Engaging with staff and patients to redesign an endoscopy pathway

As part of Sherwood Forest Hospital’s Achieving Best Care programme we were invited to support the application of Lean principles to the Trust’s Endoscopy Services.

The aim was to improve the department’s capacity, productivity and planning to enhance patient experience, employee engagement and potential income.

Our experience, in our own company, has shown that a high level of employee engagement is central to ensuring that any new way of working is sustained.

We began by engaging the department’s clinical and administrative staff with Lean thinking to ensure they understood the project’s objectives and how they would be empowered to achieve them.

Following staff interviews and patient focus groups, the department’s staff worked with us to analyse their current working practices to identify examples of best practice and areas for improvement. An 18-month implementation plan with targeted and measurable objectives was drawn up.

Joint daily communications meetings were introduced for clinical and support staff to ensure effective planning and the raising and resolving of operational issues. These meetings are supported by visual management to provide everyone with a clear, real time view of current performance. This allows problems to be quickly identified and solutions to be developed.

Best practice was captured and recorded in standard operating procedures to ensure efficient and accurate working, and clear audit trails established to ensure ownership and responsibility.

Customer quality of care was enhanced by the review of patient letters to align patient expectations with service provision, together with the enhancement of patient waiting areas and the introduction of text reminders to patients, ahead of their appointments.

At the communications meetings, each staff member is encouraged to suggest ways of further improving the service from both a quality and efficiency perspective. In addition, six monthly engagement surveys and patient focus groups were initiated to generate a further range of ideas.

The following benefits have been achieved:

• 32% reduction in patient non-attendance (Did Not Attend or DNAs)
• 21% reduction in hospital cancellations
• 42% improvement in room turnaround times has helped deliver a 47% reduction in late starts and patient waiting times
• As a result of the excellent engagement achieved, the initial performance objectives are on track to deliver a 25% improvement in productivity and together with cost savings of £385k

Endoscopy is now recognised as a flagship for using staff engagement to achieve operational excellence through the application of Lean and regularly takes part in Trust-wide presentations to share the success of ABC with other hospitals.