Skip to 0 minutes and 14 seconds Stakeholders were kept engaged by regular email updates and posters displayed in the department.
Skip to 0 minutes and 26 seconds This project is made up of six steps. Step one, collection of baseline data. We search electronic databases to identify all women who under went pregnancy testing in the emergency medicine department over a three month period. And the details of all woman who under went blood pregnancy testing from the Central Laboratory Database. We then used the Emergency Department patient database to determine the time that the patient arrived, the time they were seen by a doctor, the time a decision was made to either discharge or admit the patient. We compared groups according to whether they arrived by ambulance or walked in, and by discharged destination, for example, hospital admission, or discharge.
Skip to 1 minute and 17 seconds Step two, procurement of the point of care testing hardware and reagents. In order to implement the novel point of care test, it was necessary to procure the required equipment. For the initial pilot, we reached an agreement for the procurement of the test cartridges, quality control material, and calibrators at heavily discounted price agreed with the manufacturer for a trial period. The manufacturer also provided the handheld testing metres on loan for an evaluation period. Step three, staff training. After procurement and upon receipt of the required hardware and reagents, we commenced a training programme for emergency department staff members. Training was led by the Trust Point of Care Testing team, and supported by representatives of the manufacturer.
Skip to 2 minutes and 16 seconds Step four, evaluation of the current care pathway. To understand our current processes and how implementation of point of care testing may improve patient flow. We undertook a process mapping exercise across different clinical areas of the emergency medicine department. Step five, development of a novel care pathway. After initial drafting of the process maps based on expert knowledge, several periods of observation in the emergency department were undertaken to enable refinement and maximise validity. Following review of these observations, revised process maps were created. Step six, reporting and refinement for further work. PDSA cycles were used to evaluate the success of each step of the project. We use shewhart charts to analyse our data.
Skip to 3 minutes and 16 seconds We used tree/drive diagrams to map out our primary and secondary objectives. Every step we carried out, we monitored, and reviewed, and made changes if necessary.
Skip to 3 minutes and 36 seconds The main challenges for the project were funding, staff training, and attitude, passing the key message to staff in other departments. Communication with colleagues was also important in ensuring the success of the project. For example, we observed that attendance at staff training was poor, and through discussion with the lead manager we identified the need to rearrange training at more convenient times of the day. The project is still ongoing, and the course team hope that this will illustrate some of the innovation projects that healthcare scientists undertake.
Skip to 4 minutes and 26 seconds The project was defined from changes to National Institute for Health and CareExcellence Guidance for the assessment of stable chest pain. The addition of functional imaging and cardiac computed tomography as diagnostic tests for the assessment of coronary disease were introduced. And as such, not widely available in most cardiac centres within the north west. In addition, in those centres where these tests are available, there was no ‘rapid-access’ provided to these services that are sub-specialists within the discipline. It was clear between lead scientists and consultant physicians that there needed to be a modified pathway based on recent evidence to ensure the service remained ‘rapid-access’ and provided quality of care for the patient.
Skip to 5 minutes and 12 seconds Stakeholders were identified from within the current structure in cardiology at University Hospital South Manchester using known contacts. Lead scientists and consultants within the diagnostic services, specialist chest pain nurses, physiology staff, local General Practitioner referrers and secondary care trusts were identified as stakeholders who may be involved in service, design, delivery, and benefit from the changes made.
Skip to 5 minutes and 41 seconds It was important to influence the current Consultant Cardiology Rapid Access Chest Pain Clinic lead, imaging cardiac consultant lead, specialist chest pain nurses, and physiology/scientist workforce. This was achieved by making the changes a ‘team’ process and ensuring that any changes to staff roles was positive, allowing them to take on different and/or more challenging tasks. For some, it’s allowed a reduction in workload and a more streamlined process, thus giving them the opportunity to concentrate on other pressures. For others, it was a development of new roles and responsibilities.
Skip to 6 minutes and 24 seconds Stakeholders remain engaged throughout by their constant involvement in any decision-making processes, regular meetings, and also with the combined goal of developing the most efficient, cost-effective service to maximise quality of patient care.
Skip to 6 minutes and 42 seconds The project team was small. That is lead physiologists/scientists, lead medical consultants, and current specialist chest pain nurses. This was a natural team to lead the project, given their previous experience, clinical knowledge, and understanding of diagnostic processes. Tasks were delegated based on the same concepts, as each discipline could bring different skills to the project. For example, physiologists and scientists key in diagnostic imaging modalities, nurses key in the assessment tools for chest pain, medics key in clinical rationale and effectiveness.
Skip to 7 minutes and 22 seconds There was no official timeline decided upon at the outset. There was a clear list of small goals that needed to be achieved in order to meet the overall target. These were decided on at the initial planning meetings between the lead staff. Ultimately, timescales for achieving these targets varied constantly based on hospital politics, financial planning, and human resource involvement.
Skip to 7 minutes and 56 seconds Our department collects feedback from patients regarding our service. And one of the questions we had asked prior to this project being implemented was what they like hearing aid maintenance classes. There had been a large amount of interest in this, which gave us the confidence it would be successful.
Skip to 8 minutes and 15 seconds We identified our stakeholders in this project as our patients, their relatives, and carers, as they are people that it will benefit the most.
Skip to 8 minutes and 26 seconds We discussed the idea with other staff members within the department, and asked them to mention it to any patients, relatives, or carers they thought would be suitable. We also had to reassure patients that this wasn’t going to impact on future services and encourage them to take up the offer.
Skip to 8 minutes and 45 seconds There were two of us within the team, myself and the Associate Audiologist. As the senior lead in the implementation of the project, I developed the standard operating procedure, liaised with Phonak, our hearing aid provider, regarding patient information leaflets and literature to back up the classes. I also sourced the equipment we would need. Nicola assisted me with this were necessary. Following appropriate training, she now takes the lead on some of these sessions. And we complete regular peer review sessions to assure quality of service delivery.
Skip to 9 minutes and 21 seconds Implementing this project was part of my annual performance development review, and I quickly set a provisional start date for the class approximately six months after we decided to offer it. I had monthly one-to-one meetings, both with my head of department and the other member of the team to ensure we were progressing towards this date successfully.
Examples of project planning
By watching this innovation project planning video, you will be able to further develop a deeper understanding of the importance of project planning and techniques used. Garry McDowell, Martin Stout and Clare Wood talk about their experiences of planning the innovation projects that they described in Step 1.5.