Today’s blog is written by Priscilla Nuwash, president of the PVHS Center for Performance Excellence, who is in London with Medical Center of the Rockies CEO George Hayes and Poudre Valley Hospital Chief Nursing Officer Craig Luzinski.
George Hayes, Craig Luzinski and I just finished our fourth day of visiting top hospitals in London.
We’ve met many people who are dedicated to providing high-quality patient care – a common purpose for all who choose healthcare for a profession. We traveled from UCLH by the underground to St George’s Healthcare Trust in south London, a 1,300-bed acute care hospital and the largest hospital in London. We spent Wednesday afternoon and Thursday morning there.
Founded in 1733, St George’s has trained physicians since its founding and today has a large medical teaching university as part of its campus. Like health systems in the U.S., UK hospitals are highly regulated, and performance measures are tracked and trended for external comparisons to other hospitals in the NHS and to identify areas for improvement.
While there we observed a simulation hospital in action where participants treat mannequins that respond to their care, including eyes that dilate, arteries that pulse, and chests that expand and contract. Through simulation, participants are able to learn how to diagnose and treat patients, but just as important, they learn how to communicate and work as a team.
We met the manager of the Patient Advice and Liaison Service (PALS), an access point for patients to receive information and resolve problems, as well as the department that is a catalyst for making improvement changes. All three hospitals we visited were beginning to use LEAN as an improvement methodology. The OR, called a Theatre, uses “Productive Theatre,” and the nursing units use “Productive Ward” which is similar to the U.S.’ Transforming Care at the Bedside initiative.
Part of using Productive Ward is to assess making a difference so real-time patient feedback is gathered weekly using the Patient Experience Tracker, an electronic survey device that allows patients to enter responses at bedside and aggregates results posted on bulletin boards for staff review.
For learning purposes, a yearly mandatory meeting called Clinical Convergence Day is held at the hospital so employees can hear first-hand about serious adverse patient care events that happened at St George’s, so future occurrences can be avoided.
From St George’s we traveled to Queen Mary’s Hospital, a community hospital built in 1915 to provide treatment, rehab and artificial limbs for those who lost limbs in WWI. Queen Mary’s was completely rebuilt in 2006 and among many other services, maintains a department that creates artificial limbs.
In the UK, community hospitals do not provide any services that require general anesthesia; they have a therapy focus on care, rather than treatment. Queen Mary’s will be merging with St George’s hospital next month, and if a patient arriving at Queen Mary’s needs acute care, they are transferred by ambulance to St George’s. I can’t possibly explain in this small space all that we saw and learned, but there are many ideas that we are looking forward to sharing when we return to the states.