This Hospital had some very big challenges on its plate when it first contacted us in 2016. Having struggled with a lack of funding for some time as well as other problems, in January 2015 it had been put into ‘special measures’ with a rating of ‘inadequate’. However, they say ‘it is not how a horse falls, it is how it gets up’ and they soon got up very well indeed! 19 months later, in August 2016, it came out of special measures with a rating of ‘good’ … one of the fastest exits from special measures there has been, and the first trust to exit with a rating of ‘good’.
This Hospital sets the standard for a quick recovery!
To achieve this spectacular turnaround, an enormous amount of work and commitment was needed and a complete review of all manner of systems, procedures, etc, and it was at this stage that Clarity Visual Management’s services were called upon. An area that the report highlighted as in need of particular attention was the security of patient data and confidentiality of sensitive patient information. Another area of particular concern was the consistency of the way in which data was measured across the wards.
This hospital’s challenges were enormous … lack of funds, damning publicity, low staff morale, public criticism … the list goes on. It is a credit to the hardworking, committed staff that they could rise above these factors to achieve such a dramatic about turn!
We made several visits, both to the offices and to the wards, so that we could observe the systems in action. We realised that, although there were basic visual cues in place, confusion abounded where the same measure was being shown in different ways on different wards, leading to misunderstanding and frustrations. This particularly manifested itself in the Patient Whiteboards used by the staff on every ward, and an essential part of critical patient information during shift handover.
We set up a system of visual management boards where there was a standard design which could only be varied within certain agreed criteria. Immediately, this meant that staff could go to any visual management board in any ward and know exactly where to look for particular information, and be confident that the information they were getting was correct and unambiguous.
We went on to work with the hospital to produce an encoded system of symbols which could be instantly recognised by the relevant hospital staff, but remained confidential to visitors, other patients, etc. These symbols are used to represent a treatment, condition, etc, and printed on square magnets which could easily be placed on the visual management board. This meant that the boards could be displayed in the most useful place without fear of breaching confidentiality, thus fulfilling the need that effective visual management should be as close to the process being measured as possible. The bright, simple boards were attractive and added positively to the level of staff engagement with the boards.
We also set up compartmented storage boxes with stocks of the magnets so that these were kept organised and to hand. These boxes were printed with the name of the ward and a key to the magnets.
Results & Achievements
The Care Quality Commission’s report speaks volumes! In August, the commission found ‘outstanding practice at the trust’, and commented that ‘staff were caring and compassionate towards patients’ and also praised the hospital’s leadership. A remarkable achievement for a Trust that had been placed in special measures less than two years previously.
Internally, the difference in the atmosphere on the wards was enormous. Nurses had a system that they had confidence in and felt appreciated and trusted, and instead of the constant public criticism, they had a level of patient care to be proud of.