Theatre Refurbishment Programme City Road January 2015 Theatre - - PowerPoint PPT Presentation

Theatre Refurbishment Programme City Road

January 2015

www.moorfields.nhs.uk Theatre Improvement programme

Work streams Key actions 1

Theatre staffing

• Review of structure, roles and responsibilities

2

Service teams

• Developing service team leaders

3

Operating lists

• Review of scheduling and planning of lists

4

Admitted pathway

• Feasibility study, develop options for 1st floor

5

Operational/Equipment

• Defined management of contracts & stock control

6

MEH private

• Identify service developments for private

7

Emergency admitted

• Improve the pathways to improve communication

8

Information Technology

• Review of software, systems and metrics available

9

Governance

• Review of policy, processes and information

10

Safety

• Team Brief and WHO checklists

11

Education & research

• Recruitment of Practice facilitator

12

Efficiency and Value

• Improve utilisation of theatre capacity

13 Performance Metrics

• Accurate reporting tools

14 Communication /Progress

• Reports /updates /user groups

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Work stream 1- Theatre Staffing

 Agreed structure, roles and responsibilities  Consultation undertaken with Clinical theatre teams  Significantly improved performance management processes,

absence management and appraisal management Planned

• Administrative consultation planned January 2016
• Implementation of e-rostering programme

 Identified Theatre Service Team Leader roles and job descriptions

agreed, banded and commenced January 2016 Planned

• Each service team undertake a review of equipment and

instrumentation requirements

• Each team leader attends service review meeting and service

Governance meetings to understand the needs of the services

Theatre Improvement programme

Work stream 2- Introduction of Service Teams

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Work stream 3- Ordering and Planning of Operating lists  Scheduling and planning of operating lists meeting held weekly  Pilot project with a Surgeon and anaesthetist from each service,

reviewing and ordering the operating list developed Planned

• Local safety standards finalised describing the agreed process for

scheduling and listing of procedures

• Commence pilot of planned order of operating lists

 Review current pathways and confirmation of key weaknesses or

non-compliances against guidance to admitted pathway

 Developed an outline schedule of accommodation for facilities  Architect engaged to develop feasibility study and scope of service

Planned

• Measured survey, structural survey, review of M&E infrastructure
• Present feasibility study with option appraisal.

Theatre Improvement programme

Work stream 4 – Pathway for admitted activity

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www.moorfields.nhs.uk Theatre Improvement programme

www.moorfields.nhs.uk

Work stream 5- Operational + Equipment

 Identified all maintenance and service contracts for theatres  Introduction of material management processes in theatres with bar

coding – significant cost reduction in non-pay

 Development of new operating theatre timetable

Planned

• Annual review of equipment and instrumentation
• Finalise the move of maintenance and service

 Agreement for specific theatre to be made available to MEH private  Specific team leaders identified to lead MEH private  Reporting programme available for MEH private to review the utilisation

• f their lists

Planned

• New timetable developed and further discussions ongoing
• Scoping programme to review capacity and demand requirements

Theatre Improvement programme

Work stream 6- Moorfields Private

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Work stream 7- Emergency Service

 A full service review and audit of the VRE service to establish the

current resources and future opportunities Planned

• Review of referral source to the VRE Clinic to ensure that referrals

are triaged and signposted effectively

• Review of treatment and procedure options to ensure income

captured throughout the pathway.

 Identified requirements for integration of PAS Silverlink and OpenEyes  Installation of ‘COW’ on wards to assist with communication and flow of

activity Planned

• Implementation of data and operational requirements for the successful

integration between PAS and OpenEyes

Theatre Improvement programme

Work stream 8- Information Technology

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Work stream 9- Governance

 Review of all local procedures and standard operating processes

ensuring local safety standards are based on National Safety Standards for Invasive Procedures (NATSSIP’S)

 Weekly Theatre meeting to discuss the responsibility's of

adhering to the procedures and the impact on patients safety- all staff encouraged to report safety incidents and/or near misses

 Theatre representation to Infection control, Clinical Governance,

Risk Management and Health and safety meetings feeding back to the theatre team

 Significantly improved responsibility and accountability from

staff with clear job descriptions Planned

• Ongoing review of local safety standards to ensure compliance

against National Safety standards

Theatre Improvement programme

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Work stream 10- Safety

 Reinforce the use of the WHO checklist providing an accurate record

• f checks being performed – delivers a written record of
• Procedural verification and site marking
• Sign in, time out and sign out
• Prosthesis verification

 Conformity with the Pre-operative Team Brief encourages all staff to

express any concerns of planned procedures or patient safety issues with a debriefing session at the end

 Audit of Team brief undertaken, demonstrating improved compliance  Infection control audit  Health and safety audit  Medicines Management audit- all demonstrate compliance

Planned

• Ongoing audit of Local safety standards
• Continued discussion with staff of responsibilities for the

management of e.g. Prosthesis verification, equipment failure and prevention of retained foreign objects

Theatre Improvement programme

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Work stream 12- Efficiency and Value

 Significant improvement in management of theatre budget both pay

and non pay

 Open day being undertaken for recruitment of group of staff wishing

to work in theatres at City road- reduction of agency utilisation Planned

• Programme to define reference costs per procedure
• Recruitment to fill staff vacancies via Open days

 Introduction of programmes for monitoring and reporting of activity:

• Theatre utilisation broken down by every session
• Starting time of both am and pm sessions
• Cancellation report for medical and non medical activity

Planned

• Audit of cancellations and DNA’s to understand trends
• Audit of activity between VR elective and VR emergency activity

Theatre Improvement programme

Work stream 13- Performance Metrics

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Work stream 14- Communications

 Communications board in City Road theatres updated monthly  Monthly reports available for services and directorates of progress

and utilisation

 Weekly scheduling and cancelation meeting at City Road including all

service managers and service admission co-ordinators with P&I representative to discuss scheduling, utilisation and staffing issues

 Update provided at Clinical Governance half days and clinical service

meetings Planned

• Develop a Moorfields Theatre group for all theatres leads from City

road and satellites to meet monthly to ensure consistency in standards and resolution of concerns ensuring best practise initiatives are communicated to all

• Development of a Moorfields Medical Theatre user group

Theatre Improvement programme