Hospitals will get a shot in the arm
District health boards are snapping up a British National Health Service initiative to improve productivity in hospital wards and operating theatres.
The Productive Operating Theatre and Productive Wards – Releasing Time to Care programmes involve relatively low-cost and simple measures.
Bay of Plenty District Health Board, among the first to implement the programmes in 2009, has reported some dramatic improvements.
At Tauranga Hospital, which has a high proportion of elderly patients, patient falls and medication errors have been slashed.
In one ward which has completed all modules, medication errors were cut by 85 per cent and patient falls by 50 per cent, DHB director of nursing Julie Robinson said.
A review by staff found that nurses were often interrupted by patients, other staff and visitors as they were giving out medication.
Nurses now wear a high visibility vest when issuing medication so people know not to disrupt them, Robinson said.
Patient falls decreased after nurses were given time to identify a problem area which was difficult for patients to navigate around.
At-risk patients are now kept away from the area.
Nurses are also each spending an extra hour and 45 minutes with patients per shift, on average, due to less time spent searching for equipment.
"It's simple stuff. Good basic house-keeping. It's making sure things are tidy, have a place, and that you don't have too much equipment," Robinson said.
The United Kingdom's National Health Service developed the programmes in response to frustrations by theatre staff in delays to starting the day, which sometimes resulted in cancelled operations.
The delays were due to issues like staff turning up late after being unable to find a carpark, battling with faulty theatre doors and being unable to find equipment.
The key to the programme's success in Britain, as well as New Zealand, is that staff have identified their own areas of concern, and implemented change.
Teamwork is also a component, with first-name introductions with surgeons giving nurses a confidence boost.
If a surgical team is happy and working well, it's going to be a better outcome for the patient, Robinson said.
"It involves simple, effective things – naming each person in the team, introducing each other and being thanked at the end of a surgery."
And nurses are happier, with staff turnover in the Tauranga pilot ward dropping from an average of three a month to one.
The programme is being rolled out to the rest of the wards in Tauranga and Whakatane hospitals. Waitemata, Auckland, Tairawhiti, Taranaki, Whanganui, Hawke's Bay, Hutt Valley and Southern DHBs are among those also getting on board.