Practice nurses are being urged to take control of improving efficiency in their work environment, under the latest programme in the “productive” series.
The NHS Institute for Innovation and Improvement this month launched Productive General Practice. Nurses at test sites for the programme have used it to streamline appointment times and reorganise nursing schedules, with benefits for patients and staff.
The clinician-led programme is intended to help primary care nurses and GPs in general practices free up more time to spend with patients through increasing efficiency and productivity.
It is the latest spin off from the popular and highly successful “productive ward” programme for acute settings, which has previously been followed by similar programmes for operating theatres and community services.
The programmes are based on “lean principles” pioneered by industries, such as car manufacturing, and are intended to enable nurses and other healthcare staff to do “more with the same resource”. They are structured into modules, which are implemented from the bottom up by clinicians.
The new programme has been co-designed and tested by GPs, nurses, receptionists, practice managers and patients. Initial work started on the Productive General Practice programme in May 2010 and four test sites began testing of the programme modules late last year.
One of the test sites was at Welbeck Road Surgery in Bolsover, Derbyshire. Nurse practitioner Suzanne Hallworth-Manley used one of the programme’s modules to look at the practice’s nurse scheduling.
She said she had initially “found it quite challenging to accommodate the demands of the programme into my day to day work” but the experience had been a “good one”.
She said: “We’ve been able to improve care for specific groups of patients. For example, patients with multiple conditions may require several separate appointments to review each aspect of the multiple conditions. We are working towards streamlining services to provide one longer appointment for these patients – a sort of ‘one-stop-shop’ approach.”
A second test site was at Concord Medical Centre in Bristol. Practice nurse Sharlene Hodson used the programme to overcome a workload problem among her team.
She said: “Previously, the nurse schedule didn’t have any time to ‘set up’ for appointments before they commenced at 9am. We are paid from 9am so there was little incentive to come in early and set up before the first appointment. When analysing the nursing schedule closely it was found that there were minutes in the schedule allocated to ‘nothing time’ often at the end of the mornings.
“Now the nurse schedule has the first appointment of the day allocated to setting up,” she said. “The ‘nothing time’ has been reallocated to add on an extra appointment at the end of the day. So the schedule retains the same number of appointments as before but the time within these appointments is used more effectively to the benefit of the nurses. People are happier.”
Find out more about Ms Hodson and Ms Hallworth-Manley’s experiences from the programme – both positive and negative – by clicking on the attachments on the right.