Monthly archives: August 2018

Chief Executive’s Message – Friday 31 August

We expect to have the CQC (Care Quality Commission) on our sites over the next four weeks.  They are here to see if we have progressed from 2017 and whether we have yet achieved the Good rating that we are striving for.  You know that 70% of our services are currently rated as good or outstanding.  Next week the Trust Board meets at Rowley Regis, and I know that our community ward teams there are determined to demonstrate to them and to the CQC the huge progress made since the last inspection.  Of course our medical wards and surgical services are under sustained pressure, but recruitment has been strong, vacancies have fallen, and the Safety Plan data shows improvements in care.  The feedback I hear from patients and from you is that ward multi professional working and documentation is very different to 2017, as our consistency of care work has engaged everyone in trying to find ways to ensure, shift by shift, that care is of good quality and personalised.

Most of the week is “out of hours”.  Some of our teams only work for us in those hours.  Our patients are with us 24/7.  So today’s early hours go-see inspections were an important part of how we work.  It is good news that the hospital sites’ wards felt like it was night-time.  Calm and restful.  We have worked hard to reduce overnight moves of patients to try and get a decent night’s sleep.  That is an important part of care and health, and earlier this year the Board heard from a patient whose time with us was sleep deprived.  Good too that teams in theatres were so welcoming to the inspection and challenged appropriately who folk were, and why they were there.  There remains work to do on trolley security for drugs and paper files on wards, and on resus trolley checks.  If you are reading this and work on one of our wards, please take the initiative and talk with your colleagues about shift by shift checks and improvements.

“Out of hours” is also a big part of the work we want to do now on improving communication.  Part of that is ensuring great handover and appropriate transitions of care.  Ten days we changed the process for bed-side handover between ED and acute medicine to improve quality.  We are working to see what more we could do to make inter-site transfers work well.  And the image uploading link to the trauma centre needs more work.  But line managers are also being asked to ensure that anyone that works outside daytime hours is clearly part of the team, hears news and messages and practice changes, and has equal access to training and development work.  I suspect this obvious issue is not yet our strongest suit and I know that our group Director of Nursing are looking for good practice across our sites, so speak up.

Like every recent Friday message, I have to mention IT.  Last weekend we lost functionality, and I very much hope that the work done this week on N3 and on our servers, sustains through this weekend.  The remaining technical fix for our wifi solution is being tested in coming days.  We need that wifi for Unity, and we will go live with Unity when we are ready.  The full dress rehearsal is coming up.  Whenever we go live, having everyone trained is vital.  If you have not booked in for your Unity training this is pretty much your final call!  Out of hours of course our IT resilience is less as our support cover is different.  For gold, silver and bronze IT systems we are agreeing in the next fortnight what revised and improved cover we need to better support teams when things go wrong.  The latest performance stats are here.

Pathology is a key dependency for so much of the work we do.  This time next week we expect to confirm the transfer of undertakings conditions have been to create Black Country Pathology in October.  Our services here will change gradually but they will change and I want to record our thanks to everyone working across our laboratories for your service and for putting up with a messy and sometimes frustrating change programme.  BCP does offer us, to my twin themes, new IT in 2019, and it should offer us in time better out of hours resilience.  But its success will depend on people and on leadership.

On Sunday, notwithstanding the leadership, our team of cricketers will do our best to retain the Midland Met trophy against local GPs.  The forecast this time is sunshine, so if you have a free Sunday afternoon, do join us at Dartmouth Cricket Club in West Bromwich for the annual match.  Good luck too to those taking part next week in the Trust’s annual cycle ride – details in staff comms about sponsorship.  Come back in one piece!

#hellomynameis….Toby

Drayton Manor – Free entry weekend

On the 22 and 23 September Drayton Manor we will be offering free entry to the emergency services.

Free entry will be offered to the following sectors:

• Fire and Rescue Service
• Police Force
• Ambulance Service
• Air Ambulance
• NHS Employees

The free entry is only for the weekend of the 22 &23 September and emergency services staff will need to have a form of valid ID for their workplace.

Family and Friends joining you?

Why not book in advance and take advantage of our amazing 4 for £80 ticket where 4 people can visit together, and it works out at just £20 each. The ticket is available when booked in advance, up until midnight the night before your visit.

Those gaining free entry don’t need to book but click below to book your 4 for £80 tickets for your family and friends.

Will my family get discounted tickets?
If you are a member of the Blue Light Card then you are able to purchase discounted tickets to the park, these tickets have to be pre-booked in advance and only directly from www.bluelightcard.co.uk and not directly from Drayton Manor Park.

How to get your tickets?
To take advantage of the free entry, no booking is needed, simply arrive at any ticket booth and show your relevant ID to gain access.

Heartbeat: Aviation procedures flying high in maternity theatres

You could be easily be forgiven for thinking that life inside the cockpit of an aircraft ready for take-off is a totally different ball game to the inside of a maternity theatre. However, a pilot and a surgeon are both poised to carry out important procedures – take-off is considered one of the most trickiest aspects of flying a plane, whilst a surgeon is about to take the life of a mother and an unborn baby into their hands.

Both of these situations require a sense of calm, which is why we are seeing procedures which have been in common place in the world of aviation for a long time coming into play within settings.

Heartbeat caught up with Speciality Theatre Manager, Kay Stokes and Senior Theatre Practitioner, Alan Dickens to find out how the ‘silent cockpit’ is making a difference in our maternity theatres.

The silent cockpit is an extension of the World Health Organisation surgical safety checklist, which was introduced to the NHS after commercial airline pilot, Martin Bromiley, who lost his wife during routine surgery, suggested that healthcare services could learn from the checks involved in aviation

“There is a rule in aviation which means that below 10,000 feet the pilot and co-pilot aren’t allowed to talk about anything which isn’t relevant to that flight,” explained Kay.

Alan added: “It is a rule which has been in place in aviation since 1981 after a review of some serious incidents showed that pilots had been distracted by engaging in non-essential conversations during critical parts of the flight.”

The idea to introduce the silent cockpit into our organisation came after Kay attended training which looked at how human factors play a part within healthcare.

“We decided to ‘pilot’ the idea in maternity theatres during elective surgery,” said Alan.

“An obstetric theatre can be a busy place, there are staff from different specialities involved in a caesarean section and previously there could be different pockets of conversations going on any one time.

“The patients are awake during these procedures and we know that by creating an environment in which there are no conversations, other than about that patient or procedure, we could reduce errors, but also create a better experience for the patient.”

Kay said: “We wanted to improve the patient experience; we had received a couple of comments that patients could overhear conversations whilst in theatre.”

She continued: “No mum-to-be would want to end up in theatre, but by looking at the environment we are creating in theatre, and ridding it of unnecessary noise; we can get as close to a normal birthing experience for the patient as possible.

“We encourage them to bring in a choice of music and try to create a very calm experience.”

The silent cockpit was initially trailed during May 2018 and after taking a while to embed, positive feedback from patients and their birthing partners has been plentiful and the decision was made to continue.

“It was strange to start with,” said Alan.

“As soon as the patient walks into theatre, there is no talking other than anything which is relevant to the patient or about the procedure. It has taken a while to become the norm and we still have to issue to odd reminder during a procedure, but feedback from patients and staff alike has been brilliant. Staff have seen the difference that it can make to the patient experience and agree that it creates a better, calmer and ultimately safer experience.

“Surgeons have fedback that they like it and feel that there are fewer distractions.”

Kay added: “We have also found that communication amongst the surgical team is much improved. There is no chance of miss-communication as there is no noise disruption.”

One lady recently who was on her fourth C-section at our hospital and she commented that she experience of the silent cockpit was noticeably different to her other births.

Kay said: “She told us that whilst she never had any complaints with her previous births, this one was definitely her best experience. She said the theatre was noticeably quieter and that she felt calmer and that she could clearly hear the music which she had chosen to play.”

At the moment, the silent cockpit is only in operation during elective procedures in maternity, but both Kay and Alan have a vision to roll it out across other theatres and to continue to educate staff to its importance.

“Alan has done a fantastic job of introducing it,” said Kay.

“The challenge now is to keep pushing it and driving it more. We have done a presentation to the theatre staff during our quality improvement half day and we have signs up in the theatre to remind people.”

Alan concluded: “It has been a great start and we are really looking forward to seeing what we can achieve with the silent cockpit over the next six months.”

Blood component packs indicating the presence of latex

NHS Blood and Transplant have recently changed the supplier of blood component packs and you may notice some differences in the new packs being issued from June 2018.

Some of these component packs now may show a LATEX symbol. However, we have been assured that this label does not reflect the presence of latex in the pack that reaches the patient.

Blood component packs remain latex free. The new label has been introduced because of a change in labelling regulations and not because the content of the packs has changed.

There is, and has been for many years, a small amount of latex in a section of the blood donation pack that is used for the collection of blood samples for testing. This section of the pack is discarded after blood donation and the latex does not come into contact with the blood for transfusion at any point.

The latex symbol will be obscured by the pack label in most cases, however there may be some packs where it is partially or fully visible.

If you would like any further information please contact a Transfusion Practitioner

Roche Coaguchek XS PT Test strips

We have received an urgent field safety notice form Roche Diagnostics regarding Coagucheck analysers used to obtain INRs on some wards. The analysers continue to be reliable for INR values obtained between 0.8 and 4.5, INRs above 4.5 should be confirmed by sending a sample to the laboratory.

If you or your department use a Coagucheck device please contact anticoagulant services on ext 3615 for further information.

Wifi downtime at Sandwell due to scheduled maintenance tomorrow (6am)

There will be a short period of downtime across the Trust wifi system at Sandwell tomorrow (31st August) from 6am due to scheduled maintenance.
Users will likely experience downtime or unstable connections for approximately 5 minutes from 6am.
Once the maintenance is complete, devices should automatically reconnect to the wifi.

If you continue to experience wifi issues beyond the scheduled maintenance window, please contact the IT service desk on ext 4050.

Heartbeat: Compassion in Care – supporting people with hidden disabilities

The Compassion in Care Award this month has been awarded to a quick thinking deputy manager who stepped in to help a family in need who were desperately trying to calm a distressed child.

Victoria Atherton, Deputy Manager in the anticoagulant service was nominated by her manager after she took the initiative to step in and support the family who were struggling with the child in a busy waiting area.

Nominating Victoria for the award, Anticoagulant Service Manager Joanne Malpass recounted how Vicky had spotted the unfolding situation and used her own experience to provide some much needed support.

“Vicky sits in an office which looks out onto the waiting area of clinic area 1 in the Sandwell treatment centre.  On a daily basis her and her colleague, Kelly Barnickle, have their door knocked by patients asking questions not related to our service but they both always help with a smile.

“Vicky could see  very distressed parents with their child in the waiting area.  Vicky has a son who is autistic and drawing on her experience approached the parents.   They then explained that their daughter had a similar disability to her son and was finding it very distressing to be in a busy area, the clinic was running late, and they were all becoming very distressed and were finding it difficult to occupy their daughter.”

Vicky didn’t simply stop at talking to the family but used her initiative to find a resolution and managed to find a treatment room nearby that was vacant, where the family could wait in peace and quiet. Within minutes of being in the room the child was much calmer and was happily drawing, the parents were more relaxed whilst waiting for their appointment.

Since stepping in to support the family, Vicky is hoping to become a diversity and inclusion champion and keen to see how she is able to use her knowledge and experiences with her son to help facilitate and bring about change to help those with hidden disabilities such as autism.

Also highly regarded as by the judges this month was Research Nurse, Rebecca Brown who was nominated by colleagues for the help and support she has provided both colleagues and patients on the research studies she is involved in.

If you know someone who has excelled at consistently upholding our nine care promises, nominate them for a Compassion in Care Award. You can nominate colleagues from any department who you feel have provided compassionate care; this includes colleagues from non-clinical services.

You can nominate online via Connect https://connect2.swbh.nhs.uk/communications/compassion-in-care-awards/

The Big Interview – with Amar Puttanna

Dr Amar Puttanna is a Diabetes Consultant at Sandwell and West Birmingham Hospitals NHS Trust. He is a committee member of the Young Diabetologists and Endocrinologists’ Forum (YDEF) following a successful period as chair.

He was also Royal College of Physician Chief Registrar. He has won multiple teaching awards from the University of Birmingham and the Royal College of Physicians of Edinburgh and previously been on the Royal College (MRCP) Part 1 examining board. In 2018, he won the RCP Excellence in Patient Care Award for outstanding contribution to the profession.

Why did you specialise in diabetes?

I have always been interested in this specialty – I was fortunate enough to realise this quite early on in training as a medical student. It was the ability to combine the vast breadth of knowledge with holistic patient care. It was also the wide variety of situations encountered – from those transitioning into adult care to antenatal care through to the challenges of multi-morbidity and reduction of morbidity and mortality with above all – the patient at the centre.

Tell us about your accolade at the 2018 Royal College of Physicians (RCP) Excellence in Patient Care Awards in May?

I was very humbled to receive the RCP Excellence in Patient Care Award for contribution to the profession as a trainee. It can be difficult as a trainee – trying to balance your workload, on calls, family, with training and personal development as well as trying to get involved to make meaningful changes for patients and colleagues. I was very fortunate to be involved in projects (local or national) and various other opportunities during my training which resulted in the nomination. This award was given to the trainee across all specialties in the UK who the judges felt had made meaningful and valuable contributions to colleagues and patients. You don’t expect to win awards but I was proud to receive it, even more so as it showed you don’t have to wait to be a senior in the specialty to make changes and also because it added to the perception of our specialty nationally!

To Read the full interview click here. 

Peter Edge sadly passed away

It’s with great regret and sadness we have to inform you that Peter Edge passed away on Saturday 18 August. Peter has been a cheery face in I.T. for years. He couldn’t do enough to both fix I.T. problems and, more importantly, cheer people up. He will be missed by us and all those that phone the service desk. He will be missed.

Details regarding the funeral will be announced in due course.

Heartbeat: Baby friendly initiative awarded to infant feeding team

Infant feeding colleagues were celebrating this month after being reaccredited as Baby Friendly by Unicef Baby Friendly UK.

The programme helps professionals provide sensitive and effective care and support for mothers, enabling them to make an informed choice about feeding, get breastfeeding off to a good start and overcome any challenges they may face. The program also supports the importance of close and loving relationships and safe responsive bottle feeding.

Thanks to this work, breastfeeding initiation rates have risen by 20 per cent since the Baby Friendly Initiative was established in the UK.

Our infant feeding team was reassessed after the original accreditation had reached its two year mark. Reassessments take place on a regular basis to ensure that the standards are being maintained and to explore how the service is building on the good work it has already done.

Louise Thompson, Infant Feeding Co-ordinator, said: “We are thrilled to have been reaccredited as Baby Friendly.

“It is an important public health programme which has also helped us to ensure we are giving new parents all the support and help they need when their baby arrives.

“Most mothers in the UK stop breastfeeding before they want to and many will be left feeling guilty and upset. It takes all of us working with mothers and babies to give evidence based effective care so feeding gets off to a good start and individual women do not feel blamed when they encounter feeding problems.

“The accolade is based on a set of standards for maternity, health visiting, neonatal and children’s centres services, which provide a roadmap for services to improve care.

“The process is quite intensive and involves colleagues and mothers being interviewed by the assessors to check audit results and discuss how the standards are being maintained. Internal audit results and outcomes such as breastfeeding initiation, continuation and exclusive rates and supplementation rates are also reviewed.