Post on 15-Jun-2020
Ugochi Agbasimelo
Hannah Bowman
Lucie Butler
Gayle Elder
Barts health NHS Trust
The Royal London
Birthing Centres at: Barkantine
Barking
Barts Health overview
2
Many work streams of independent activity requiring
action
Another initiative!!!!
AAU Independence
project- We will help you to
Leading change adding value
Privacy and Dignity
compassionate care work stream-
Ambulatory care
T&O nursing and therapies silo working
ED
EM CARE
Dementia and Delirium action
plan
Red to Green
Without recourse to
public funding
Aging population-
RLH and NUH buck the trend
Some the highest levels of
deprivation
Lengths of stay
Expectations- Carer, Patient and staff
External and regulatory pressures
Patient choice and safe discharge
Journey to #EndPJParalysis
Maintaining Patient’s Privacy &
Dignity
Teach us to live that we may dread
unnecessary time in bed.
Get people up and we may save
patients from an early grave
• spending 10 days in bed ages your muscles by 10 years!
80 years of age?
• reduces muscle power by 2.5% and not just in the arms and legs but also in the heart and lungs
Just 24hrs of bed rest
Pre-Launch Steps
• Collaborative working and meeting with #endPJParalysis
working group (patient panel members, therapists, nursing staff
– all grades – on the flagship wards, communication team)
• Flagship wards cut across all disciplines – surgery, OPS,
medicine
• Baseline audit – literally to count
– How many patients sat out at lunch time
– How many patients in own clothes
Launch
Pledges
Post Launch Window in the Atrium
Creating stimulating environments
Background
Therapies
Therapy team working on 12C ward- Trauma, Ortho and plastics
Difficulties with communication between Therapy team and Nursing
staff
Established using mobility charts above beds to facilitate better
communication
Involvement in the end PJ paralysis working group with Ugochi-
Matron
Mobility board
Therapies
Goal setting booklet
Looking at 4 elements • Washing and dressing
• Transferring to the chair
• Toileting
• Eating meals
Poster
Therapies
Highlighting for patients, relatives and staff
reasons why to get up and get moving
Reiterating what will be discussed with patients in
their goal setting booklet
What we gave to the wards to make things easier
Resources to help discharges
• Discharge Folder – a central source of information to
make things easier for busy ward staff.
• Patient acceptance form for patients moving ward to
ward amended to include discharge planning as a
prompt.
• Ward induction packs for new start HCAs, band 5s and
band 6s – covering discharge planning, SAFER etc
A guide for all disciplines
SAFER Flash Cards
• Designed to be a quick and easy guide on
SAFER, red to green and discharge planning.
• To incorporate all disciplines to be involved in
flow and early discharges – not just nurses and
doctors.
• To make all staff feel included in new processes
• Pocket sized to allow staff to carry around as a
prompt.
Independence project AAU
Staff poster
? By Default
Fit to sit
ED initiative to move to an ambulatory majors
Patient who need hospital admission or further
investigations are dressed and sit in a separate
part of the department being taken into cubicles
for examination.
Keeping Moving…. forwards
• Embed practice – Make endPJParalysis the norm
• Communication (including visuals) for the flag ship wards
• Measure achievement on a daily basis – create data to
show improvements
• Senior leadership support in rewarding/encouraging areas
that have worked hard made great strides
• Roll out to all other wards in the Hospital and Trust
• Publicity- blogs, meetings, demos
• Rolling out mobility charts, posters and goal setting
booklets across the hospital
• Incorporating this into the Surgery Enhanced Recovery
Programme
• Work on a fit circuit for our staff and patients