Jacqui Ballantyne- Lead Clinical Pharmacist Community Services - - PowerPoint PPT Presentation

Transfer of Care Project - Referral to Children’s Community Nursing Service.

Jacqui Ballantyne- Lead Clinical Pharmacist Community Services

Why? Story board Issues How What Did it work? Future Work

Overview of Presentation?

Transfer of Care Children’s Community Nursing Northumbria Healthcare

P

What were the issues with the current referral?

 Patient Safety – delay in treatment  Documents all separate, inconsistencies  Communication issues  Missing medicines or equipment  Frustrated staff and families  Poor impression of community service provision

How did we address this?

 Move the issue out of the “too difficult to deal with “ box  Active Engagement& Ownership  Organise and facilitate key meetings  Motivation to change  Ensure engagement and motivation towards achieving the project objectives was sustained.  Monitor outcomes

What difference have we made?

 Happier staff/happier patient & family  Expected standards to be met & consistency of referrals  Provision of small stock (diluents) to community nursing teams facilitates any lapses  Children’s community nurses able to administer medication to the child as per planned visit  Improved relationships & engagement with families  Communication improved (but still not perfect)

What were the outcomes identified

 Tertiary team understanding the issues & consequences  New referral form required  Engagement of tertiary team  Governance and Ratification of any new documentation  Communication with tertiary teams & dissemination of information  Empowerment

What were the issues with the current referral?

Four separate documents- inconsistencies leading to poor referrals

Frustrated staff and families Communication issues Missing medicines or equipment Poor impression

• f community

service provision Result Patient Safety issue – delay in treatment

RISK

Stepping Stones- Hospital to Home

Do healthcare professionals talk to each other ? Where and how does social care fit in? Why is it taking so long?

Negotiation of move Phased Responsibility of Care Empowerment VS uncertainty FUNDING/ Financial concerns

Battleground

How did we address this?

Move the issue out of the “too difficult to deal with “ box Active Engagement& Ownership Organise and facilitate key meetings Motivation to change Ensure engagement and motivation towards achieving the project objectives was sustained. Monitor outcomes

• Actively engage the right stakeholders - set key goals and objectives of

the project.

• Organise and facilitate key meetings- Agree actions- “Own” the project.

PDSA.

• Ensure engagement and motivation towards achieving the project
• bjectives are sustained.
• Ratification of relevant documentation.
• Monitor the outcomes achieved following implementation of the new

referral service, identify any issues and follow up with community team.

PROJECT- Roles and Responsibilities

What were the outcomes identified?

Tertiary team understanding the issues & consequences New Referral Form required Engagement of tertiary team Governance and ratification of document

Communication with tertiary teams and dissemination of information

Empowerment

Referral Form PART 1

Situation- Reason for admission/PC/dIagnosis Background- PMHx, social circumstances, details of attendance/admissions Assessment- Action, treatment, management, other services e.g. community Recommendations – information, subsequent actions

Discharge Checklist – Part 2

Supporting information for referral, e.g. children’s service, environmental factors. Medication /Equipment checklist

Prescription & Administration Details- Part 3

Referral Form – Part 4

What differences have we made?

Celebrate success Happier staff/happier patient & family Expected standards to be met & consistency of referrals Provision of small stock (diluents) to community nursing teams facilitates any lapses Children’s community nurses able to administer medication to the child as per planned visit Improved relationships & engagement with families Communication improved (but still not perfect)!

Transfer of Care Children’s Community Nursing Northumbria Healthcare

P

What were the issues with the current referral?

 Patient Safety – delay in treatment  Documents all separate, inconsistencies  Communication issues  Missing medicines or equipment  Frustrated staff and families  Poor impression of community service provision

How did we address this?

 Move the issue out of the “too difficult to deal with “ box  Active Engagement& Ownership  Organise and facilitate key meetings  Motivation to change  Ensure engagement and motivation towards achieving the project objectives was sustained.  Monitor outcomes

What difference have we made?

 Happier staff/happier patient & family  Expected standards to be met & consistency of referrals  Provision of small stock (diluents) to community nursing teams facilitates any lapses  Children’s community nurses able to administer medication to the child as per planned visit  Improved relationships & engagement with families  Communication improved (but still not perfect)

What were the outcomes identified

 Tertiary team understanding the issues & consequences  New referral form required  Engagement of tertiary team  Governance and Ratification of any new documentation  Communication with tertiary teams & dissemination of information  Empowerment

• Evaluation and audit of new referral forms
• Medication Incident monitoring
• Intranet availability of new referral forms
• Review form 2019
• Continue “can do” attitude
• Share good practice

Future work

• Graeme Mitchell Curry- Children’s Community

Matron Northumbria Healthcare NHSFT

• Helga Charters- Matron Child Services -Great

North Children’s Hospital

• Julie Henderson- Children’s Community Nurse
• Emma McClay- Senior Clinical Pharmacist

Northumbria Healthcare NHSFT

Acknowledgements

• Millar AR, Condin CJ, McKellin WH, Shaw N, Klassen AF, Sheps S. Continuity of care for children with

complex chronic health conditions: parents’ perspectives. BMC Health Services Research 2009;9:142.

• Brenner M, Larkin P.J et al, Parents’ perspectives of the transition to home when a child has

complex technological health care needs. Int J Integr Care 2015; Jul–Sep;

• Young J, McCann D, Watson K, Pitcher A, Bundy R, Greathead D. Negotiation of care for a

hospitalised child: nursing perspectives. Neonatal, Paediatric and Child Health Nursing 2006;9(3):7– 14.

• NHS Improvement ACT Academy- SBAR Communication Tool. Jan 2018
• RPSGB – Picton C, Wright H, Keeping patients safe when they transfer between care providers –

getting the medicines right. June 2012

References