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From left to right: Liz Wescott (head of clinical healthcare, Oxford Brookes), Jo Atkins, Tessa Slater and Pam Treadwell

Frontline staff at Oxford Health NHS FT are consistently finding time to spend with their patients despite tight budgets and stretched hours. Since 2009 the Productive Care team at Oxford Health NHS FT have worked with 180 of over 200 clinical teams, helping them to develop sustainable improvements that release more face-to-face time with patients.

At a recent Health Matters talk at Oxford Brookes University, Jo Atkins, Tessa Slater and Pam Treadwell explained how a bottom-up approach gives clinical staff control over change to their daily routines. No-one is better placed with the knowledge, skills and experience to embark on improvements that make a real difference to patient care.

An essential foundation for implementing change, Jo explains, is to have a well-organised working environment, know how well you are doing, and be able to see patient status at a glance. That’s knowing what your patients think, what your latest patient statistics are and how, and within what timeframes, their care is being delivered.

So what does sustainable improvement look like, and how does it work? “It’s reducing delays, reducing errors, thinking differently and reducing waste while adding value to patients and staff,” says programme lead, Pam Treadwell. Teams recognise areas for improvement and use the programme toolkit – photos, timing activities, waste management, spaghetti diagrams – to determine how they can sort, set, shine, standardise and sustain their new procedures.

This routine has worked particularly well for our district nurses, who have developed their own systematic routine for signing nursing bags in and out and restocking supplies. Instead of filling their cars with supplies and equipment, the nurses now have efficiently stocked bags with everything they need at hand.

What’s also important is showing how sustainable improvements make a difference to the patient experience, patient safety, the efficiency of the care being given and to staff wellbeing too. Know How We are Doing (KHWD) boards are visual management tools placed in team environments that collate positive and negative information, available for staff, patients and the public to see. It’s a transparent communication about the performance and aspirations of a team, used to celebrate their successes and highlight areas for improvement while including patients in the changes being made to the care they receive.

Productive care recognises how small changes to everyday routines can make a real difference by saving time and resources and increasing efficiency. Even the Productive Care team make changes to their routines – look out for new, electronic KHWD boards coming soon, helping to improve their access and interactivity to staff and patients.