Sheffield Teaching Hospitals (STH) is the secondary adult care provider, with over 2000 beds and 15000 staff. Similar to other health systems, Sheffield is under pressure to improve the quality of healthcare at the same or reduced cost, and improve the flow of patients. The Service Improvement team at STH is responding by helping build improvement capability at the front line of a care and supporting this with coaches trained by the UKs only Microsystem Coaching Academy (MCA). Ward based improvement work started with four Respiratory wards (Respiratory Change Room), their success in reducing length of stay and mortality gave the MCA the confidence to test our first learning collaborative in 2015, engaging 12 further wards across the trust.
Building on the learning of the MCA Ward Collaborative and involvement in the NHS Improvement safety initiatives to test we knew we needed to develop new approaches to piloting and spread from 12 wards to 65 wards
Piloting a new approach - Red2Green is a new development to the Trust and there was uncertainty of how it would work locally.
Guidance from the Emergency Care Support Team is to adapt this tool to different contexts. In March 2018, teams from 3 ward areas across 2 different directorates worked together to design and implement a Red2Green pilot for Sheffield Teaching Hospitals. Members of the multidisciplinary team from each area, including Consultants, Ward Clerks, Nurses, Therapists and Transfer of Care Nurses came together, supported by members of the Organisational Development Team, Technology Transformation Team and Information Services Team. This proved to be a very successful way to engage teams in the design of changes that affect them. The teams designed the Red2Green process and flow chart and decided which technological changes would support the pilot on the eWhiteboard and the data set that they would find useful.
The impact has been a sustained 6.5 day reduction weekly average LOS on pilot Geriatric ward and a reduction reduction LOS on D&E pilot ward by 3 days following introduction of board rounds and red2green.
The spread pack, engagement and support from the improvement team and supporting technology has supported spread across 13 medical and geriatric wards at November 2018. Work starts this month to design red2green in a surgical setting.
