Trains, Planes and Ambulances
04 Nov 2016
I’m almost two months into the scheme and I’ve been lucky enough to have filled every moment with something new and different.
I started with a month of orientation days shadowing staff across the NHS and beyond. My month was designed to follow a patient’s journey through the multitude of services provided by the NHS, whilst also seeing some of the vital services that aren’t directly in contact with patients. I’ve travelled all over Leeds and Yorkshire, in cars, buses and trains, to cover as many different experiences as possible including;
- A 12-hour shift with paramedics that transformed into 14 hours as we travelled across Yorkshire on calls,
- Understanding the huge range of patients A&E receives on any given day, from chest pains and traffic accidents to a man being attacked by a bull,
- Watching open heart surgery and the level of communication needed between every medical professional to take a patient off by-pass,
- Observing discussions by midwives on how to change community services in response to a changing community,
- Appreciating the level of compassion needed to support patients and their family during their final days at a hospice, and to support fellow staff in these environments as well,
- Seeing how changes in one department can cause changes in a completely different and seemingly separate department, such as new postal practices in Estates and Facilities meant Outpatients had to review when they send out appointment letters to reduce non-attendances at clinics.
Something I took away from my visits was that the NHS is a huge network of services, each evolving to adapt to its own pressures and to embrace new technology, but every service is dependent on another. When one service changes a practice, or encounters a difficulty, it is likely that will impact another service and catalyse a change in that service. The staff I shadowed approached every day as an opportunity to implement ideas to improve their service and were always aware of how they impacted other services. For example, I visited a community nurses’ health centre on a Friday and some of the senior nurses assigned to work the weekend shift called in sick. There was instantly a concern how the area would support discharges from hospitals to ensure there would be ward beds available over the weekend. Within a few hours neighbouring health centres were calling to offer their support if needed, other nurses from the centre were rearranged and normal weekend service resumed.
The connected nature of the NHS and dedication from its staff is something my trust is trying to capitalise on, as if a service is empowered to improve its performance then that will help another service improve theirs. Leeds Teaching Hospital Trust is one of five acute-care hospital trusts in the country working with the Virginia Mason Institute to implement their bespoke management system, which lead the Virginia Mason hospital in Seattle to be considered one of the world’s safest hospitals. During my orientation, I attended a training session to start understanding how I can implement the method to improve safety and quality wherever I go. I never thought building paper aeroplanes could teach me so much about how to look at processes to make them more efficient and, ultimately, to lead to better patient outcomes.
Now that I’ve spent a few weeks settling into my first placement I’m already thinking about those paper aeroplanes again. I’ll be the Business Manager for the trust’s laboratory service which analyses blood and tissue samples for types of cancer. They have never had a business manager before so they don’t know what my role will entail and I know nothing about cancer or biomedical science so it will be a learning experience for everyone. My placement is a little different from others as I don’t have much contact with patients and yet without this lab many patients wouldn’t be able to receive personalised and effective cancer treatment.
Over the next year, I’ll be helping them to expand their service to support other trusts and clinical trials, as this service is one of a few areas of the trust which makes money and, therefore, supports other services. However, I also will be helping the team face the challenge of losing vital scientific experience as several senior scientists are due to retire soon.
I spent my first few weeks talking to every member of the team to develop an organisational structure, something they’ve never done before, and to properly understand the different areas of the lab. I can’t stress enough how useful it was to spend time with every staff member as everyone had a different perspective of the challenges and opportunities the team faced, and had different ideas on how to proceed in the future.
How do my paper planes fit in? Well, over the next few weeks I’ll be developing sample pathways, rather than patient pathways, to understand exactly what happens from the moment a sample enters reception to the moment a diagnosis report leaves the reporting room. Then I’ll use the lessons learnt from my plane building sessions to see where possible improvements to how samples are processed can be achieved.
Every service in the NHS is connected. So, whilst I don’t have day-to-day contact with patients, it doesn’t mean I can’t help improve their experience within the hospital. If I can remove the delays, senior staff have more time to train newer staff, the entire lab can expand to process more samples, and ultimately patients get their results quicker so their own pathway is improved. I make it sound simple, but something else I’ve learnt these past few weeks is that simple questions don’t always lead to simple answers, but that hasn’t stopped me from asking.