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The Productive Ward: Releasing Time to Care TM : A Review of the Literature for Implementation

The Productive Ward: Releasing Time to Care TM : A Review of the Literature for Implementation. Mr. Mark White, HSE/WIT Professor John Wells, WIT Emeritus Professor Tony Butterworth University of Lincoln. The Productive Series. The Productive Community Services. The Productive Ward.

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The Productive Ward: Releasing Time to Care TM : A Review of the Literature for Implementation

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  1. The Productive Ward: Releasing Time to Care TM: A Review of the Literature for Implementation Mr.Mark White, HSE/WIT Professor John Wells, WIT Emeritus Professor Tony Butterworth University of Lincoln

  2. The Productive Series The Productive Community Services The Productive Ward The Productive Operating Theatre The Productive Leader The Productive Community Hospital The Productive Mental Health Ward

  3. Key Points in Relation to the PW • Structured, methodical ‘Lean’ approach that focuses on the ward team and the clinical leader • Analyses the way the ward team works and suggests changes to improve processes • Makes the environment more user friendly • Highlight KPI’s to demonstrate ‘knowing how we are doing’ measures • Encourages a culture of continual improvement

  4. DIRECT NURSING TIME The Productive Ward aims to turn this... INDIRECT NURSING TIME NURSING CARE PATIENTS – THE REASON WE EXIST 25 - 40% direct time spent with patients

  5. INDIRECT NURSING TIME NURSING CARE DIRECT NURSING TIME To this… 60% …So that both patients and staff benefit

  6. And it looks like this……

  7. 2. PW in Ireland • Designed by NHSi in 2005/2006 • Piloted in 2006 & initial roll-out commenced 2007 • 2 Early adopter sites in Ireland in 2010: Roscommon and Cavan • NHSi/WIT Collaboration in early 2010 • NHSi/WIT/HSE ‘Improvement and Innovation Fellowship’ design 2010 • ONMSD engagement and national rollout plan

  8. National Implementation Group National Advisory Group Chair – ONMSD Director 3. Model of Implementation in the HSE Director Nursing Director of Public Health Nursing National SIPTU Rep. National INMO Rep. National PNA Rep. National Therapy Leads Rep. NMPDU Rep. National PW Rep. Clinical Program-me Rep. HEI Rep. Productive Ward Areas/Sites

  9. 4. National Phase 1 Productive Ward Sites • HSE DNE • Cavan General Hospital • OLOL Drogheda • Beaurmont Hospital • Connolly Hospital • HSE West • Letterkenny General Hospital • Sligo General Hospital • Our Lady’s Manorhamilton • Roscommon County Hospital • Ennis General Hospital • St Johns Hospital Limerick • HSE DML • St. Vincent’s University Hospital • Coombe University Hospital • Midlands Regional Hospital Portlaois • Midlands Regional Hospital Tullamore • HSE South • South Infirmary/Victoria University Hospital • Cork University Maternity Hospital • HSE South (SE) • Waterford Regional Hospital • South Tipperary General Hospital

  10. 4. Sites & Site selection Readiness Audit of applicant sites: • Leadership at Executive level  • Aligned with strategic direction  • Governance of the programme  • Continuous improvement  • Capability and knowledge  • Right people in place 

  11. Progress • All 17 sites (23 wards) have completed Module Implementation • All 23 wards are have completed the 3 foundation modules & commenced process modules • KHWD data is being Collected on Falls, Unplanned Absenteeisim, Infection Rates • Preliminary results see improvements in the KHWD data and direct patient care times (eg. Up to 30 mins/day on handover, 15 minsper dressing, 25mins per discharge, Unplanned Absenteeism from 17 episodes/pm to 1/pm )

  12. Barriers • Executive buy-in & support • Backfill/Locum replacement • Finance to re-shape/layout the ward • Energy/Motivation to collect Data • Collecting the right data for improvement • Efficient reporting • Release for training and networking

  13. The PW Literature • 3 NHSi Reports: Lessons for the PW 2010/Learning & Impact Review/Rapid Impact Assessment 2011 • Belfast Evaluation 2008, NHS Scotland 2009 • Excellent Nursing Press and grey literature in the UK and internationally • Peer Reviewed Journals from 2009

  14. Inclusion/removal criteria of ‘Implementation’ ‘challenges’ • ‘lessons learned’ • 53 relevant articles • Duplicate and non-relevant removed=109 Potential • 74 articles for consideration. • 318 PW references • 210 RTC search theme Literature Review • Exclusion criteria: Multiple/Eclectic initiatives (Lean, TCAB and tPOT). • Key search : Productive Ward, Productive Series and Releasing Time to Care. • Initial search of Standard Electronic Databases (Jan 2006 until June 2012).

  15. Productive Ward Implementation

  16. Next Steps • Project Implementation • Phase 2 Site recruitment Commenced • Continue with Phase 1 module implementation. • Improvement metrics and reporting being refined. • A project implementation evaluation will take place 2013

  17. Many Thanks… The Productive Ward: Releasing Time to Care™: What we can Learn from the Literature for Implementation. In Press Journal of Nursing Management

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