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Review of staffing skill mix to maximise capacity in Cardiology

Undertake a review the role of staff required to deliver an ECG appointment to increase capacity in the department, ensuring quality and safe care is delivered by the right person at the right time.

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  • Idea
  • 2019

Meet the team

Also:

  • Consultant Cardiologist - Ben Davison
  • Diagnostic Lead - Carron Painter
  • Divisional General Manager - Stephen Smyth
  • Nursing Lead
  • Project Support

What is the challenge your project is going to address and how does it connect to your chosen theme?

At present there is a large demand for ECGs from many sources, both inpatient and outpatient services.  As part of a larger programme of work, the project team would like to explore the ECG appointment, looking specifically at the roles required to deliver the entire appointment.

By breaking down the different parts of the appointment and focussing on the tasks and functions required, we would like to explore the potential for support workers in the appointment, freeing up the time of the technicians to be able to focus on undertaking the ECG and developing a quality report.

The redesign of the appointment will also increase capacity allowing for an increase in the number of appointments offered.

What does your project aim to achieve?

The project aims to achieve more capacity regarding the number of ECG appointments that can be delivered which will provide a more timely response to requests for ECGs.

Staff will have the opportunity to develop and focus on the tasks and functions most appropriate for their role.

Care will also become more standardised and a reduction in variation should be achieved through the introduction of a skill mix and clear documentation around roles and responsibilities.

The project will also form a platform for learning to take the skill mix approach into other areas of diagnostics.

How will the project be delivered?

On order to deliver the project we have already involved:

Consultant cardiologists: The consultants have already been actively involved in developing this idea and would like to see this move forward

Technicians, consultants, support staff, admin staff from within the service: Mapping sessions to develop ideas and a process.

Patients: will be involved to ensure we understand their experience of the service before and after.

Q members: Will be consulted to network and gather ideas and experience around skill mixing of staff and the impact of this.

The change will be delivered within a project management framework, capturing risks and issues and lessons learned along the way.

What and how is your project going to share learning throughout?

The project will demonstrate the impact of staff skill mixing ensuring staff focus on the right elements.

The project will develop a toolkit for how to approach skill mix across diagnostic services in order to reduce variation and increase capacity and consistency.

The learning can be shared through online forums (Q community network), throughout the Trust and through other NHS forums where this may be useful (e.g. NHS Future Collaborative).  Progress updates will be provided throughout the Trust and other forums that would like to hear about the progress.

How you can contribute

  • Advice
  • Information
  • Prior learning
  • Collaboration
  • Constructive feedback

Plan timeline

1 Jan 1970 Map current service delivery
16 Jul 2019 Adapt as required and test again
16 Jul 2019 Develop PDSA cycle
16 Jul 2019 Develop new process
16 Jul 2019 Feedback on progress and next steps to the community
16 Jul 2019 Identify other areas where this could be used
16 Jul 2019 Identify requirements to ensure the new process is sustainab
16 Jul 2019 Identify staffing requirements at each stage
16 Jul 2019 Implement new process accross the service
16 Jul 2019 Review outputs of PDSA
16 Jul 2019 Undertake PDSA cycle

Comments

  1. A 'standard work' methodology may be useful during the execution of this project. Please have a look at https://q.health.org.uk/idea/2019/process-management-how-to-make-qi-outcomes-more-sustainable-and-scal/ and see if our two projects can collaborate.

  2. Hiya! Are ECGs performed by your cardiac physiologists as well as technicians? The IQIPS standard, endorsed by CQC, applies to cardiac physiology services. The biggest part of IQIPS is establishing procedures for tasks such as ECG, which facilitates a reduction in variation.

    I'm happy to provide some guidance on this, it may help future proof if the Trust works towards IQPS in the future!

    1. I would really appreciate it if you could send me the information through if that's ok?

      Thank you, Marianne

  3. Agree that process management might be a good approach to kick things off with some mapping.

    1. Thanks Sarah, I think that this is a really good idea and will build this into the more detailed proposal.

      Thanks for taking the time to comment.

       

  4. You have mentioned 'tasks' and 'functions' and 'standardized care' also reduction in variation. Have you considered 'Process Management'?

    1. Hi thank you for your comments.  I agree, I think that this would be the best approach and will build this into the more detailed proposal.

      I really appreciate your feedback.

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