Macchiavello Dolores, Blackhouse Jennifer, Clark Jennifer, Haddock Claire, Hinder James, Jelley Benjamin, Joyce Amy, Matchett Kate, Morris Eden, Moss Carys, Rees Chris, Walters Alun, White Susan
Shaping Change, NHS Wales Cardiff and Vale University Health Board, Cardiff, UK
Cardiff and Vale University Health Board, Cardiff, UK.
BMJ Open Qual. 2024 Dec 30;13(4):e003043. doi: 10.1136/bmjoq-2024-003043.
Stroke is a leading cause of disability among adults, and any treatment that improves functional outcome, like higher intensity of rehabilitation therapy, can significantly reduce its financial burden. Clinicians on a stroke rehabilitation ward are expected to track and nationally report on rehabilitation time to contribute to the Sentinel Stroke National Audit Programme (SSNAP), a process that was manual, paper-based, time-consuming and redundant, which in turn impacted on a reduction in clinical time to provide stroke rehabilitation. We aimed to release 20% of clinical time by reducing inefficiencies within their time management and reporting process, ensuring that clinicians had more time available for direct patient care. To do so, we developed a tool to gather and analyse SSNAP-specific data and use Kanban cards to make weekly actions visible to reduce miscommunication. As a result, the whole occupational therapists team gained 7.5 hours a month (25% of released time, 12 extra additional therapy sessions available) when improving their data gathering and analysis process. A specialist physiotherapist saw a 2 hour a month gained and 4 hours a month gained for a Physiotherapist. Dietitians also saved 3 hours a month by not having to duplicate information. This process is part of a key organisational requirement for clinical teams working with stroke patients admitted to hospital and by addressing some inefficiencies, we were able to impact on direct patient care.
中风是成年人致残的主要原因,任何能够改善功能结局的治疗方法,如更高强度的康复治疗,都可以显著减轻其经济负担。中风康复病房的临床医生需要跟踪并向国家报告康复时间,以参与中风全国哨兵审计计划(SSNAP),这一过程是手工操作、基于纸质的,既耗时又冗余,进而影响了提供中风康复治疗的临床时间。我们旨在通过减少他们时间管理和报告流程中的低效率情况,释放20%的临床时间,确保临床医生有更多时间用于直接的患者护理。为此,我们开发了一种工具来收集和分析特定于SSNAP的数据,并使用看板卡使每周的行动可视化,以减少沟通不畅。结果,整个职业治疗师团队在改进数据收集和分析流程时,每月节省了7.5小时(占释放时间的25%,可增加12次额外的治疗疗程)。一名专科物理治疗师每月节省了2小时,一名普通物理治疗师每月节省了4小时。营养师也因无需重复信息而每月节省了3小时。这一过程是与入院中风患者合作的临床团队关键组织要求的一部分,通过解决一些低效率问题,我们能够对直接的患者护理产生影响。