Title of project: Business Case for the Development of an Orthopaedic Assessment and Treatment Centre and its implementation.

Project Team:
Business Case
Directorate Manager of Orthopaedic Services, Directorate Manager of Emergency Services, Associate General Manager Orthopaedics, Knowledge and Library Services Manager, Director of Finance.
Implementation of Business Case
The group of people above plus: orthopaedic consultants, orthopaedics nursing staff, physiotherapists, occupational therapists, radiology department, estates, IT department,

Resources Required: Capital Funding

Timeframe: Three month turnaround for the business plan then 12 months for implementation

“The Story”: The library service was asked to be part of a project to develop an assessment and treatment centre for orthopaedic patients on the Chorley Hospital site. This was in response to a public consultation carried out with the population of Chorley and South Ribble. The Knowledge and Library Services Manager (KLSM) was asked to be part of the project team and to provide information via literature searches to support the business case. The topics included: Independent Treatment Centres, best practice and the clinical pathways on the map of medicine. Once the business case had been approved the KLSM was assigned a coordinating role and produced the weekly checkpoint reports after each meeting and chased actions to ensure they had been completed for the next meeting. In addition to this, the Library Manager was asked to design, co-ordinate and write a report on the findings of 3 patient surveys and 1 survey to find out about staff views on the new service and how the new ways of working had affected them.
The first questionnaire was sent out to patients who were using the existing service to obtain a baseline measurement and discover areas for improvement. The second survey sent out to patients was to provide feedback about the piloting of the new service and if there were things that still needed to be improved. The last patient survey was undertaken three months after the new service had been commissioned. All three surveys were then compared to discover how the old and new services compared and how to see how patient outcomes had improved.
The staff survey was sent out after the pilots to
highlight if there were any further training needs and how they were managing the transition to the new service.
During the business case phase there were two meetings a week to ensure momentum was kept. Once the project had been approved the meetings were weekly. Time to design, send out and report on the surveys was also required.
The expected outcomes were:
The ability to compare the previous delivery of the Orthopaedic Outpatient service with the delivery of the service provided by the ATC
To provide a template that could be used to deliver other patient services using the ATC model
To compile a list of lessons learnt to improve the delivery of the existing Orthopaedic ATC and could then be incorporated into other ATC services as they come online
To collect data from the delivery of the traditional service model, the pilots and the current service to provide a benchmark to measure the effectiveness of the new ATC model.
To provide a one stop shop for patients which would allow all their tests and diagnosis be carried out on one visit.

Alignment to local, regional and national drivers:
Achieved library service objectives by:

• Participating in the delivery and maintenance of Trust initiatives.

• Raising the profile of library services to specialised groups.

• Supporting evidence-based practice in projects.

• Maintaining and develop internal partnerships with departments.

Worked towards local, regional, national drivers by:

• This project linked with the Healthier Horizons for the North West agenda by involving front line staff to be at the heart of the decision making process, to improve patient care and access to services.

• The NHS Plan identified that there was a need for greater choice for patients on how and where they received their treatment. This development was in response to this need.

 

Impact of this project/service for the:
• customer • organisation • library
The objective of collecting the data from the traditional service, the pilots and the new service was to provide benchmarking information to evaluate whether the new ATC service had delivered any improvements and had increased it’s effectiveness with regard to patient care.
Analysis of the data suggests that the new service is delivering a better service than the traditional service in the following areas:

• Improvement in booking-in at arrival for the appointment.

• Patients’ perceptions were positive with regard to: the environment, infection control and being treated with dignity and respect.

• The new facilities have had a very positive reaction from patients

The project resulted in changes to working practices and the development of a new role i.e. the Patient Experience Co ordinator. The new working practices have required existing staff to undertake a training programme to address these needs.
In addition, a new orthopaedic pathway has been developed and implemented for patients.
Involvement in this project has raised the library services profile and has highlighted that librarians have skills that can be used to deliver and enhance trust projects. One noticeable benefit has been that managers are using the library service more to find evidence when implementing new services and the KLSM is being asked to be involved in other Trust wide projects.

Lessons Learned:
Being involved in this project has provided the following benefits:

• Increased knowledge of how the organisation works and departments interact with each other.

• Increased knowledge on how staff work in out patient clinics and how this has highlighted the difficulty staff have inaccessing information due to time pressures within clinics.

• Highlighted to managers that the library service has more to offer than their traditional supporting role for the delivery of educational programmes and have skills that are valuable to the organisation and them.

• Identified champions who support and recognise the library service’s worth to the organisation.

Issues

• Being part of this type of project exposes the participant to the frenetic way managers and clinical staff have to work. Deadlines are always short and are expected to be met. Initially, this can be an issue and adjustments need to be made to cope with this way of working.

• Workload can be an issue, as often you will be expected to deliver your identified deadlines within the project and continue to do your existing role at the same time.

Sustainability / next steps? The project has know been completed. However, the KLSM is still receiving e-mails and telephone calls from new users who have been told to contact the library service with regard to information provision for new service development and redesign.
Literature searches on management topics are now offered and the library’s daily health management newsletter reflects manager’s trust priorities.

Contact details: Mandy Beaumont, Knowledge and Library Services Manager
Mandy.beaumont@lthtr.nhs.uk

Date case study completed: 01.12.10

Tagged: Business case, North West, Orthopaedics