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

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

Transfer of Care Children ’ s Community Nursing Northumbria Healthcare How did we address this? What were the issues with the current  Move the issue out of the “ too difficult to referral?  deal with “ box Patient Safety – delay in treatment   Active Engagement& Ownership Documents all separate, inconsistencies  Organise and facilitate key meetings  Communication issues  Motivation to change  Missing medicines or equipment   Ensure engagement and motivation towards Frustrated staff and families achieving the project objectives was  Poor impression of community service sustained. provision  Monitor outcomes P What difference have we made? What were the outcomes identified   Happier staff/happier patient & family Tertiary team understanding the issues &  Expected standards to be met & consistency of consequences  referrals New referral form required  Provision of small stock (diluents) to community  Engagement of tertiary team nursing teams facilitates any lapses  Governance and Ratification of any new  Children’s community nurses able to administer documentation medication to the child as per planned visit  Communication with tertiary teams &  Improved relationships & engagement with dissemination of information families  Empowerment  Communication improved (but still not perfect)

What were the issues with the current referral? Four separate Result documents- Patient Safety Communication inconsistencies issue – delay in issues leading to poor treatment referrals RISK Missing Poor impression Frustrated staff of community medicines or and families service provision equipment

Stepping Stones- Hospital to Home Do healthcare Negotiation of professionals talk move to each other ? Phased Where and how Responsibility of does social care fit in? Care Why is it taking so Empowerment long? VS uncertainty FUNDING/ Battleground Financial concerns

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

PROJECT- Roles and Responsibilities • 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 objectives 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.

What were the outcomes identified? Tertiary team understanding the issues & consequences New Referral Form Empowerment required Communication with Engagement of tertiary teams and dissemination of tertiary team information Governance and ratification of document

Referral Form PART 1 Situation- Reason for admission/PC/dIagnosis Background- PMHx, social circumstances, details of attendance/admissions A ssessment- 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 How did we address this? What were the issues with the current  Move the issue out of the “ too difficult to referral?  deal with “ box Patient Safety – delay in treatment   Active Engagement& Ownership Documents all separate, inconsistencies  Organise and facilitate key meetings  Communication issues  Motivation to change  Missing medicines or equipment   Ensure engagement and motivation towards Frustrated staff and families achieving the project objectives was  Poor impression of community service sustained. provision  Monitor outcomes P What difference have we made? What were the outcomes identified   Happier staff/happier patient & family Tertiary team understanding the issues &  Expected standards to be met & consistency of consequences  referrals New referral form required  Provision of small stock (diluents) to community  Engagement of tertiary team nursing teams facilitates any lapses  Governance and Ratification of any new  Children’s community nurses able to administer documentation medication to the child as per planned visit  Communication with tertiary teams &  Improved relationships & engagement with dissemination of information families  Empowerment  Communication improved (but still not perfect)

Future work • 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

Acknowledgements • 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

References • 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