A year of innovation in the ED.

It has been a year of change and innovation in the ED. We were given the unique opportunity to work with Andy Currie, a change leader from GSK to analyse and redesign some of the processes within the ED. Andy’s secondment to us ended last week. Over the next series of blogs I thought it would be good to reflect how far we have come; the results we’ve achieved; and start to reflect on how we’re going to take this work forward and build upon it.

Andy started with us in July last year. The first month he spent ‘learning the department’. He shadowed the staff, attended the management meetings, and looked at the problems we were facing. I think it would be fair to say it was an eye-opening experience for him….especially the nights on call and the trips out with the ambulance service!

A multidisciplinary team was set up to work with Andy, its scope to be decided. The team consisted of representatives from every discipline in the ED; receptionists, portering staff, CSWs, nurses, doctors, OT's, physiotherapists, radiographers, managers and statisticians. The first meeting was interesting. It is fair to say that at the hectic pace the ED runs at you don’t often get the chance to sit, consider and analyse what it is you do, how efficiently you do it and what your ultimate end goal is. I have to admit to having been slightly uncomfortable sat in a room for a group discussion and assigned roles (observer/scribe/time-keeper/rabbit hole-er(?!)). It seemed a world away from what I considered my role to be.

Over a series of meetings, we named the group (The Kaizen Chiefs), developed a project charter and had a team visit to GSK Montrose to see ‘operational excellence’ in action. The level of detail with which the Montrose team recorded and analysed their processes at was amazing. You could almost see each individual tablet as it made its way from raw materials to packaged goods. In each area we visited they had reminders of the patients for whom the medicines were intended…patient-centred care in the factory! But still the doubts lurked…could we take this model of performance analysis (60 days from raw material arrival to finished product) and adapt it to our setting (4 hours from patient arrival to discharge)?

Andy noted early in his secondment that the NHS was generally very data heavy but that much of the data was stored and not used. There was certainly plenty of data for us to consider over the 2 Kaizen events that then took place. We were presented with our performance data (uncomfortable reading), the results of a staff survey (highs and lows) and the results of a patient survey and patient mapping exercise (hugely complimentary, great reading!). We worked our way through the data and came up with 3 areas of work for the team: the patient journey; measurement and presentation of performance data and communication and recognition. The journey had begun……