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The Productive Series enables NHS organisations to take up the challenges and opportunities that currently face them by improving quality, whilst at the same time making significant savings in productivity and efficiency

Developed by the NHS Institute for Innovation and Improvement, the series helps staff to improve the way they work and the care they deliver.  The main programmes in the series make up the Productive Care national QIPP workstream, which plays a key role in helping organisations deliver their QIPP strategies.

Many organisations who are implementing Productive programmes have achieved real improvements in quality and productivity.  In numerous cases the improvements achieved have come at no extra cost.

Airedale NHS Foundation Trust


Airedale NHS Foundation Trust has drastically reduced rates of MRSA and C-difficile infections by using visual management techniques from The Productive Ward programme.  Crucially, the Trust has also addressed the problem of medication errors on a ward of elderly patients.

Improving infection control


In 2006/07, the Trust was experiencing high infection rates of C. difficile and MRSA.  During the year the number of cases reported was as high as 128 C. difficile and 12 MRSA bacteraemias. Visual measurement techniques from The Productive Ward Knowing How We Are Doing module were used to help bring infection rates down.

Previously there were three to four cases a week on Ward 2, since the introduction of the Knowing How We Are Doing display boards and active infection control measures, the Trust has not seen a case for six months.   The Trust has attributed a year on year cost saving of £177,300 to the avoidance of MRSA and £98,100 to the avoidance of C-diff (figures based on avoided bed day costs reported in the Rapid Impact Assessment of The Productive Ward, NHS Institute for Innovation and Improvement, 2011).

Reductions in medication errors

Staff on an acute elderly ward used the programme to redesign their handover process to make it more efficient. The quality of handover increased but the time taken was reduced to 20 minutes – staff then reinvested this time into medication rounds.

Medication rounds on elderly wards can be complex and increasing the time available to staff to undertake these have lead to a decrease in medication errors.   “When we started work on The Productive Ward in August 2009 there were 32 incidents in one month” says Senior Sister, Sara Robinson.  “In February 2011 there were only four.”

University Hospitals Bristol NHS Foundation Trust

University Hospitals Bristol NHS Foundation Trust used The Productive Operating Theatre programme to help it achieve a £2 million saving as a result of reductions in waiting lists, and improvements in list utilisation.

£2m saved in first 12 months

The Trust achieved a £2 million saving as a result of reductions in waiting lists. The saving was achieved by the Trust stopping waiting list initiatives requiring additional payments to staff by ensuring:

•    Each funded consultant PA was allocated to a fixed theatre session.
•    Team job planning had a robust mechanism to ensure that if a session is dropped it is picked up by another member of the team.
•    A six week look ahead, which tracks sessions that are dropped and whether they have been picked up and that lists are full.

Improvements in list utilisation

Bristol Eye Hospital has sustained 85%+ list utilisation through lists starting on time.  This is also supported by the development and implementation of a “Short Notice Protocol” for second eye cataract patients, whereby patients are brought in for operation with one hour notice.  The new service has been positively received by patients and its success has encouraged the team to extend this to plastics patients within the hospital and the principles are being rolled out across the other four theatre suites.

As financial resources become more challenging in the future, NHS organisations need to find ways to continue delivering safer, more reliable care for their patients that is sustainable.  Working through Productive programmes can help organisations deliver significant improvements in productivity and efficiency, which over time, can be reinvested into delivering greater efficiency and productivity gains.

 

Lynn Callard,National Lead for The Productive Care QIPP work stream, NHS Institute for Innovation and Improvement, will be speaking at Govtoday's forthcoming NHS Efficiency and Productivity Conference on the 13th October at the Brewery Conference Centre, London. Further details can be found here

Written by Lynn Callard
Monday, 12 September 2011 10:10

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