Embrace a culture of continuous improvement to push the art of the possible in Ward Accreditation

“Our ambition is to be the best we can be. Not to always score 100% and create a 'sea of green' to but work as a team to identify what's wrong, how to change and hold ourselves to account for driving the changes. Technology is helping us as every step.”

Les Porter, Associate Director of Nursing, WUTH

Over a 12 month period the respiratory ward at Wirral University Teaching Hospital (WUTH) was transformed - moving from 11 vacancies and worryingly low staff morale. To zero vacancies and a ward ‘full of smiles’ from patients and all the newly engaged staff.

How was this achieved?

The ward team embraced new technologies and improvement processes, to became 100% harm-free, and an inspiration for best practice, not only to other wards but other hospitals.

A WISE Programme was created

The priority for the team at WUTH is to constantly push to deliver high standards of quality. To ensure the care provided to patients is personalised and safe. The Wirral team created WISE - which stands for Wirral, Individual, Safe Care, Every time and has become the standard for outstanding ward accreditation within the Trust, and beyond.

Based on the model developed at Salford, the WISE ward accreditation process encompasses additional elements to ensure local policies are accurately referenced. Wards are scored using the "Ward Accreditation Scoring Matrix" with those achieving consistent and consecutively high scores awarded WISE Ward status.

Rising to the ward accreditation challenge

Prior to WISE Accreditation, wards were reviewed annually, and like many Trusts the process was long and cumbersome, requiring time-consuming manual processes.

WUTH is a forward-thinking Trust, and selected Perfect Ward to provide a new digital solution to support their drive to pursue excellence and deliver greater efficiency in the process by reducing duplication, bureaucracy and create an engaging review process with high levels of transparency.

The team on Ward 38, had their first WISE ward accreditation inspection in January 2019 and received a Level Two (amber) result.

The newly appointed Ward Managers along with the multidisciplinary team were disappointed and immediately started to develop an improvement plan - the stated goal was to attain Level Three (Green) by their next inspection.

Over the next the ten months, the team performed 298 inspections, covering:

  • Hand Hygiene
  • Adult Harms Prevention
  • Ward Managers
  • Matrons Inspections
  • Controlled Drug Management
  • Medication Management
  • House Keepers
  • Mealtime Observation

Results were discussed in daily "safety huddles" and at ward meetings with action plans developed to rectify any issues identified.

Results were also presented in the monthly newsletter to all staff. Crucially these steps were planned and not seen as negative but as an enabler to improve. Best practice suggestions for improvement and specific actions were published.

Staff used Perfect Ward to review results from other wards within the Trust, learning from others about how to improve the care delivered became an essential behaviour to foster a greater sense of ownership across all staff.

In October 2019, the team’s hard work and dedication paid off. They received a Level Three result for their WISE ward accreditation.

WUTH’s Continuous Improvement Model requires ward teams to undertake a series of self-checks. Self-checks allow clinicians to identify and correct any issues at source without waiting for results of their accreditation inspection. Staff have responded positively to this increased level of responsibility. Staff know that management see them as accountable for delivering improvements and see low scores not as a 'stick to be beaten with' but an objective to resolve through the correct interventions.

“For the first time, we have access to a tool that allows our staff to see how they are doing at a ward level. They are able to respond immediately if required.”

Jenine Kelly, Matron, WUTH.

Perfect Ward has had a tremendous and positive impact on WUTH’s continuous improvement programme. Every ward is provided with iPads to access the solution making it the ideal tool for clinicians and managers on the move. Real-time reporting has allowed staff to address issues immediately, empowering them to make changes and drive quality improvements.

Data from Perfect Ward migrates to the Trusts BI Portal multiple times per day, populating a data base that is used from Board to Ward. The solution has encouraged active involvement from all levels of staff - from designing audits to understanding what the results mean. Ward teams have even used it to develop quizzes, engaging staff in a fun way and boosting team morale.

Additionally, the solution has eliminated large amounts of administration freeing up time for staff to care for patients. WUTHs Wards have been significantly improved since implementing Perfect Ward as teams have embraced using the suites of inspections and undertaken actions to improve patient safety, experience and their scores!

About Wirral University Teaching Hospital NHS Foundation Trust
As Wirral’s largest employer, Wirral University Teaching Hospital NHS Foundation Trust (WUTH) is the thriving heart of the local community. Comprising Wirral’s only Emergency Department, it is one of the biggest and busiest acute NHS trusts in the North West. WUTH’s 6,258 strong workforce serves a population of approximately 400,000 people across Wirral, Ellesmere Port, Neston, North Wales and the wider North West footprint at two main hospital sites and at two health centres in the community.

For more information, visit www.wuth.nhs.uk

Or watch the video to hear Les Porter talk about the programme at Wirral University Teaching Hospital.