Redesigning Cardiology Services at Warwick A Personal Journey

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Redesigning Cardiology Services at Warwick A
Personal Journey

• Claire Davenport
• Cardiology Unit Manager
• 16th May 2008

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Background 1998-2006

• Cardiology inpatient services delivered in two
  areas, CCU Malins.
• Managed by two separate ward managers, two
  completely separate entities.
• Never the twain shall meet!

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2006

• Decision taken as a result of organisational
  change that CCU and Malins could be managed by
  one ward manager and run as one unit.

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And the lucky person?

• ME!

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My Background

• AE ü
• Emergency Assessment Unit ü
• Night Co-ordinator ü
• General Medicine ü
• Rheumatology/Dermatology ü
• Cardiology û

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Remit

• The remit was to take on the management of two
  clinical areas, which were historically run as
  two independent wards, and to merge them into one
  effective and efficient unit with a shared
  budget, workforce, resources and vision.

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Barriers

• The wall
• Inequity in care delivery
• Distribution of staff
• Consultant perception
• Reputation of Malins ward
• Reconfiguration
• My lack of Cardiology experience

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Key achievements

• Successful combining of two budgets and resources
  resulting in a cost saving of 15K on drugs and
  stock between the two areas.
• Implementation of an effective working pattern
  between the two areas, which has allowed the
  development of a cardiac outreach team to improve
  patient access to cardiology, services and reduce
  length of stay.

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Key achievements

• Rotation of all staff through both areas to
  ensure appropriate skill mix and knowledge base
  with a positive impact on patient care
• Appointment of Band 6 Clinical Sister onto Malins
  with extensive cardiology knowledge/experience.

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Key achievements

• Engagement of consultants, junior medical staff
  and nursing team in working together as a more
  cohesive team with a shared vision of cardiology
  service delivery.
• Empowerment of staff to take ownership of service
  delivery and cardiology inpatient services
• Extensive cardiology education programme

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Key achievements

• Transparent pathways for Cardioversion and
  cardiac rehabilitation resulting in income
  generation of 100K
• Engaging consultants and IT department to ensure
  all activity is recorded for ad hoc attendances
  resulting in income generation of 75K
• Raised profile of tariffs and importance of
  activity recording with all members of cardiology
  team.

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How ?

• Lean methodology/ productive ward
• Leadership
• Support / Teamwork
• Passion for patient care

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Lean

• Efficient service with minimum waste
• Handovers
• Transparent pathways
• Drugs rounds
• Housekeeper role
• Fostering Ownership

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Leadership

• Having a vision and articulating it.
• Putting patients,relatives carers at the centre
  of the vision
• Effective dynamic communication
• Displaying encouraging innovation
• Motivating developing staff
• Achieving delivery
• Inspirational
• Being a facilitator
•  

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Leadership

• Asserting the importance of audit bench marking
  processes
• Empowerment
• Demonstrate motivation to transform improve
  services
• Clinical credibility

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Support / Teamwork

• Internal Team
• Other Internal Departments
• Cardiac Network

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Passion

• Passion for patient care and essential nursing
  skills is always transferable

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Bed of Roses
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Long Way to go