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Leading Better Care - Delivering for Patients

Leading Better Care enables Senior Charge Nurses / Midwives and Team Leaders to deliver better care in consistent, measurable, evidence based way

To achieve this vision, the following aims and objectives have been agreed:

LBC Aims

  • All Senior Charge Nurses, Senior Charge Midwives and Team Leaders will be working in the context of the LBC components:
  • To ensure safe and effective clinical practice
  • To enhance the patients experience
  • To manage and develop the performance of the team
  • To ensure effective contribution to the delivery of the organisations objectives

by March 2013 and able to demonstrate this.

  • Nurses & Midwives will be able to demonstrate  the contribution they make to the quality and experience of care that patients receive under the three themes by March 2013:
  • Safe
  • Effective
  • Person centred

  • Improvement Processes

    When developing practice, make good use of existing data. Build on previous good work and use the expertise available to you.

    You will need the correct tools and techniques to successfully plan, monitor, evaluate and sustain change.

    Key questions

    • How can you assess current practice?
    • What are the key stages that need to be addressed in planning?
    • What is/are the best quality improvement processes or intervention(s) for this change?
    • How do you implement the chosen improvement method?
    • How do you evaluate any improvement in practice?
    • How can you build robust evaluation into the process?
    • What skills/knowledge/expertise are available?

    Consider

    • Data from other national and local initiatives
    • Existing audit/monitoring tools
    • Action research
    • Fourth generation evaluation – uses claims, concerns and issues to look at a specific development
    • Realistic evaluation – considering mechanisms, context and outcomes of change
    • Clinical audit cycles
    • PDSA cycle
    • Process mapping
    • Care pathways
    • Lean thinking – or other service improvement methodologies

    Organisational support

    Quality improvement processes can be supported by systems and structures such as:

    • Clinical governance plan
    • Integrated IT infrastructure that can capture quality improvement data
    • A central team providing information management and project support
    • Systems that coordinate and integration information for different purposes
    • Structures in place to support performance management, risk management, incident reporting, appraisal, controls assurance, complaints, clinical audit, ethical review of proposed projects.

    More on Organisational Support

    The Releasing Time to Care programme helps senior charge nurses and their teams find ‘ time to care’ in ward areas using a range of quality improvement tools.

    NHS boards nominated facilitators to work with the senior charge nurses in each unit.
    Baseline and progress data is collected using:

    • Releasing Time to Care methodology
    • clinical quality indicators
    • and a balanced score card adapted from NHS Ayrshire & Arran.

    “One of the aims of the project was to increase staff time spent directly caring for patients” explains Vicky Thompson, National Programme Leader for Senior Charge Nurse, Clinical Quality Indicators and Releasing Time to Care programmes.

    “Improvement methodologies such as the adapted lean methodology by the NHS Institute for Innovation and Improvement were key to the project.

    “Working in this way helped to demonstrate that the Releasing Time to Care programme can increase the amount of staff time spent on direct patient care, and fits with the use of quality improvement and practice development to support the implementation of policy.

    “The staff time released in the programme supports the implementation of several streams of work including the revised senior charge nurse role set out in Leading Better Care. All of which contributes to improvements in patient care.”

    April 2009

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