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LYMINGTON MINOR INJURY UNIT

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Presentation on theme: "LYMINGTON MINOR INJURY UNIT"— Presentation transcript:

1 LYMINGTON MINOR INJURY UNIT

2 Currently the 15 mins target is recorded but not reported
The Current State Currently the 15 mins target is recorded but not reported It will become reportable from July 2019 when we become an Urgent Treatment Centre.

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4 Current Waiting Times Average booking time is 3.1 mins
Average wait for initial assessment is 9.9 mins Average time for the initial assessment is 11.7 mins Total ‘work time’ is therefore 24.7 mins

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8 Booking in at Reception
CURRENT STATE VALUE STREAM MAP Refer – NP Wait Booking in at Reception Treatment Room – NP + - HCSW Wait Discharge IX-ray Wait Radiology discharge Wait Wait Book to x-ray IInitial Assessment - NP Wait Treatment Room - HCSW Wait Refer - NP Wait Refer – NP Discharge Discharge / redirect

9 MIU Standard Operating Procedure
See and Treat Within 15 mins of checking in at reception the patient will be called to be assessed by a Nurse Practitioner (see “See and Treat Protocol”) If there is more than a 15 minute wait the Nurse Practitioner will implement triage using the Manchester Triage System.

10 Ideas and key themes for improvement
130 ideas for improvement generated by participants to enable achieving 15 minute initial assessment Key themes identified; Environment, Staffing, Communication, Patient flow, IT Priorities identified using a scoring system to ascertain objectives that would provide the most impact, with the lowest cost, low use of energy and with ease These were rated and small groups formed to develop ideas including; Discharge from radiology, Role definition, amend SOP, develop patient signposting information and environmental estates works. Insert Picture of Ideas Forms

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12 Ideas and key themes for improvement
Insert Picture of Completed work Inclusion of all staff affected e.g; staff working in MIU, radiology, estates Patient handout developed, shared and amended. Role play to assess the timings of the initial assessment and how this felt for patients and staff, including expert patients.

13 Proposed future state Improving initial flow to ensure all patients reviewed within 15 minutes Improved patient experience Reduced risk Improved staff satisfaction

14 Patient Flow diagram Arrival Self Redirection Registration: 3 mins
Signage indicating what we see/ patient information Patient Flow diagram Arrival Self Redirection Need to alert nurse on completion, so minimise delay time Registration: 3 mins Much shorter the currently Generally no examination of patient reduces duplication and free up nurse time Initial Clinical Assessment (5 mins) Define problem Identify severe Identify inappropriate Clear need for x-ray Analgesia Obs (where necessary) ‘ simple’ treatment Documentation Treatmet

15 Electronic xray requesting
Initial Clinical Assessment Redirection /signposting to more appropriate service Analgesia prior to full assessment Immediate full assessment Cardiac presentation ( Chest Pain) HI with LOC Significant MOI, Heavy Bleeding, Breathing difficulties, Anaphylaxis, Burns, Limb Deformity, Opthalmic emergency, chemical/blunt trauma. Acutely unwell Adult/Child. Suspected sepsis, FAST Positive. Wait for full assessment Electronic xray requesting Full Treatment room assessment X-ray Radiology discharge Onward referral Leaves department Treatment

16 Proposed future state Streamlined registration process
Alert mechanism for nurse when patient is waiting for assessment Changed environment – 2 rooms available for assessment Patients no longer ‘examined’ during initial assessment Electronic radiology requesting and direct radiographer discharge

17 Outline Implementation Plan
Key aspects of plan: What has been delivered and in place now (Cardiac Monitors, New Patient facing website, Updates leaflets!) Action initiatives developed within QI week that can be commenced as soon as next week. Complete objectives, audit and monitoring relating to our new Booking In/Initial Assessment process over the next 30/60/90+ days

18 Implementation Plan

19 Lessons Learned Reflections
Insert Picture of Lessons Learned

20 Reflections and Conclusions
Barbara and Stephen – Service Users Marion – HCSW MIU Chris – RPIW Sponsor

21 Thank you’s Thank you to: Picture Barbara Strange Stephen Hales
Staff working in MIU this week Team in the RPIW Chris Brown Clare Bundy Liz Pusey LoF Volunteer - Jenny Picture


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