2 / jab done! 4&5 / urgent and emergency resilience 7 / hola ... story/inside story...resistant...

October 2015

2 / Jab done!4&5 / Urgent and emergency resilience7 / Hola! Ola! Ciao!

InsideStoryOctober2015.indd 1 13/10/2015 15:08:31

2 News

Meet the teamProduced and designed by: The communications department

Front cover photo: Don’t forget to send us your #flujabselfie

Inside Story magazine is published by UCLH (University College London Hospitals NHS Foundation Trust) for our staff

Contact usIf you have any information you would like included in Inside Story, or on Insight, contact: Communications Unit, 2nd Floor Central, 250 Euston Road, London NW1 2PG. Email: [email protected] Tel: ext 79118, Fax: ext 79401. Visit us online at: uclh.nhs.uk

Chief nurse Flo Panel-Coates and infection control nurse Suzanne Carroll.

Research led by UCLH’s Biomedical Research Centre director has shown that a drug used for over 50 years as a diuretic could revolutionise treatment of resistant hypertension.

In up to 10 per cent of patients with high blood pressure it is difficult to control even when three or more drugs are used together. These patients have “resistant hypertension” and are known to be at particularly high risk of stroke and heart attack.

Now the study led by Professor Bryan Williams (pictured) has found that adding spironolactone, first developed in 1959 as a diuretic, is substantially more effective than other blood pressure-lowering drugs.

Prof Williams said: “The

results of the study offer a spectacularly cost-effective approach to a previously intractable problem. These are some of the most difficult to treat patients with high blood pressure and we have identified a very effective treatment that is both cheap and readily available world-wide.

“This has the potential to influence the treatment and

improve the outcome, for over 100 million people with this condition globally.”

Results of the study also suggest that the predominant underlying cause of resistant hypertension may be salt retention – partly a result of reduced diuretic doses in recent years, and partly a response to the adrenal hormone, aldosterone.

50-year old drug could revolutionise blood pressure treatment

Chief nurse Flo Panel-Coates and medical director Jonathan Fielden were among the first in the queue to have their flu jab at the launch of the UCLH vaccination campaign. They are urging other front-line staff to follow suit. The vaccination remains the most effective way of protecting your patients, yourself and your family.

Check out Insight flu pages and local cascades for details on vaccination clinics and mobile sessions. UCLH expects to vaccinate a minimum of 75 per cent of front line staff. Remember to take part in the selfie competition – and vote for your favourites!

Jab done!


3News

Word on the Tweet...

Follow us: @uclh@BtSteph Thanks to the Linac D team @uclh for all their care the last three weeks. Go Radiographers! #radiography #radiotherapy

@pregcitygirl New boy on the block #baby PCG has arrived . Thanks to the amazing#midwives @uclh

@cristinamassei Big shout out to dr Iskaros and his team at @uclh + nurses and staff! You make @NHSEngland worth fighting for! #NHS #Uclh

@LookUpAtStars V. reassured by amazing #surgeon &#radiotherapy & ultrasound doctors today @macmillancancer centre @uclhGrateful

@ pstilwell 45 mins in and out of @uclh A&E. Brilliant staff, brilliant service. All for a broken finger. I love our #nhs

Do you have a colleague who goes above and beyond on a daily basis? Perhaps a colleague who exemplifies our values through their work?

The Celebrating Excellence Awards 2016, funded by UCLH Charity, are your opportunity to show recognition to those colleagues who go that extra mile. Nominations will be open from November 2 – January 4.

Last year our judges had a difficult time trying to choose winners from the exceptionally high calibre of nominations that

were submitted. They were impressed by the hard work, dedication and commitment of staff. The judges are looking forward to receiving your nominations and the winners will be announced in early 2016. The ceremony will be held next spring.

A golden envelope will be given to our 2015 Celebrating Excellence nominees who will all be contacted shortly with details of how to collect them. Good luck to all of this year’s nominees! Nominate via the Celebrating Excellence page on Insight.

Celebrating Excellence Awards 2016

We’re now a month into the UCLH annual survey but there’s still time to get your voice heard. Many of you from across our sites and a wide range of specialities have responded telling us what you like about working here at UCLH and the things that we could do better.

The annual survey is one of the easiest ways to get your thoughts and opinions heard by the Board. Last year your feedback helped us make the following improvements:

> The staff suggestion scheme was launched and more than 100 suggestions have already been submitted. Initiatives include the Good Deed Feed where more than 650 of you have recognised your colleagues for living our values.

> You said the quality of your appraisals had improved but could still be better. We now offer management training and assess your view of the appraisal quality.

> You highlighted a need for better personal development opportunities. We’ve increased the emphasis on learning and development with a number of new programmes and have also launched The uclh Institute.

Don’t miss out on the chance to help shape 2015/16 – if you haven’t already done so, please complete your survey by Monday 30 November. If you have any questions, contact [email protected] or call ext 77778.

Staff survey 2015 – tell us what you think

Barbara Windsor, host of the 2015 awards.


Spotlight4

Attendances are back up and patients are getting sicker. There is no let up on the pressure on our urgent and emergency services, but winter adds increased pressure. Like our Emergency Department we need to get operationally fit ready for the colder months.

Winter brings increases in influenza-like illnesses, respiratory ailments, worsening heart conditions and longer term conditions. Accidents due to adverse weather conditions and seasonal illnesses such as flu (remember to get your jab!) and norovirus add complexity and can also affect staff.

Like hospitals across the country, UCLH came under intense media scrutiny last winter and this spring. Meeting the four-hour A&E target is just one measure of our standard of care; last year was challenging but our performance was among the best in London.You can help us regain that leading performance by following our golden rules of patient flow, making sure patients are seen, treated and returned to the comfort of their own homes as quickly as possible.

Urgent and Emergency Resilience

1

“An acute bed isn’t necessarily the best place for some patients. Your patient might be better off being cared for by the ambulatory care team, or being cared for at home by the UCLH@Home team.”

Dr Nicoletta Gaston, clinical lead for AMU

Top tips...

> Don’t admit a patient into hospital unless absolutely necessary – think ambulatory emergency care, Outpatient Parenteral Antimicrobial Therapy (OPAT), day case pathways and rapid access clinics before thinking bed.

> If a patient does need an inpatient admission, they should be on a pathway and alternatives to staying in an acute bed should be considered every day.

Every patient is on a clear pathway known to patients and staff and cared for in the right clinical environment. 2

4All therapy specialties and diagnostic departments are working on reducing the time it takes to see a patient from point of referral. Your inpatient should expect to wait no longer than 24hrs from referral to receiving care or diagnostic procedure – particularly if needed to facilitate a discharge home.

To avoid unnecessary delays ensure all referrals are made promptly and recorded on CDR or your ward visual status board. Think discharge to assess rather than assess to discharge.

Need for therapy or diagnostics input does not cause a delay for your patient.

5

Make sure that...

> Patients and relatives are given a predicted date of discharge (PDD) when they arrive. It’s important to plan for their departure from hospital, from day of admission.

> Put an accurate PDD record in our systems – this helps to know what capacity is coming up in the next 24-48 hours.

> Follow the new discharge checklist, and use the support and expertise provided by our discharge support teams.

> Remind patients that we will aim to discharge them before lunch on day of discharge wherever possible.

Patients are given a predicted date of discharge on (or before) arrival.

FL

OW GOALS • FLOW GOALS

•

FL


•FL


•

FL


•


Spotlight 5

2

“See patients in the right order – don’t follow the bed numbers – and get investigations like blood tests and imaging done promptly. No one should wait more than a day for tests and results. After the sickest

patients have been reviewed, give priority to those who can

be discharged first.”

Jonathan Fielden, medical director

Some of our wards are going even further and undertaking ward rounds more than once a day (seven days a week) to review patients and work as a multi-disciplinary team to check on their needs and progress. Acutely sick patients need seeing more frequently.

Visual status boards on the wards give key information about a patient to all clinical teams involved in their care. Every patient in an acute bed needs a daily senior review.

Ward rounds occur with a senior decision maker every day with the senior nurse. 3

“Electronic discharge prescriptions should be completed by 4pm the day before the patient’s discharge date. Pharmacists should be notified as soon as a discharge prescription has been prescribed so it can be clinically screened then scheduled for dispensing. If discharge prescriptions need to be prepared on the day of discharge the medicines can be delivered to the Patient Lounge so patients don’t need to wait on the ward for their medicines.”Kenny Mole, pharmacist

What you can do... > All patient electronic TTAs (medication to take away)

should be completed and sent to pharmacy by 4pm the day before a patient is due to be discharged, meaning they’ll be ready first thing in the morning.

> If your patient leaves the ward to go the patient lounge, their medications can be collected there.

Medication does not cause a delay for your patient.

“The Integrated Discharge Service works with all ward multi-disciplinary teams to lead, support and provide expertise on complex discharge planning which will be done using our new discharge checklist from this winter. When patients are ready to leave we can transfer from the ward to the Patient Lounge with our ‘Pack and Go’ service. The Patient Lounge provides a place of comfort where they can wait an hour from arrival for transport home and their TTAs, with food and drinks on hand.”

Julie Pluck, senior discharge nurse

Make sure that...

> Follow the new discharge checklist, and use the support and expertise provided by our discharge support teams.

> Remind patients that we will aim to discharge them before lunch on day of discharge wherever possible.

Patients are given a predicted date of discharge on (or before) arrival. 6

“Wards must update their bed state in real time, so we can see empty

capacity straight away by looking at our electronic “Ops Centre site

and ward dashboards”. This allows us to reduce the number of patients who wait too long to be admitted, and removes the need to call or visit the wards to collect this information manually.”Lorraine Walton, clinical operations manager

Having accessible real time information about our patients is key to maintaining patient quality and safety and helps us be more efficient in knowing what is needed next for our patients. If your clinical team is not using patient lists – please contact Breid O’Brien on ext 77665 or look on

Insight. Wards should ensure their Carecast bed state is updated with all transfers,

discharges and admissions – as soon as a patient leaves or arrives on the ward.

We are all working from the same information about our patients.

FL


•

FL


•FL


•


6 In the know

Climbing the career ladder – UCLH lends a handA new internal recruitment strategy to nurture our home-grown talent and encourage Band 5 nurses to climb up the ladder at UCLH has reaped rewards for more than 80 staff.

Senior staff nurse Natalie Mills (pictured right) is among those who’ve been promoted to Band 6 following the launch of this initiative six months ago. UCLH now aim to advertise and recruit Band 6 nurses internally, wherever possible.

It was in response to staff feedback: many Band 5 nurses felt leaving UCLH was the only option for career progression.

Natalie, who previously worked as a nurse at North Middlesex Hospital, joined the critical care unit as a Band 5 nurse, a year ago.

She said: “I felt it was the right time to develop my career and my line manager

was really supportive. We talked it over in my appraisal and she encouraged me throughout the selection

and interview process. I like working in an acute setting – I am increasing my skills and knowledge to deal with a wide range of patients with complex conditions and now have the opportunity to study for a BSc at

South Bank University.”It has been a positive move for

UCLH too. “Natalie’s smile is like a ray of sunshine in mid-winter.

She was ready for the next step and I’m glad she could achieve that at UCLH,” said line

manager Wendy Sandajan (pictured left), sister in the critical care unit.

If you are interested in a Band 6 promotion, visit the job vacancies section on Insight.

UCLH@Home – one year onDo you have patients who would benefit from being able to recover in the comfort of their own home as soon as they’re clinically stable? The UCLH@Home team are able to deliver a broad range of services to your patients and can offer home visits up to three times a day. As the service celebrates its first year, we take a look at some of the highlights.

If you would like more information on how to refer a patient, call 03331 039 813.

*Figures correct as of September 2015.

281PATIENTS

SEEN

45EARLY

DISCHARGES

BED NIGHTS SAVED

1680PRESSURE ULCERS

AND

MRSA CASES

0

3207Patient visits

97%the average

percentage of patients who

were very happy with the service


7

Consultant in sport and exercise medicine at the Institute of Sport, Exercise and Health and team doctor for Harlequins Rugby Club, Dr Courtney Kipps is no stranger to the multitude of injuries associated with rugby. We caught up with him before he headed off to join the elite medical professionals who will be supporting players in the Rugby World Cup 2015:

How did you feel when you were asked to support the players in the World Cup? Very excited! It’s not every day you have the world cup in your back yard so playing even a small part is a big honour. What’s the strangest rugby related injury you’ve seen?A dislocated thumb... on a streaker tackled by a security guard! What are you looking forward to most about working at the World Cup? Interacting with and learning from the best rugby and sports medicine doctors from around the world.Rugby or football?Rugby is more physical; more complicated but also has more injuries. Football is faster and simpler. Both produce very talented athletes with extraordinarily physical and technical skills. I grew up playing rugby so it has the edge for me. I can’t get through the week without?Exercise.Who are you backing for world cup victory? It was England. Now my head says New Zealand but South Africa will also bounce back.

In the know

60-seconds with... Dr Courtney Kipps

Active at work

Simone, Marta and Diana (pictured) are among more than 30 new nurses who’ve recently been recruited from Europe in a drive to reduce staff vacancies and maintain patient safety.UCLH is committed to reducing reliance on agency staff to fill the gaps and is recruiting staff nurses from Spain, Portugal, Italy and Romania.So how are they finding their new life in London?Marta Sales Perez. Valencia, Spain. Works at the NHNN day care unit:“It is great here. Everyone on the unit has made me feel very welcome. I need to study, to do assessments before I can carry out different techniques so it is harder work than in Spain

– but I prefer it here. I am not allowed to do anything unless I am 100 per cent sure and 100 per cent safe and that’s good.” What do you miss most? “The weather – I feel cold!”Simone Cattarin. Rome, Italy. Works on T6:“I think this is one of the best choices I’ve made in my life. My setting is going well, or I hope so! I have had to learn a new way of working – in the hospital where I have been trained the bleep number doesn’t exist! The simple question that everyone asks “is everything ok?” In my opinion mean a lot, it means you’re not alone and you can ask for help easily if you have a question, doubt or problems. It’s very helpful!”

What do you miss most? “Italian food :) but I can survive!”Diana Aguiar. Near Lisbon, Portugal. T10 elderly medicine:“My mum has been a nurse for 35 years and she taught me that it is a good feeling to look after those that need help. I’m really excited to start working here, such a big place! It’s my first job after four years of study and I am really looking forward to putting everything I’ve learnt into practice. I am really motivated to keep improving and to get better and better every day.”What do you miss most? “The beach – in Portugal I live five minutes walk away.”

Yoga and meditation in the park was top of the agenda during the quality and safety team’s latest monthly meeting.

They were among many staff who stretched, biked, ran and walked as part of The Get Active at Work Week to promote a healthier lifestyle and encourage UCLH staff to integrate activity into their working day.

Hola! Ola! Ciao!

Winners: The Quality and Safety Department having a yoga and meditation class in Regents Park following their monthly meeting.


8

This cartoon was published in the 1978 Middlesex Hospital Journal.

The Middlesex Hospital rugby team was beset with problems in the first half of the 1978 season: they had not recruited many new players, and at one point more than half the team was out with injury. At the mid-point they had played 15 games and lost 10 of them. As the injured players returned, they looked forward to a better second half of the season.

Love the archive? Follow UCLH on instagram for more archive gems. #artsheritage

Inside out

It is a sight guaranteed to make you smile: a grown man clutching his beloved ukulele.

“When I took out my ukulele in the café, staff came up and asked questions. They were curious about such a small instrument. It looks cute and people can’t help but smile! said Joey Clemente, a research practitioner in Imaging.

For such a teeny, tiny object, the ukulele packs quite an emotional punch. “It sounds so sweet … very calming. I feel like I am on a beach, on an island, swaying in a hammock.”

But it all started during a musical adaptation of Midsummer Night’s Dream.

“I was watching the show and heard two of the characters playing ukulele. I thought ‘I want to get one of those!’”

So he did. The next day he popped out to Tottenham Court Road during his lunch break and bought one, for £49. “It was a bit rubbish and kept needing retuning. But it was a start.”

An evening session with a drop-in ukulele group further fired his

enthusiasm. “I walked into a pub near work and there were 30 people of all ages playing music. It gave me goose bumps. Such a lovely sound – its simplicity is its appeal.”

A member of the lute family, the instrument has four nylon or gut strings, was one of the instruments played by George Formby (along with the banjo), originated in Portugal and roughly translated its name means ‘jumping flea’ in Hawaii. What else is there to say about the ukulele? Anything else? Well, to be honest, not much.

Joey who also taught himself to play acoustic guitar, the concertina, mouth organ and ocarina has recently established a ukulele group for UCLH staff which meets every week.

“It’s more fun to play music with others and it is a great way to learn and improve. I would love to know how many other ukulele players there are at UCLH. Please come and join me!”

So, what are you waiting for? You can contact Joey on [email protected].

Archive

Secret lives

A new team was welcomed on board at the start of October when the staff of Sir William Gower ward at the Epilepsy Society in Chalfont St Peter transferred to UCLH.

The purpose-built unit is a 26-bed facility offering video-EEG telemetry, MRI, drug level monitoring, neurology, neuropsychiatry and psychology to 1,000 patients a year. Although UCLH has employed the

ward sister for the service, a team of around 25 staff has historically been provided by the Epilepsy Society.

Cathy Beaton, senior matron for Queen Square, said: “This is a significant change and is the right one for both staff and patients. The team will benefit from having stronger line management, and more opportunities for training and development.”

Epilepsy team transfer


2 / jab done! 4&5 / urgent and emergency resilience 7 / hola ... story/inside story...resistant...

Documents