Occupational Therapy, Derbyshire Healthcare NHS Foundation Trust, Derby, Derbyshire, UK
Occupational Therapy, Derbyshire Healthcare NHS Foundation Trust, Derby, Derbyshire, UK.
BMJ Open Qual. 2024 Oct 23;13(4):e002883. doi: 10.1136/bmjoq-2024-002883.
Care-planning is vital to the delivery of timely, person-centred, safe and effective care. Despite the understanding of the benefits of person-centred care-plan in both services, occupational therapists (OTs) within our forensic and rehabilitation services had difficulties in inputting into patient care-plan an efficient and person-centred manner.The OT team developed a Quality Improvement (QI) project to improve the efficiency of the OT process to create more time for care-planning and improve person-centredness of OT input into care-plans to 82% in the forensic services and rehabilitation services by December 2023.The results indicated an increase in the person-centredness of care-plans from 63.64% to 84.34% within the rehabilitation service and an increase from 65.15% to 95.45% in the forensic service. This project used feedback from patients to develop our input into care-plans. The project also increased the efficiency of the admission process and released time to be spent on care-planning and treatment.We improved the quality of our input to care-plans in a sustainable way by using the Royal Academy of Improvement sustainability measure and taking actions which included training our band 6 and 7 OTs to complete their monthly audit and reporting this as part of the head of nursing report for assurance in our monthly Clinical and Operational Assurance Team meetings. These actions ensured that our project fitted with the organisation's strategic aims and values. We also used low carbon alternatives by holding most of our improvement meetings online and eliminating the use of paper.Lastly, we improved the generalisability of this project by using the Goal Directed Care Plan audit tool, which is a well-researched, evidence-based tool created by service-users, carers and members of staff. This was used to train members of staff and develop an example of a person-centred input into care-plans to improve their practice.
护理计划对于提供及时、以患者为中心、安全有效的护理至关重要。尽管我们的法医和康复服务中的职业治疗师（OT）理解以患者为中心的护理计划的好处，但他们在以高效和以患者为中心的方式将其输入患者护理计划方面仍存在困难。OT 团队开展了一项质量改进（QI）项目，以提高 OT 流程的效率，为护理计划创造更多时间，并提高 OT 输入护理计划的以患者为中心程度，到 2023 年 12 月，在法医服务和康复服务中达到 82%。结果表明，在康复服务中，护理计划的以患者为中心程度从 63.64%增加到 84.34%，在法医服务中从 65.15%增加到 95.45%。该项目利用患者的反馈来改进我们对护理计划的投入。该项目还提高了入院流程的效率，释放了时间用于护理计划和治疗。我们通过使用皇家改进学院的可持续性衡量标准并采取行动来可持续地提高我们对护理计划的投入质量，包括培训我们的 6 级和 7 级 OT 完成他们的月度审计，并将其作为护理主管报告的一部分，以在我们的每月临床和运营保障团队会议上获得保证。这些行动确保了我们的项目符合组织的战略目标和价值观。我们还通过在线举行大部分改进会议并消除纸张的使用来采用低碳替代方案。最后，我们通过使用由服务使用者、护理人员和工作人员创建的经过充分研究和基于证据的目标导向护理计划审核工具，提高了项目的通用性。该工具用于培训员工并开发一个以患者为中心的护理计划输入示例，以改进他们的实践。
