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

Theatre Refurbishment Programme City Road January 2015

Theatre Improvement programme Work streams Key actions • Review of structure, roles and responsibilities Theatre staffing 1 • Developing service team leaders Service teams 2 • Review of scheduling and planning of lists 3 Operating lists • Feasibility study, develop options for 1 st floor 4 Admitted pathway • Defined management of contracts & stock control 5 Operational/Equipment • Identify service developments for private MEH private 6 • Improve the pathways to improve communication Emergency admitted 7 • Review of software, systems and metrics available 8 Information Technology • Review of policy, processes and information 9 Governance • Team Brief and WHO checklists 10 Safety • Recruitment of Practice facilitator Education & research 11 • Improve utilisation of theatre capacity Efficiency and Value 12 • Accurate reporting tools 13 Performance Metrics • Reports /updates /user groups 14 Communication /Progress www.moorfields.nhs.uk

Theatre Improvement programme 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 Work stream 2- Introduction of Service Teams  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 www.moorfields.nhs.uk

Theatre Improvement programme 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 Work stream 4 – Pathway for admitted activity  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. www.moorfields.nhs.uk

www.moorfields.nhs.uk

Theatre Improvement programme www.moorfields.nhs.uk

Theatre Improvement programme 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 Work stream 6- Moorfields Private  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 of their lists Planned  New timetable developed and further discussions ongoing  Scoping programme to review capacity and demand requirements www.moorfields.nhs.uk

Theatre Improvement programme 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. Work stream 8- Information Technology  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 www.moorfields.nhs.uk

Theatre Improvement programme 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 ( N AT SSIP’ 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 www.moorfields.nhs.uk

Theatre Improvement programme Work stream 10- Safety  Reinforce the use of the WHO checklist providing an accurate record of 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 www.moorfields.nhs.uk

Theatre Improvement programme 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 Work stream 13- Performance Metrics  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 www.moorfields.nhs.uk

Theatre Improvement programme 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 www.moorfields.nhs.uk