Great Western Hospitals NHS Foundation Trust

Our improvement journey - January 2016

Staffing

Making sure we have the right number and mix of staff across all services at all times Although a challenge for most NHS trusts, we are making steady progress and since our last inspection in 2013, we now have around 200 more staff on our wards and in the community. We are now focusing on:  Recruitment of up to 70 nurses from the Philippines Continuing our careful use of premium rate agencies Investing in new nursing assistant practitioner roles Building on the success of our internal staffing agency Continuing our Return to Practice and Return to Acute Care courses Retaining talent with internal development opportunities Recruitment events throughout 2016

Patient flow and emergency care 

Making sure patients experience a smooth journey of care through our services and beyond remains a challenge for the whole local health and social care system More of our emergency patients now need to be admitted onto a hospital ward, with approximately half of the 220 patients who attend each day now requiring admission.As part of our 'Right Patient, Right Bed' programme, a range of new approaches is already being used to improve the flow, safety and experience of our patients. We are now focusing on: Continuing our work with health and social care partners on early discharge planning Involving family, friends and carers in discussions around care after discharge Launching our Home for Lunch campaign Developing the process for initial nurse assessments in the Emergency Department Utilising our new expanded Ambulatory Care and Triage Unit Making changes to how we monitor patients, to ensure each patient remains as safe and comfortable as possible while waiting in the Emergency Department Expanding training so we have more staff working in our specialist children's area in the Emergency Department Looking at how we use our Observation Unit in the Emergency Department Continuing to work with our healthcare partners to ensure patients needing urgent care are aware of all local options Continuing to work with our health and social care partners to explore further opportunities to help prevent potentially avoidable attendances and admissions

Caring for patients with mental health needs

Making sure we adapt our care to meet the individual needs of patients To improve how we care for patients with mental health needs, in a way which keeps them safe, while protecting staff and others close by, we are focusing on: Reviewing how we assess and care for patients with mental health needs Investing in an additional specialist mental health nurse Specialist training on the Mental Capacity Act 2005 and Mental Health Act 1983

Learning and effective governance

Making sure we are open, learn, share and improve We encourage a culture of openness and transparency because we know that recognising where improvements can be made will lead to improved patient safety. We are focusing on: Continuing to encourage a culture of reporting incidents Focusing on sharing improvements made following incidents Making sure all services are effectively reviewing their quality performance and reporting concerns and exceptions

The above information is available in a downloadable PDF file:

Our improvement journey - January 2016