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Hull and East Yorks NHS Trust looks to lean to break Trauma Services log jam

Virtual College (Lean Healthcare Academy) : 08 April, 2008  (Company News)
Hull and East Yorkshire Hospitals NHS Trust has made a positive start in tackling its first major project following the adoption of ‘Lean’ thinking as it strives to streamline working practices, cut waiting times and improve the quality of patient care and safety.
The Trust has established a flagship public and private sector partnership with the Lean Healthcare Academy, which works extensively in the UK healthcare sector delivering services similar to those widely used in the manufacturing industry to streamline operational procedures and boost productivity.

Hull and East Yorkshire Hospitals NHS Trust has taken up the gauntlet on the Trauma Services Pathway Project, launched at Hull Royal Infirmary at a presentation involving the Trust’s executive team, divisional managers and external support agencies.

Trauma Services is one of the toughest pathway challenges for the NHS nationally, involving patients with orthopaedic bone injuries sustained as a result of accidents. Hull and East Yorkshire Hospitals NHS Trust alone has 4,000 admissions a year in this area, of which 570 are hip fracture patients who account for 50 percent of bed days occupied.

Three working groups, made up of nursing, medical, therapy and other staff, have been put in place to diagnose which areas along the patient’s treatment pathway - from admission, though surgery to discharge – experience the biggest problems or bottlenecks.

Major areas open to improvement, including unacceptable delays, inconsistencies throughout the pathway, communications problems, lack of facilities and resources, along with staffing issues, have been identified at an early stage.

So, too, have a number of solutions, with actions already being taken to enhance the process as part of the overall objective to make the entire pathway much more efficient and patient-friendly.

Ann Hunt, divisional manager of surgery 1 and Lean co-ordinator at Hull Royal Infirmary, said: “The Trauma Services Pathway Project is a first for the Trust and we have given ourselves a real challenge because of the size and complexity of it.

“It has made us focus on the patient – and the patient must always be regarded as number one. Improvements have occurred since we adopted the Lean process, which can be put down greater empowerment of the clinical team, coupled with enhanced communication and awareness of each other’s responsibilities.

“We are confident that if it works – and though it is early days there’s no reason to think otherwise - then the whole impact of Lean can be adapted and adopted for similar projects across the Trust to further enhance the delivery and quality of our patient care.”

Mike Wright, director of nursing strategy, told delegates: “A massive amount has already been done, but the real work starts now. Diagnosing the problems is the first step – it is now a question of making the solutions a reality.

“We do not want any of our trauma services patients to get a raw deal, but the stark reality is that some are - and we have a duty to put this right. Adopting Lean thinking has reignited the passion to put things right and we must sustain the momentum already achieved.

“There is no doubt this will be a challenge within our existing resource base and we may need extra resources to deliver. We have to prioritise these and decide which actions will have the greatest impact and benefits for ourselves and our patients in a way that is manageable, as we cannot hope to achieve everything all at once.

“However, many of the challenges we face are achievable and the directors of the Trust will give a commitment to dedicate what resources we can to this initiative as we want our patients to get the best care possible. We and our partners must continue to work together and deliver this project effectively. The work starts here.”

Stephen Greep, chief executive of Hull and East Yorkshire Hospitals NHS Trust, added: “It’s all about collaboration and co-operation within the Trust and the wider NHS, not only to reduce waiting times and raise the safety, quality and delivery of our patient care, but also to create solutions that are less time-consuming, much more cost-effective – and make better use of public money, which is vital as far as public conceptions are concerned. But, most important of all it is about improving services for our patients.”
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