implementing collins at frimley
DESCRIPTION
Implementing Collins at Frimley. Mrs. Geeta Menon Director of Medical Education Frimley Park Hospital NHS Foundation Trust. Collins report. Stakeholder Discussion Groups. Chief Executive Officer and Medical Director - PowerPoint PPT PresentationTRANSCRIPT
Implementing Collins at Frimley
Mrs. Geeta MenonDirector of Medical Education
Frimley Park Hospital NHS Foundation Trust
Collins report
Stakeholder Discussion Groups
• Chief Executive Officer and Medical Director
• Clinical Directors, Heads of service, FTPDs and Consultants in charge of rota
• Trainees
Initial response
• Changing the mind set of colleagues
• Discussion around training and service provision
Key themes and challenges• Options of integrating community placements
• Service delivery and effects on rota
• Links within the community
• Opportunities
Trauma & Orthopaedics
• Fracture neck of femur pathway
• Working with physiotherapist and occupational therapist
Surgeons
• Upper GI and Breast surgery
• Phyllis Tuckwell Hospice
Urology
• Community urology clinic with specialist nurse
• Incontinence clinic
Obstetrics &Gynaecology
• Community midwife
Paediatrics
• Community paediatrics
Ophthalmology
• Diabetic screening programme
Pilot• Urology
• Trauma and Orthopaedics
• Surgery
Results of Pilot
• Pilot in T&O and Urology
• Trainees views
NOF Fracture Pathway
Dr. Serjevan Kalsi, Dr. Leila Mohamed, Dr. Thorrmela Vijayaseelan
F1 Doctors Orthopaedics, Frimley Park Hospital
Pathway Outcomes
• Reduce variation in length of stay, reduce mortality and re-admissions
• Surgery within 24 hours at FPH• Early mobilisation• Multi disciplinary team• Discharge
– Farnham/Fleet– Home +/- Care package
Farnham/Fleet
• Rehabilitation Centres• Small Wards• Consultant Led Beds• F1 Review Daily• 1-1 Consultant Contact• Daily Physio/OT input• Experienced Nursing Staff
Home• No Orthopaedic follow up
• No further OT input – Extra facilities in place
• Physiotherapy Outpatients
Intermediate Care Team
• ‘Promotion of independence & Safety first’• Aims to build confidence in the home
– Initial Interview– Mobility– Transfers– Domestic activities and Activity tolerance
Advantages of Project• Realistic process of discharge
• Highlighted gaps in holistic care
• Not just a simple social history
• Are patients coping?
• Recognising potential follow up
Disadvantages of Project
• Difficult to get time off– Trauma, Post Trauma, Oncall Dedications
• Difficult to co-ordinate visits
Recommendations
• Incorporated into Rota/Taster Weeks • MDT Attendance
• Presentation at Trauma Meetings
Thank you
Community Experience
Dr Emma Humphreys
FY2 Urology
Frimley Park Hospital
1 day at Fleet Community Hospital Bladder Cancer CNS Haematuria Clinic Flexible Cystoscopy Intravesical BCG Consultant OP clinic
Advantages
Off-site so free from ward jobs Enthusiastic nurse willing to teach More time for learning Able to carry out procedures Observation of other OP Ix OP clerking new pts 1 to 1 with Consultant DOPS/CEX
Difficulties
Rota challenges Liaising with DNs Incontinence clinic proved impossible Relevance to job Mostly observation
Recommendations
Build into rota 5 days in 4 month placement sufficient Placements to be organised Utilise experience of Nurse Specialists
Thank you
Results of Pilot
• Trainers and service provision
• Community
• Roll out to all posts in August 2012
Take home message
• No easy answers• Engagement from
- Leadership i.e CEO Medical Director- Middle management i.e Clinical Directors, Heads of Service, FTPDs, Consultants in charge of rotas- Trainees
• Feedback