Community Nursing Dressings Delivery – Quality Improvement Project

Background

Project led by: Anne Roberts, Operational Lead and Sam Anderson, Senior Community Staff Nurse  

Team: Community Nursing – Shelton and Hanley PCN and Hanley, Bucknall and Bentilee PCN (Stoke-on-Trent

The COVID-19 outbreak forced teams to work differently and explore the required skill mix and skill / task alignment. This work looked to test how the delivery of dressing could be done differently to free up clinical time to care.

Aim

Free up clinical time through the development of ‘delivery driver’ role. 

Using data to:

• Demonstrate why we needed to change – looking at the clinical time taken up by non-clinical work
• Allow is to measure the impact of the change

Outcome highlights

Time – Clinical time saved, increased time for providing care and a better skill mix 

Staff – Feel happier. 100% of staff reported being more efficient with time since the introduction of delivery driver

Patient –overwhelmingly positive feedback – improving patient experience  

Quality – Better Dressing availability on visits  

Spread – Successfully adopted by other teams who have now successfully implemented this improvement.

Measured outcomes

	Baseline measure (pre test of change)	Outcome measure (post test of change)
Time to deliver dressings	34 minutes	11 minutes
Number of times practitioner returned to base to collect dressings	73% report returning to the base daily	86% report returning to the base once a week
Number of dressings delivered per week on average = 125	100% by clinical staff	17% by clinical staff 83% by delivery driver Clinical time saved per week = 52.13 hours Financial costs savings per week = £598.53
Percentage of visits where dressings were available	Less than 50% of the time	More than 75% of the time

Challenges

Initial hesitation to change by spread teams, mitigated through demonstrating measurement.

Next steps

• Cost benefit analysis – delivery driver costs/miles, offset against the benefit.  Review if the cumulative team mileage has reduced and is this off set against the drivers’ miles? 
• Explore the links to green agenda and opportunities to reduce environmental impact by measuring the miles, better route planning and electric cars.

Opportunity for shared learning

• Identifying further opportunities to use the solution in the community to get greater economies of scale. 
• Use measured data to strengthen the case for scaling up the change further.  

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