autumn a time for change

ADNS Alison Lynch,Doing the housekeeping and introductions – keeping me organised!

I always feel that the month of October is a month for changes, the trees are loosing leaves, animals are preparing for hibernation, the nights are getting darker and the weather is, finally, turning colder.

In the world of a hospital new students are starting, newly qualified staff are starting and the types of patients coming through the doors change too.

At Warrington and Halton NHS FT October has seen a few significant changes, all, I hope, for the benefit of patients, staff and the local population. The nursing strategy has been launched, the 5E’s – From Essential to Excellent, we are working to change and improve the standards of care and we are seeing real, tangible results: pressure ulcers falling; falls reducing; good friends and family test performance.

Wednesday was also our first (hopefully to be annual) patient safety conference, the day was well attended by over 100 staff and we were honoured to have a range of speakers: Elaine Inglesby – Burke, DNS at Salford; David Fillingham, AQUA; Dr Jackie Bene, medical director at Bolton Royal; colleagues from Hill Dickinson law firm; internal speakers and closing remarks from Gill Harris, Chief Nurse North of England.

But this wasn’t your “bog standard” talk and chalk or death by PowerPoint, we heard some very personal and inspirational stories from a range of dedicated and engaging speakers. Over the next few weeks I will attempt to bring some of these sessions to life in my blog, hopefully I can share some of the important messages, all within the context of patient safety and service improvement.

In the afternoon we had our own version of “speed dating” lots of different stands and initiatives covering a range of subjects and topics from infection control to safe maternity care and early warning tools to mortality data. One thing in common was the joint enthusiasm, willingness and drive to make improvements across a range of disciplines for the benefit of our populations, staff and patients 


The launch of the “NEWS”

So what else have we changed this week, well our wonderful staff health and well being team gave on average 1 flu jab  every 3 minutes with over 700 staff vaccinated in the first week of the campaign, we have seen unprecedented demand for flu jabs, probably due to a well run awareness campaign by Clare Blackman and her team.

So what are my final thoughts on the end of this week and the start of a new one? Well I hope to keep the energy going from this week into the next week, but also take time to consolidate our learning so that it becomes embedded in the organisation. One key message to pass on? Never stop looking for ways of understanding the quality of your care and always be open, honest and learn from your mistakes.

Oh yes and how to insert pictures properly!!!!


48 hours and counting

Well after the roller coaster week of last week I am resting up this weekend in preparation for what may well be the biggest week of my NHS career to date.

On Monday we will be launching our nursing strategy, “the 5 E’s from essential to excellent”, this is following an extensive review of our previous nursing strategy and lots of input from staff, governors and board. Based, loosely, on Maslows hierarchy of needs the strategy describes how by behaving in certain ways we can all go from essential to excellence in the care that we give.

I hope the nursing staff @WHHNHS embrace this and use it as the building blocks for the future. I believe in this and so do the 20 senior nurses that turned up, in uniform, on mass at Board this week to support my presentation and the proposal to board to adopt the strategy

Wednesday will be our first safety conference, held on the Warrington site, with internal and external speakers. We are lucky to have David Fillingham (AQUA), Gill Harris (chief nurse north) and Elaine Inglesby the inspirational director of nursing at Salford, to name but a few speaking.

The conference is the result of learning from a tragic event, several years ago, when a patient died in our care. As a result of this the entire organisation embraced change to make things better and completely review how we manage patients coming into our hospital. Great learning but also a reminder of the impact we have when things go wrong and to make sure this never happens again. Or as the senior nurses mantra goes “not on our watch – never on our watch”

In the afternoon, expertly planned by Alison Lynch, we will have “speed dating” a run through of stands with different groups of staff showcasing their involvement in patient safety initiatives, everything from work around mortality to falls prevention and so much more.

There might also be a few surprises so watch this space and watch my twitter feed @karendawber on what I hope will be more of a rocket week than a roller coaster, here’s hoping and of course starting the week with all of those “good intentions”

Good intentions

About 8 weeks ago I decided to write a blog, as with most ENTP’s I wanted it now! In true “Dawber”style, when excited about an idea I collared Chris Horner and insisted that he dropped everything to show me how to do it. Unfortunately, with all good intentions of doing over the weekend I did a million and one other things first, so sorry Chris 🙂 but here it is.

So I suppose my theme on this roller coaster week is good intentions….

No one comes to work wanting to do a bad job, I believe everyone in the NHS has “good intentions”, no one wants to make a drug errors, cause harm, have a patient develop a pressure sore, delay an appointment or cancel an operation. Yet we know this happens, so why?

I come to work with good intentions, to do no harm, treat staff well do the best for the patients. Yet most days something doesn’t always go to plan.

The week started with an unannounced visit from the CQC, the organisation with the role to register and monitor our hospitals, they arrived at 6pm on Monday and left at 5pm on Tuesday after observing practices and talking to staff, patients and relatives. The inspectors fed back at the end of the day, one saying that one of the wards had “inspirational staff” a moment to be very proud.

Wednesday was Trust Board day, large agenda nursing strategy and dementia strategy presentations, watched by the board and all of the senior nurses showing support, in uniform, truly awesome.

Everyone on a complete high, proud and excited for the future. We also formally signed up to the Nursing Times NTSOS campaign, encouraging staff to speak out when concerned and feel safe to do so.

It came to my attention later that day that some of the staff, in some areas, are concerned about staffing levels and staff being moved to different areas, that’s the low point.

So back to good intentions, we all want everything to be perfect, never be criticised, never get it wrong and always do our best. But sometimes things go wrong, don’t always go to plan and we all think how could we have done that better / prevented that from happening / anticipated that event.

The NHS is a hugely complex organisation, with risky things undertaken, high risk factors, potentially catastrophic consequences when we make a mistake. We must mitigate these risks to the best of our ability.

Hind sight is a wonderful tool but what we actually need is to all keep our good intentions but add to that a dose of tolerance, respect for each other and a culture that allows us to speak up, speak out and do the right thing for the patient.

No one works in the NHS to do harm or a bad job, everyone counts and everyone wants to make a difference.