great Ormond Street Hospital Children’s Charity.
A royal visitor Things were not quite what they seemed this April Fools’ Day, as staff welcomed a special visitor to the Children’s Hospital School at Great Ormond Street and UCH. Expecting a royal guest, the teachers dressed to impress and eagerly awaited a visit from the Queen. But it was Elizabeth I, complete with ruffles and rotten teeth, who graced them with her presence, cheerily imploring staff to ‘bow to their queen’. The prank, organised by Head Teacher Yvonne Hill, offered some light relief to a staff training day.
Morgan Stanley Clinical Building With just one year to go until the opening of the Morgan Stanley Clinical Building (MSCB), part of the Mittal Children’s Medical Centre, construction works are moving ahead. The stone cladding and glazing on the Guilford Street elevation (right) is complete and the contractor is in the process of removing the scaffold and building wrap. Work continues internally, such as fitting out ceilings, walls and installation of hardwood screens. The MSCB Art Group is also working on the various commissions planned for the new building. Information on these commissions will be presented in the next edition of Roundabout.
The redevelopment is funded by Great Ormond Street Hospital Children’s Charity and the Department of Health.
The new eight floor building will provide inpatient accommodation, including Cardiac Intensive Care beds, three theatres, one hybrid angio and a new restaurant for staff, patients, families and visitors. Construction works are due to be completed in December 2011. The MSCB will then be handed over to the Trust for operational commissioning. The first moves will begin in March 2012 and will be completed in May 2012. The Procurement and Redevelopment teams will be holding an open day on Friday 27 May 2011 for the clinical units moving into MSCB to view examples of furniture. The time and venue will be confirmed to attendees. 13
The whys and wherefores of hospital tours By Lottie Wilkins, Family and Hospital Liaison Officer
Hospital tours are an important part of Great Ormond Street Hospital Children’s Charity’s fundraising process. However, we understand that for staff at the hospital, visits can be an inconvenience. So why are hospital tours important? And how do they make a difference to Great Ormond Street Hospital (GOSH)? Every year the charity needs to raise £50 million to help rebuild and refurbish the hospital, buy vital equipment and fund pioneering research. For many of our donors, seeing first hand the amazing work which happens at GOSH inspires them to support the hospital. Planning the visits Our Major Gifts and Community Fundraising teams liaise with key supporters who are interested in the work of the hospital. It can take many months to prepare for a hospital tour, but it makes a big difference if people see the work they are supporting. With so many charities asking these individuals for support, the hospital is the most effective tool in our armory to make us stand out from the crowd as deserving such substantial donations. Corporate partners The charity’s Corporate Partnerships team manages relationships with companies such as Morgan Stanley, Disney, LV=, Harrods and RBC. Our corporate partners support us in a whole range of ways including charity of the year partnerships, payroll giving and encouraging staff to take part in our events or volunteer at the hospital.
A case in point: Center Parcs We invited some of the call centre staff fromCenter Parcs to visit the hospital, and becauseof their association with our Beds for Bedz campaign, they also visited the family accommodation at Weston House and the Italian Building. The tour helped bring to life the importance of free accommodation close to the hospital and how it allows families to 14
Celebrity guests Celebrities from all walks of life have visited GOSH over the years, from actors and royalty to sports stars and musicians. These tours aim to lift the spirits of patients and their families, as well as raising awareness of the hospital in the media. However, hospital staff should please remember that with limited time these visits are primarily for the children, so please try to wait until the star has met all the patients before requesting personal photographs. We are grateful to all the staff who help with our visits. Your assistance is important to help support the future of the hospital. Not only do hospital tours present a real, tangible sense of how donations are spent, they also allow people to see how they can improve care in the future. Our Press team is keen to work with hospital staff to ensure the least possible disruption to the wards. If you have any questions or concerns regarding hospital tours, please contact Lottie Wilkins on ext 6438 or email lottie.wilkins@gosh.org.
Right: Eight-year-old Kaychanel meets Dancing on Ice’s Johnson Beharry and his skating partner Jodeyne.
stay together during treatment. The visitors left with a new enthusiasm and commitment to the partnership, and as a result, Center Parcs have a very healthy donation rate of roughly one-in-10 customers, with the largest donations coming from customers who have spoken to the highly motivated call centre staff.
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Young volunteers at GOSH Volunteers play a huge role in supporting the work at Great Ormond Street Hospital (GOSH). Here, we take a look at some of the projects currently underway. Activate is a youth volunteering project that got off to a flying start in January 2011. Teams of volunteers now provide a variety of options, from sports lessons in outpatients and befriending on the wards to games clubs and English lessons. As well as providing brand new services, our volunteers are also helping to support established services like the Youth Group, the shop, ward reception and even the pharmacy. Saturday Club For patients staying at Great Ormond Street Hospital, weekends can be rather quiet, so our
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team of young volunteers have set up a Saturday Club offering some much needed entertainment. Every other Saturday, volunteers spend the day in the activity centre, inventing games and having fun with children and young people who are interested in joining in. Over 200 children have taken part since January, and the volunteers hope to take the fun and games onto the wards so even more children and families can join in. Volunteering in the pharmacy Another area of GOSH benefiting from young
volunteers is the Pharmacy department. “At the moment we have two volunteers,” says Ann Horton, Chief Technician.
The Voluntary Services department is funded by Great Ormond Street Hospital Children’s Charity.
“Charley is based at the dispensary reception and has been trained to take in prescriptions from patients, parents, carers and nursing staff. Fowzia has spent time in the quality assurance section of the Pharmacy department and has also been trained to work at the dispensary reception. “Charley and Fowzia are our first volunteers and they have become integral members of the Pharmacy team. They set a very high standard for others to follow. They are both enthusiastic, conscientious and a real pleasure to work with.” To find out how you can involve young volunteers in your team, please contact Eli Wislocka at wisloe@gosh.nhs.uk or on ext 0097.
Clockwise from left: Neba paints with patients at the Saturday Club (photo: Paul Wills, www.paulwills.com); volunteer Marcus plays pool with Tobias and John; Stephanie helps Jade with arts and crafts (photo: Paul Wills, www.paulwills.com); some of our young volunteers; Jo gets arty with Hedaya and Wafaa.
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Hitting the right medical note By Tony Higgins, Communications and Engagement Officer Accurate medical notes are a crucial component in delivering safe, reliable healthcare. So it may surprise many to know that the quality of medical records is a pressing issue. Over the last few months, a project group has been formed with the aim of improving the quality of notes in the Cardiac Unit. The clinical lead on the project is Consultant Anaesthetist Ian James and he’s detected a worrying shift in the quality of notes in recent years: “It’s been my perception over the last five or 10 years that note-keeping is not as good as it used to be. Ten years ago, all we had were the clinical notes; these days we’re in a transition between writing down on paper and some form of electronic recording of notes, much of which does not get into the clinical records. As a lot of clinical information is being recorded electronically, when people are very busy written medical notes have somewhat taken a back seat.” A broader issue However, it’s not just an issue for the Cardiac Unit; most wards in most hospitals could probably point to notes that don’t reach the right standard. The old cliché about doctors’ handwriting is no joke when it highlights the potential for error. “I do a lot of medical legal work and I’m frequently being asked to review notes from other hospitals and it’s become apparent to me that really good note-keeping – documenting what you’ve done and why, when you’ve done it, how you’ve done it, is crucial if cases come back to haunt you five years later.
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“So I’m trying to tell people that if, heaven forbid, something terrible happens to a child and the parents sue in a few years’ time, we can’t defend ourselves if there’s nothing written down to show that you were aware of a problem and trying to address it.” The basic rule here seems to be ‘if it’s not written down, it didn’t happen’. It’s a maxim worth remembering alongside the 10 golden rules that already exist and should be followed. Project group progress The project group has wide staff membership with the admin staff being very keen to assist. Although this work is one of the key projects in the Cardiorespiratory Unit’s improvement plan, this is a Trust-wide project and the group works across multi-disciplinary teams. The aim is to ensure 80 per cent of medical notes in the cardiac wards comply with the 10 core standards set out opposite. The next step is to sustain changes by June 2011, before rolling the project out to Badger and Miffy Wards. In April, the Cardiac Intensive Care Unit (CICU) also commenced a three-month bedside notes pilot project. Since starting in November there have been notable improvements, with individuals responding well to feedback. The project is open and transparent, with all project documentation available on the cardiorespiratory intranet site. A fuller version of this can be found on the Transformation intranet site: http://gosweb/ transformation/cms/index.asp
The 10 core standards for medical
note keeping
1. A ll entries in the health record mus t be written legibly and indelibly usin g permanent black ink. Where an alte ration or change must be made, the existing information should be cros sed out using a single line. This mus t be initialled clearly and dated correctl y. 2. A ll entries must be clearly dated and the time (24hr clock) of entry recorded. 3. All entries must be made in chro nological order and signed by the author. The name and designation of this pers on must also be printed under the signature on the first entry mad e by that person in the care of any particular patient, ie J Smith (SMITH SHO bleep 333). 4. All entries must have a unique reco rd number or reference and the child’s full name and date of birth on every page. 5. Only well-recognised abbreviatio ns and symbols should be used and those which are relevant to the spe cific specialty. 6. All allergies and sensitivities sho uld be immediately noticeable in the record, ie in the alert box on the fron t cover and on prescription and treatment sheets. 7. There should be no unnecessary personal comments about the child or family. 8. Details of verbal instructions or information given to children and thei r families should be recorded. 9. All reports and results must be see n, evaluated and initialled by the responsible clinician before they are filed in a timely manner. 10. There should be regular and time ly progress notes throughout the child’s stay with a minimum of a dail y record together with any untoward or unexpected events doc umented in full.
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Out & about May
A Cockroach Tour of Free the Science Museum event Science Museum Throughout May Cockroaches are one of our planet’s true survivors and throughout May, the Science Museum is giving us a unique chance to step into their shells. The project is part of their Climate Changing programme, which highlights global issues and suggests alternative solutions. Participants get the chance to dress up as a cockroach and tour several of the galleries, getting a quirky and innovative take on the human race. Tours take place on Saturdays and Sundays. Check out the website to book a place: www.sciencemuseum.org.uk/ cockroachtour RHS Chelsea Flower Show Royal Hospital, Chelsea 24–28 May Green-fingered enthusiasts won’t want to miss out on this top gardening event run by the Royal Horticultural Society. The show is held in the grounds of the Royal Hospital and showcases the latest trends, products and techniques in the gardening world. Stroll around hundreds of floral displays in the Great Pavilion and be inspired by innovative show gardens from a long list of top designers and organisations. Log on to the website for tickets: www.rhs.org.uk
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Shrek the Musical Theatre Royal, Drury Lane From 6 May Hot on the stage this month is the theatre production of Shrek. The musical is based on the story and characters from the award-winning film, and features a brand new score including the cult Shrek anthem I’m a Believer. The London cast includes Amanda Holden as Princess Fiona, comedian Richard Blackwood as Donkey, Nigel Harman as Lord Farquaad, and Nigel Lindsay as the green ogre himself. Take a look at the website for dates and ticket prices: www.shrekthemusical.co.uk The London Australian Film Festival Barbican 5–12 May This popular festival is now in its 17th year and continues to showcase the latest films from down under. Whether you’re a fan of comedy, horror, romance or historical drama, there’s something for everyone. The programme also includes documentaries, short films and for the first time in its history, artist films. Highlights this year include the UK premiere of Red Dog and acclaimed feature films Animal Kingdom and The Tree. Go to www.barbican. org.uk/australianfilm for listings and to book tickets.
Sports and Social Committee GOSH Book Group
Sister Rosamund Lupton This highly-charged psychological thriller explores in vivid detail the power of sibling relationships. Beatrice is told her sister is missing and returns to the UK from America to search for her. The investigation leads her to personal discoveries that have wider consequences, and the novel ends with a dramatic twist. “Sister is extremely well written, and our heroine’s search for the truth makes it a real page turner. There are some very moving sections that brought me to tears, and there are one or two twists in the story that make you really hope for a sequel.” Rosa Pizer “I thought it was very clever for a first novel and would adapt well to a screenplay.” Kim Phipps “A crime thriller about a woman looking for her sister in London. An engrossing read, and especially poignant if you have a sister.” Solmaz Oskooei
GOSH free film show This month’s free film show will take place on Monday 9 May in the Ground Floor Lecture Theatre at Weston House. Both films are about swapped roles and a journey to the truth. For our younger audience we have Megamind (PG) at 6.15pm. What happens when a super villain finally destroys their superhero foe? Megamind, voiced by Will Ferrell, grows bored after finally defeating his good-guy nemesis, Metro Man (Brad Pitt). To break the monotony of his new life, Megamind creates a new superhero and he hopes foe in Titan. However, the creation of Titan goes wrong and instead of making a force for good, Megamind finds he has produced a new super villain even more devious than himself. Megamind must now turn good in order to defeat Titan and bring order back in the world. At 8pm we have The Tourist (12A). Elise (Angelina Jolie) sits next to an American tourist, Frank (Johnny Depp), on a train to Venice. Unbeknown to him she is wanted by several police forces across Europe and intends to use him as her cover. Not only will they need to evade the police, but also the mobster whose money was stolen by her lover. A thrilling adventure starring two of Hollywood’s most charismatic stars.
Review rating: The Sports and Social Committee is funded by Great Ormond Street Hospital Children’s Charity. 21
Executive Safety Walkround diary
Faith in practice
Elephant Ward 10.30am, 3 May Bill McGill (Executive), Stephen Moxley (Corporate Facilities), Aidan Holmes (Clinical Governance and Safety), Toral Pandya (Transformation)
Festival focus Wesak (Buddha Day) Date: 17 May Faith: Buddhist
Wesak takes place on the full moon in May and celebrates Buddha’s birthday. It is the most important of the Buddhist festivals, and for some also marks Buddha’s enlightenment and death. Buddha literally means ‘one who is awake’ and is used for those who have attained the supreme wisdom and compassion of Enlightenment. To Buddhists, Enlightenment is a blessed state in which the individual has transcended desire and suffering to reach the perfect state of Nirvana. Lifestyle implications Buddhists will often celebrate this festival by decorating their homes and offering gifts to others. In many countries, Buddhists will visit their local temple for services and teaching, and will give food, candles and flowers to the monks. Gifts are also offered to Buddha statues to demonstrate respect and gratitude to the Buddha for his life and teachings. Chanting and prayer are also important components of Wesak. Salutations Although there is no formal greeting for this festival, the word ‘namaste’ is often used by Buddhists, which roughly translates as “what is highest in me meets what is highest in you”. Wesak at GOSH No special services will be held at Great Ormond Street Hospital (GOSH), however, any individuals or groups who would like to mark the day are welcome to contact the chaplaincy who will provide space for the service.
Other festivals in May
1 May – Beltane (Pagan) 1 May – Yom Hashoah (Jewish) 2 May – St George’s Day (Christian)
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Wesak celebrates Buddha’s birthday.
Reflection May 2011 is one of those months that, due to the solar and lunar calendar, does not seem to have many major festivals. Perhaps this is more typical of life than those months when festivals and celebrations abound. Often our days are characterised by ups and downs, with the big events happening more to individuals and small groups than in the collective shared emotion that characterises so many festivals. This does not mean, however, that these times are devoid of a sense of spirituality or the sacred. Indeed, perhaps it is at these times when we are most able to find hope, meaning, and transcendence in the little things. Miracles, if you believe in such things, are still there, just not necessarily on the grand scale. So even if you aren’t particularly celebrating one of this month’s festivals, there is still the hope, wonder and mystery of the moment.
Ladybird Ward 10.30am, 10 May Martin Elliott (Executive), Martin Nightingale (Corporate Facilities), Roisin Mulvaney (Clinical Governance and Safety), Olivia Waller (Transformation) Lion Ward 10.30am, 17 May Barbara Buckley (Executive), Anna Cornish
(Corporate Facilities), Andrew Pearson (Clinical Governance and Safety), Toral Pandya (Transformation) Mildred Creak Unit 10.30am, 24 May Robbie Burns (Executive), Terry Durack (Corporate Facilities), Angela Dewhurst (Clinical Governance and Safety), Caroline Wells (Transformation) Louise Ward 10.30am, 31 May Liz Morgan (Executive), Margaret Hollis (Corporate Facilities), Leigh Gibson (Clinical Governance and Safety), Elizabeth Ball (Transformation)
The Clinical Document Database The idea was simple: to enable wider access to documents and to standardise the methods of saving and retrieving them. In reality it was a highly complex project that took four years to complete, but the new Clinical Document Database (CDD) is a huge achievement.
Contact Jim Linthicum, Chair of the Great Ormond Street Hospital Multi-Faith Group for Spiritual Care on ext 8232. Great Ormond Street Hospital Children’s Charity helps fund the chaplaincy.
The successes The CDD implementation began with a small pilot in Neurology last May. The pilot involved 20 staff and 14,000 migrated legacy documents. Ten months later, the CDD has 61 departmental sites, around 1,500 users and stores almost 900,000 documents. Staff across the entire Trust use the CDD daily to store and locate documents, enjoying the improved access to vital patient documentation. In an average day, the CDD receives 1,800 hits by 400 different users.
2 May – Birthday of Guru Arjan Dev (Nanakshahi calendar) (Sikh) 23 May – Declaration of the Bab (Bahá’í) 29 May – Ascension of Baha’u’llah (Bahá’í)
The challenges While the CDD has proved helpful for many users, the varied working practices across the Trust have meant that some have found it challenging. The project team has worked with several departments to develop small changes and improvements,
some of which are still ongoing. The CDD as a project is drawing to a close and will soon be handed over to the business as usual teams (ICT Service Desk, Infrastructure, Application teams and Information Services). Looking ahead For the future, the Trust has selected Microsoft SharePoint as the development environment for a replacement of the Trust’s intranet so there will be further upgrades and developments as this project progresses. A big thank you to all staff who helped the team understand your processes and for providing invaluable feedback and suggestions along the way. If you have any questions regarding these developments or would like further training on the CDD, please contact Helen Vigne, ICT Project Manager, at vigneh@gosh.nhs.uk If you have any support queries please contact ictservicedesk@gosh.nhs.uk
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Charity pages We need to raise £50 million every year to help rebuild and refurbish Great Ormond Street Hospital, buy vital equipment and fund pioneering research. For more information please call 020 7239 3000 or log on to www.gosh.org
Hare Styling Title? Fancy getting your hands on some original celebrity art? Then check out our latest fundraising campaign, Hare Styling, which features an array of fantastic canvasses from famous names in music, art, film, fashion and politics. Where did it start? Angelica Van Clarke had a life-saving operation at Great Ormond Street Hospital when she was two days old. Now 15, she drew a hare to raise funds for two new operating theatres. Following in her footsteps, a selection of distinguished artists and celebrities have expressed themselves on canvas for this great cause.
Grab yourself a one-off piece o f celebrity art an d support GOSH in the process!
race for the
Kids
We’re counting down the weeks to 5k RBC Race for the Kids and there’s still plenty of time to sign up. And if you’re still not sure, we’ve got five reasons why taking part in RBC Race for the Kids is an absolute must.
Cheryl Cole
Get up close The original works of art will be exhibited at the Heartbreak Gallery, Marylebone, until Sunday 8 May, so why not pop down and see them for yourself?
1 Your hospital needs you! In 2010, RBC Race for the Kids runners raised an impressive £300,000 for Great Ormond Street Hospital, and this year we want to do even better. Every penny of the money raised will benefit our patients, giving you the perfect reason to dig out those running shoes. 2 Treat your family and friends to fresh air and exercise Whether you walk, jog, skip or run, taking part in physical activity is a great way to improve the health and wellbeing of you and your loved ones.
Heartbreak 17 Bulstrode Street, London W1U 2JH Nearest tube: Bond Street (Central and Jubilee) Exhibition dates and times: 16 April – 8 May, Monday to Saturday 10am to 6pm, Sunday 11am to 4pm Admission: Free Website: www.heart-break.co.uk
3 Catch a glimpse of participating celebs Last year we saw the likes of Vernon Kay and Blue Peter’s Andy Akinwolere taking on the 5k
5k fun run Battersea Park 12 June 2011 run. But who can we expect this year? You’ll have to take part to find out… 4 Get competitive with your colleagues We all love a bit of healthy competition, so why not set up a team in your department and take on other colleagues across the Trust? 5 Bring a picnic and make a day of it RBC Race for the Kids isn’t just a 5k run. It’s a perfect opportunity to spend a fun day out in beautiful Battersea Park. So why not bring a picnic rug and frisbee and settle down for a day of fun? Convinced? Log on to www.raceforthekids. co.uk and set up your fundraising page.
Help your hospital! Sign up today!
Hang it on your wall Each of the unique canvasses is up for auction, with all proceeds going towards the hospital. Anyone can bid, but get in quick! Final bidding will close on 2 June. Visit www.givinglots.co.uk and snap up a one-of-a-kind piece of art. Stella McCartney
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©2007 Great Ormond Street Hospital Children’s Charity. Registered charity 235825.
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Learnabout Online learning changes It’s important to us that your learning experience on GOLD is the best it can be. That’s why we’ve made some exciting new changes to our Online Learning front page. We’re now getting up close and personal, so checking your progress has never been easier. Each course has a colourful status bar beside it that corresponds to either ‘not started’, ‘in progress’ or ‘completed’. These provide a summarised view of all your online learning progress to date on the new system. You can now identify more easily the courses most relevant to you by selecting the sub category tab appropriate to your role. You’re even welcomed personally and addressed by your name. Please log into GOLD via www.goshgold.org/ learning to see the changes for yourself. As always, the GOLD team welcomes your feedback. Please contact us at gold@gosh.nhs.uk GOLD: brand new homepage design We believe the current GOLD homepage is in need of an update and we need your help to make this happen. The purpose of the page is to easily direct you to the section you need and provide the latest news and information related to education and training. You can find a draft design of the new GOLD homepage at www.goshgold.org/ newdesign.html Please get your ideas and thoughts to us by 10.30am on Wednesday 11 May 2011. GOLD is funded by Great Ormond Street Hospital Children’s Charity.
ward e h t on Word Island Day U nit Roundabout paid a visit to Island Day Unit this month to ask some of the staff: What is your favourite London attraction? “The London Eye. My husband took me on it for Valentine’s Day and we had champagne as we went round. It was early evening so it was lovely seeing the sunset over the city.” Tracey Ghosh, Staff Nurse “I love the buzz of Covent Garden. There’s always something going on, whether it’s summer or winter, and there are lots of great restaurants and bars to choose from.” Denise Taylor, Senior Staff Nurse “I really like Tate Modern. It changes all the time and there’s loads of interesting things on. I like the Southbank area in general, there’s always something to do.” Rebecca Hunt, Senior Staff Nurse “My favourite is Regent’s Park. I enjoy hanging out there with friends and doing lots of relaxing and sunbathing!” Natalie Vincent, Health Care Assistant
Five minutes with Terry Durack I have been at Great Ormond Street Hospital (GOSH) since January 1985, initially as Theatre Sister and then Senior Sister, and led the team that opened the Variety Club Building (VCB) theatres in 1993. In 2000 I was a project nurse for Chief Nurse Sally Nethercott, and then became the Trust’s Clinical Supplies Advisor. During a secondment for former Chief Nurse Judith Ellis I created the Clinical Skills Toolkit. This enables newly qualified nurses to assess their generic paediatric clinical competencies. As Modern Matron for Corporate Facilities, I contribute a clinical perspective to facilities issues, including the anticipated work involved with the new clinical building, and lead the Materials Management (top-up) team to ensure wards have the consumables they need to care for patients. I chair the Clinical Practice Committee and Hand Care Group, edit the clinical guidelines posted on the Trust website, participate in Executive Safety Walkrounds, and work in theatres once a month as part of the scrub team. What was your childhood nickname and how did you get it? Chicken Nag, but I have no idea why and my parents are no longer here to ask. What’s your favourite thing about your job? The variety: leading, teaching, coaching, assessing, portering – there seems to be no limit to what I can be asked to do.
If you were stranded on a desert island, what CD would you most want with you and why? Handel’s Messiah. I sing regularly with the Malcolm Sargent Festival Choir and GOSH Singers (always looking for new members, especially gentlemen) so I could wile away the days brushing up my repertoire. If you could visit any point in history, when would it be? 1950s New York. I was born in Brooklyn, one of the city’s five boroughs, and I would like to relive it as an adult to see if it really was as full of the drive, excitement and anticipation that I remember as a child. With the horrors of the Second World War behind us, it was an era of new technologies, rock and roll and, above all, hope that the world’s suffering was past and the future would be bright for everyone. What’s the most memorable place you’ve ever visited? I’m going to cheat and say the most southerly points in New Zealand and Africa because I could look unimpeded towards Antarctica, the place I have always wanted to go. As a child, what did you want to be when you grew up? An actress or singer. I did work in cabaret for several years and still sing publicly. I guess you could also say I still perform in a theatre, just not the one that everyone thinks about.
About Island Day Unit: This is a day care ward for children having investigations or operations under anaesthetic. Children from a range of specialties come here and occasionally children who need infusions or transfusions. For your ward to feature here, email Sally Mavin at sally.mavin@gosh.org or call ext *643042.
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Sports update By Paul Ryves and Hayley Dodman
GOSH football sitting pretty
GOSH netballers teach Old Ladies new tricks
GOSH 2 – 0 ITV2 GOSH continued their winning ways with a comfortable victory over yet another ITV team. Two goals from Ian Sabini secured the victory for GOSH. Ian’s first goal – a long-range belter – hit the underside of the cross bar and went in, a contender for goal of the season. Shame he did his back in at the same time.
GOSH 15 – 12 Old Ladies The Old Ladies were the most athletic and competitive team GOSH has faced this season. Close fought for three quarters, GOSH were able to open up a three-goal lead in the fourth. Eugenia Abaleke as Centre was awarded player of the match following some outstanding interceptions.
GOSH 0 – 2 CARAT A somewhat disjointed performance from GOSH allowed CARAT to take full advantage, resulting in a defeat that hampered GOSH’s winning run. A tough opposition with good movement on the ball was too much for GOSH to handle on this occasion. With four games to go, GOSH are still sitting pretty in the league, so fingers crossed for a good business end to the season.
GOSH 25 – 13 Swanettes A game of two halves. Tied after two quarters, GOSH were galvanised by substitutions in the third quarter and opened up a comfortable lead on the Swanettes. A prolific shooting partnership between the GOSH Goal Attack and Goal Shooter created a 12-goal gap between the teams at the final whistle. GOSH 14 – 7 Old Ladies In the final game of the season GOSH faced the Old Ladies again in a play-off game for fourth place. GOSH led at each quarter time break and were able to capitalise and extend their lead in the final quarter, opening up a seven goal advantage on their opponents.
The Sports and Social Committee is funded by Great Ormond Street Hospital Children’s Charity. 28