Somerset NHS Foundation Trust (SFT) provides acute, community and mental health services. In November 2020, during the pandemic, we successfully bid for capital to increase ophthalmology day surgery capacity. In July 2021, the new Ophthalmology Theatre Suite (OTS), which comprises one operating theatre, a day ward, and changing and staff facilities, opened to its first patient. Here are some of the ways that we made this happen in just 8 months.
1) Governance
We set up a Design and Build Steering Group at the beginning of the project that engaged all stakeholders including the future users of the new unit. The SFT Clinical Director, chaired the group. Other stakeholders included senior clinical and managerial leads, the Matron, the Sister, the Capital Projects Team, and a Quality Improvement Advisor.
2) Commissioning Plan
A detailed Commissioning Plan was created. This documented contained all the actions required from each SFT department, with dates and dependencies. Actions were documented by the areas themselves. The Capital Projects Manager ensured that the plan was documented to an appropriate standard, actions were completed, and issues escalated.
3) Communications
Throughout the design, we kept all SFT staff appraised of the design, construction and mobilization of the OTS. To do this we shared progress on the project fortnightly in the all-staff bulletin.
4) Simulation Testing of the OTS
We used simulation to ‘stress test’ the new OTS before it opened to ensure that the building and the processes within it were safe and efficient, and identified any areas of concern (latent threats). Three different scenarios were simulated. Each scenario was run twice with separate groups of staff, allowing different perspectives on the process. Members of the SFT Simulation Team managed and supported the simulations, playing the role of patients and recording and categorizing the latent threats. After the simulations latent threats were reported to the clinical stakeholders, and the team developed an action plan to mitigate them ahead of the unit opening.
5) Enhanced sign-off
As is usual, the Capital Projects and Estates teams were responsible for ensuring that the building met the design specifications. However, they were not in a position to provide assurance that the unit was safe to undertake patient care. We required each department to sign off that the building was ready and safe for patient use in their own area. In addition, we added an additional step of Executive sign-off to provide assurance that the OTS was clinically and operationally safe, that risks had been identified and satisfactorily mitigated, and due process had been followed. A compilation of the critical documentation describing how the team had ensured the safety of the OTS was sent to them to review. A sub-group of the Executive Team, including the Chief Operating Officer, Chief Nurse and Clinical Medical Director, conducted a walk-around of the unit and made final observations and recommendations before giving their executive approval for the opening of the unit.
You can see and download the Simulation Observation Log Template. HERE
Look at the areas tested during simulation HERE
Understand the roles and responsibilities HERE