Redesigning Cardiology Services at Redesigning Cardiology Services at Warwick – A Personal JourneyWarwick – A Personal Journey

Claire Davenport Cardiology Unit Manager

16th May 2008

Background 1998-2006Background 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!

20062006

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

And the lucky person?And the lucky person?

ME!

My BackgroundMy Background

A&E Emergency Assessment Unit Night Co-ordinator General Medicine Rheumatology/Dermatology Cardiology

RemitRemit

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.

BarriersBarriers

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

Key achievementsKey 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.

Key achievementsKey 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.

Key achievementsKey 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

Key achievementsKey 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.

How ?How ?

Lean methodology/ productive ward

Leadership

Support / Teamwork

Passion for patient care

LeanLean

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

LeadershipLeadership

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 

LeadershipLeadership

Asserting the importance of audit & bench marking processes

Empowerment Demonstrate motivation to transform &

improve services Clinical credibility

Support / TeamworkSupport / Teamwork

Internal Team

Other Internal Departments

Cardiac Network

PassionPassion

Passion for patient care and essential nursing skills is always transferable

Bed of RosesBed of Roses

Long Way to goLong Way to go