The results of a 7-day working pilot within an acute ­respiratory medicine unit

Martin Chadderton; Sarb Clare

doi:10.7861/futurehosp.4-2-s34

Aims

A 7-day week was piloted in respiratory medicine in October 2015, with the aim being to analyse the effect of this way of working on staff and patient care.

Methods

A multidisciplinary (MDT) approach was adopted, with engagement from clinicians, nursing, physiotherapy, pharmacy, radiology and community teams (including GPs and specialist COPD nurses). The project was led by an acute physician who is the new hospitals clinical lead.

Consultants’, junior doctors’ and nurses’ emergency work was backfilled by the acute medicine team.

Before, during and after the pilot, quantitative (SPC charts with comparison against 2 years of trends) and qualitative data were collected. Patients and staff ranging from healthcare assistants, ward clerks to junior doctors participated in this feedback.

Results

Quantitative results have been summarised below. The most significant results were seen among the qualitative data:

Patients: Wanted to see a consultant on ward rounds and this approach improved communication and feedback.
Junior doctors: Received training and education, received feedback, had opportunities for procedures, felt part of a team but felt stress levels increase with consultant presence.
Workload out of hours: No significant change in workload, found wards with daily consultant ward rounds had clear, succinct plans.
Nurses: Disparity across the wards analysed, issues with feeling valued.
Senior consultants: Found experience rewarding as continuity of care and training juniors, frustrations when diagnostics delayed, physically tiring.

Conclusions

None of the quantitative metrics showed statistically significant change, but the qualitative data illustrated some expected outcomes, ie patient reassurance increasing, and some unexpected, ie stress levels of junior doctors increasing.

The respiratory team are reorganising their services to look at how 7-day care can be provided and this pilot has started the momentum. Results have been shared with the wider organisation as other specialties will be following this model on the journey to the new hospital.