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Welcome to the RD&E - Demonstrating Difference

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Learning and improving practice

 

At the RD&E we consistently strive to provide safe, high quality and excellent care for every individual. Listening to what our patients think about the service they have received forms a vital part of this process. Below are some recent examples of the ways in which your feedback through our patient experience and complaints programme has led to direct improvements in care.

 

Renal Department
The Renal dietetic staff identified the lack of a weight management service for renal patients and a questionnaire was compiled which identified a patient’s preference with regards to how a weight management service would be delivered.  Following the results of this an eight month nutrition and exercise weight loss service was developed and commenced on 9th May offering 1:1 diet and exercise advice in a 90 minute appointment.  An evaluation will be conducted at the end of the 8 sessions (December 2018).

 

Cardiology Department/Taw Ward
Following a number of complaints, Taw Ward has identified an ongoing issue with Cardiology patients waiting for procedure who no longer require or want the procedure or who have symptom changes. A test of change has been undertaken whereby a band 4 elective co-ordinator contacts all patients following their booking. The co-ordinator discusses the patients’ needs in order to highlight special requirements for the ward and advice about post procedural requirements. The coordinator also ensures the day case environment has the correct skills, safety and specialised equipment required for the elective activity. All patients are greeted on the day of their procedure by the co-ordinator, someone they have already been speaking with and who understands their needs. The aim of the role is to prevent cancellation on the day of any patient and to improve patient satisfaction. This has been received positively by patients, Consultants and the booking teams.

 

Pre-Assessment Unit; Acute Surgery Admin Teams; Specialist Surgery Admin Teams; Knapp Ward
Patient feedback was received with regard to problems with pre-assessment appointments.  The Preparation for Surgery team reviewed their booking process for pre-assessment to identify if there was a way that patients could be seen on the same day they were listed for Surgery and also, if they could prevent patients attending for surgery without being offered a pre-assessment.   This led to two changes in their processes:-

  1. The clinics were restructured to create “one-stop” clinics on a number of the lists and where patients are listed for surgery they now have the pre-assessment on the same day.  This has been positively received by the patients and is currently in practice for four specialities with the view of rolling this out across the remaining areas.  The main focus is cancer patients and those who have travelled out of area.
  2. Pre-Assessments booking has been centralised within the actual team rather than each speciality leading to maximising the utilisation of their capacity, resulting in more patients being seen together with the introduction of a reminder service.  There has been an increase in the number of patients now attending with a pre-assessment and a reduction in cancellations due to unknown co-morbidities.

Otter and Abbey Ward

Otter & Abbey Ward patients and staff had commented on the lack of recycling facilities available. The ward housekeeper has worked to improve recycling and reduce waste in the ward environments. Otter ward have been able to demonstrate that up to 75% of their waste can be recycled. In addition to this the wards have stopped using plastic spoons and are using reusable cups. These initiatives are being fedback to look at Trustwide adoption. 

 

Yeo Ward – Radioactive Iodine Room
Patients often feel very isolated as they have minimal contact with nursing staff during their stay due to the radiation levels.  Artwork has been provided for the walls and staff have provided a DAB radio, TV, games, puzzles, DVD’s, books for entertainment and a laptop so patients can keep in touch with family and friends. There are tea and coffee making facilities also provided.

 

Peninsula Clinical Genetics – Truro
A support group has been set up for women who have inherited a breast/ovarian cancer genes (BRCA 1 and BRCA2). The first support group was set up at The Cove, Macmillan Support Centre, RCHT. Thirteen ladies attended and were able to discuss their experiences.  Positive feedback has been received as these patients often felt they were alone and had no support.

 

Gynaecology clinic 2
Gynaecology services have identified an ongoing issue with 25-30 year olds not regularly attending for their smear test. Nationally, there is a shortage of women in this age range attending. The Matron put together a bid for some National Screening Funding and was successful in securing funds for a 3-months trial to pilot an evening drop-in service at the RD&E. The aim was to see if this would improve the number of women attending screening. The team designed the posters and circulated them on social media. The service offers women the chance to attend an evening clinic on Tuesdays between 6-8pm. The first clinic was held on the 12th June with 9 patients dropping in for their smear test.

 

Exmouth Community Nursing
A complaint was received from a patient’s family regarding funding arrangements and care home availability.  Following a meeting with the staff involved one of the actions was to create a “family meeting agenda”- which would ensure everyone is heard, gives a record of what was said and if any actions are required and by whom and also allows the family to be involved. 

 

Community Nursing – Barnfield Hill
Barnfield Hill community nursing team have been visiting a housebound patient daily for over a year to support with the management of pressure damage. The patient was very reluctant to engage with advice and education. The patient had fed back that the times the nurses visited disrupted their television viewing and she just wanted them to do the dressings and leave without discussion/education/support. Team ensured a consistent approach to engage the patient with advice and adapted the visiting times to facilitate this. By changing the times a therapeutic relationship was gained thus compliance with the advice treatment and subsequent healing. Whilst the patient is looking forward and optimistic of being able to self-manage without input from Nurses, she reports looking forward to the support and treatment which the nurses provide as she can see that it is helping her recovery.

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