Patients in Waikato District Health Board’s Older Persons and Rehabilitation service are reaping the practical benefits of the DHB’s five-year commitment to the internationally acclaimed Productive Wards programme.
The programme empowers staff to look at how processes such as drugs rounds, ward rounds and discharges work.
It strips out what is stopping those processes from being better and release staff from activities that prevent them from direct patient care.
Patients in wards OPR 2-4 pay the staff plenty of compliments about the care they receive, said nurse manager Belinda Macfie.
“We bribe the patients with our smiles and we have clear expectations for our patients,” she said.
Releasing Time to Care was developed in the United Kingdom by the NHS Institute and introduced in New Zealand at several district health boards including Waikato, in 2009.
Releasing Time to Care is a staff-led programme using a modular structure allowing staff to control the improvements themselves.
It is now in place in all inpatient areas at Waikato Hospital, Emergency Department, Oncology, Women’s Health Assessment, Delivery Suite and Mothercraft as well as wards in Thames and Te Kuiti hospitals and starting soon at Tokoroa Hospital.
The productive programme also extended into other areas of health in the community, Mental Health and Radiology.
Quality and Patient Safety project manager Vin Kaur has been working in the programme since it started.
“This has been a huge journey. At first it was a struggle to get people to understand the concept but now after five years everyone wants to be a part of the programme.
It wouldn’t have been that successful without the constant executive support. Every two weeks the chief executive, chief operating officer and director of nursing and midwifery would visit and spend an hour with the staff to see how things were going and how they could further help in the process.
Director of Nursing and Midwifery Sue Hayward today held a special celebration in Waikato DHB’s Bryant Education Centre, cut a giant chocolate cake and handed out awards.
“It was a fun time, the awards were very tongue in cheek but everyone appreciated them.”
Mrs Macfie and the three charge nurses managers from the Older Persons and Rehabilitation service. Raewyn Lee, Neera Grover and Hayley Colmore-Williams work together as a team even though they are in charge of separate wards.
Productive wards started in each of their wards four years ago when they were in their former home in the Elizabeth Rothwell Building.
While the new year-old facilities in the Older Persons and Rehabilitation Building have helped productive wards, the reasons for the success lie in the team work.
“We meet once a week as charge nurse managers so if any of us are away, the others know what is going on in the ward,” said Ms Lee.
“We are using productive wards as a mechanism for professional development.”
Ms Colmore-Williams is a relative newcomer to the service but not to Productive Wards. The difference in Older Persons and Rehabiltiation was that the wards worked in a cluster.
“We all work together and have the same approach to staff handovers.
“It helps that each of the three wards have the same layout.”
But there is more to it than that.
“When we were in the Elizabeth Rothwell Building last year, before we moved here, we clearly explained the benefits of collaboration and role modelling.
“It’s to reduce the silos and to share the workload,” said Ms Macfie.
“Plus we share knowledge and experience. Making productive wards though doesn’t happen unless someone drives it through and here it is very much a team effort. It’s the culture and the fact that three (charge nurse managers) get together regularly.
Ms Kaur said she felt the Older Persons and Rehabilitation service were working Productive Wards the best of any area.
“There a lot of respect and good will and there’s a collectiveness which is impressive.”
Former chief executive Craig Climo, a regular attendee on Productive Wards tours, echoed that belief the service was operating Productive Wards better than any other before he left the DHB earlier this month.
“Why it stands out is the leadership in Older Persons and Rehabilitation, staff involvement and commitment including medical staff – junior and senior, and that three wards are doing things jointly.
“The results being achieved are outstanding, both in the areas targeted for improvement and the results from patient and staff satisfaction surveys.”
Chief operating officer Jan Adams said she liked the collaborative approach.
“It is very clear the charge nurse managers have a unified approach and are driving change through an agreed framework of productive wards and a clear older person’s nursing strategy.
“They also have a good approach to including the wider team, they call it high achievers whereby two staff from each ward noted to be high achievers are mentored and take a significant part in the productive series, helping them prepare for senior leadership and wider responsibilities,” said Mrs Adams.
Director of nursing and midwifery Sue Hayward said the charge nurse managers in Older Persons and Rehabilitation moved from being very ambivalent about producitves to the point where they now have the vision that allows them to use methodologies in all improvements.
“They have taken control and are thoroughly enjoying the spin offs this is giving them.”