Throughout Cambridge University Hospitals foundation trust - the 2008 HSJ Awards acute organisation of the year - there is a strong desire to raise already high standards.
Transformation is given direction by five priorities through which the trust seeks to improve the patient experience, improve care and safety, ensure clinical excellence and effectiveness, value staff and partners and strive for innovation in everything.
The organisational culture that upholds these priorities and determines the trust’s progress as it strives to improve quality has been distilled from staff feedback and captured in a clear set of values - kind, safe and excellent - that frame and focus every aspect of patient care.
As it has done over several years, feedback from patients across the clinical areas continues to further inform innovation and improvement. The mechanisms for this were recently extended to include children and younger people, a number of whom now come together regularly to discuss and help staff involved in their care understand how their experience of being at the hospital might be improved.
The trust also places a high premium on good leadership, as chief executive Gareth Goodier explains.
“Leadership is the driver of everything in the organisation and we don’t just see that as coming from the top team but throughout the organisation, says Dr Goodier.
“I think it’s fair to say that in most hospitals clinical staff are promoted to leadership positions without enough training or education about management, let alone leadership. That’s why here we have 200 staff a year going through our leadership academy, with 70 per cent of those from a clinical background.
“The academy was designed to strengthen leadership throughout the organisation from the ward and the clinic upwards.”
Prioritising patient experience, care and safety has also sharpened the trust’s focus on infection control. As well as launching the NHS’s first central venous access service - with a dedicated theatre suite and inpatient and outpatient services supporting safe line insertion - the trust has restructured its clinical quality and governance committees.
A new patient safety executive and patient safety council review every clinical department to ensure that key outcomes are being measured across the board. The 41 MRSA bacteraemias recorded in 2007-08 represented a 49 per cent improvement on the previous year while this year rates of C difficile have fallen by 25 per cent.
“Because long stays in hospital are probably adverse for the patient both in terms of morbidity and mortality we have also had a major programme looking at patient length of stay,” says Dr Goodier. “We focused on getting the clinical pathway right so that investigations, scans and x-rays, along with any subspecialty opinions, are sought and completed and the patient can be diagnosed as quickly as possible and goes home as swiftly as possible.
“We have had something like a 10 per cent improvement on length of stay and aim, over three years and through efficiency, to create effectively 280 spare beds.”
“The HSJ Awards are regarded as the healthcare Oscars really,” he continues. “Winning acute organisation of the year was like winning best film. It was a great thrill and a terrific boost to staff morale.”
For more information on how to enter, visit www.hsjawards.co.uk
What judges want
- Indicators of high quality, patient centred care
- A clear strategy
- Excellent engagement between managers and clinicians, with demonstrable unity of purpose, and collaboration to drive service improvements
- Good people development throughout the organisation, with leadership at all levels, and a culture where staff feel valued and respected and everyone understands the organisation’s goals
- Use of management and clinical information to drive improvement
- Proof of a culture which encourages innovation at all levels
- Real involvement of patients and the wider local community in shaping services. This should demonstrate an understanding of health inequality issues in the catchment population
- Progress on the key public service agreement targets
- Strong financial management which supports the organisation’s strategic goals
- Partnership working with other organisations, both in the NHS and outside it
- High performance on key access targets including accident and emergency, outpatient and inpatient times
- Evidence of long term strategic planning