- Increased staff capacity of 5% across district nursing teams from the rapid improvement workshops; this is the equivalent of 3 FTE community nurses
- The amount of time saved overall means that 35% more Band 6 district nursing time is available to deliver patient care.
City Healthcare Partnership (CHCP) is a co-owned community interest company providing a wide range of health and care services to over half a million people across numerous geographical areas (Hull, East Riding, Knowsley, Wigan and St Helens). It is a socially motivated company, with a diversifying portfolio of businesses and a registered charity. Health services include district nursing, sexual health and health visiting.
We were asked to undertake a mini-diagnostic in district nursing which revealed series of issues including varies utilisation of administrative support, no common approach to caseload management or workload, a lot of non-value-adding activity, limited and disordered workspace, a backlog of daily worksheets and difficulty for managers to obtain accurate performance information. We were asked to work with the team to improve service delivery and patient care, standardise practice, increase capacity to reduce costs and re-invest back into service delivery, and get some quick wins to demonstrate the value of applying Lean elsewhere in CHCP.
Using the outputs from the diagnostic work we focused on two Lean Foundation tools – launching 5S in the office and stockroom areas to improve the work environment, and the introduction of an Information Centre to collect and monitor performance measurement and to problem-solve issues arising. We also worked with the team to consider a number of processes in rapid improvement workshops, and to standardise processes in case management. We ran management workshops to ensure that managers were able to lead and role model Lean principles. All sessions involved the team and were interactive and practical.
Within a month of completing the workshops all staff at all offices were using the new processes. Information Centres were up and running with now accurate information and the backlog of activity sheets were completely cleared.
Standardisation and the removal of non-value-adding activity have released capacity to move resource where it is most needed, covering sickness and absences. There is now no worry of ‘that’s not how we do it here’.
Work environments are easier to use and navigate with less time searching for kit or items before visiting patients.
‘The four-day workshops facilitated teams of district nurses coming together and brainstorming current working systems. We were able to standardise ways of working across the city and the process assisted us in reaching consensus.’ Band 6 District nurse.