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| Capacity Management |
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Capacity management job skills: capacity to keep going in the face of adversity! Two bleeps, two sturdy feet, an extra layer of skin, an additional measure of tact and diplomacy and a special sense of humour! These are the attributes - and a few more besides - that are needed if you want to become part of the capacity management team. And, perhaps not surprisingly, it's not a job that everyone can rise to. s Above: Head of Capacity Management Claire O'Brien writing up the afternoon's capacity and demand at one of the twice-daily capacity management committee meetings Working as a team The capacity management team is committed to ensuring that patients come in, and go out, as efficiently as possible - and at the same time they politely need to give a reality check to those people whose expectations of the system are unrealistic! It's a hard job and the people involved have long experience of life on the front-line in the NHS. They've taken up the challenge because they do care about the patients and they do care about the problems ward staff encounter with the movement of patients. Said Head of Capacity Management Claire O'Brien: "The team strive throughout the day to try to balance emergency and elective demand. The bleep never stops! It's not an easy job and they are both loved and hated at the same time, but they are really here to help!" s Above Sister Vicky Powell discussing the patients requiring transfer from the surgical assessment unit (SAU) to surgical wards with Senior Capacity Manager Tarina Useful terms used by the Capacity Management Team
A Typical Day A typical day is fast and varied with a morning and afternoon planning meeting involving at least 12 people. The numbers of expected discharges is crucial and, like the number of people in A&E who need a bed on a ward, the number is constantly changing. s
Right: A&E Snr. Sister Emma Shelton discussing patients needing admission to a ward with Head of Capacity Management Claire O'Brien Discharge may be the end of one in-patient's experience but it begins the chain of events for the next patient. Once a patient is ready to leave hospital it is imperative that they go to the discharge lounge as soon as possible to facilitate access for the next patient to the now empty bed. Throughout the day capacity managers are in constant liaison with the multidisciplinary teams, helping to co-ordinate patient placement and throughput. Pressure on bed space can result in a medical patient being on a surgical ward. These "outliers" need to be moved as quickly as possible to the ward most appropriate for their nursing needs. Other patients may have been in intensive care, or in critical or high dependency beds and as they improve they need different nursing on a regular ward, and beds need to be found. Trying to ensure patients are placed in single-sex bays is another critical part of the role. Porters move patients around hospital as requested. Not all patients go home from hospital and arranging transport for patients being transferred to community hospitals or nursing homes can take time and planning by the ward teams. Linda Smith, Capacity Manager, explains: "The work of our team is difficult and many people do not understand the complexity of the job and the amount of autonomy that we have in our role as capacity managers." Summing up, senior capacity manager Tarina Tribe said: "What we are actually doing is caring about patients at home; in A&E; coming out of ITU; after day surgery, or even in clinics when an outpatient may be found to need an immediate bed. "It's a demanding job but there's huge satisfaction in trying to place a patient in the right bed at the right time and we take pride in rising to the challenge!" s Above: Capacity manager Linda Smith looking across at the Falcon Ward bed state board with Charge Nurse Romel Mendoza and Ward Clerk Chris Cross while they discuss which patient is likely to be moving on shortly. Who takes priority? The one priority patient never cancelled by the capacity managers are those due for surgery under the two-week rule for cancer, and the capacity managers work closely with consultants' secretaries across a range of disciplines to clinically prioritise patient admission. Above left: The clinical site nurse practitioners are in charge at night. Pictured here in their office are "late" medical unit matron Kathryn Wood, capacity manager Linda Garland and CNSP Lisa Roisetter at an evening hand-over s Above: Pictured on the Medical Assessment Unit (MAU) are capacity manager Peter Newman and Sister Michelle Soane clarifying patient's details when prioritising them for transfer The 18 week pathway has significantly increased workload with additional theatre lists in orthopaedics and general surgery on Saturday mornings. If there are not enough beds on the day ward then additional day cases result in patients being placed on a ward. Capacity managers work closely with Day Surgery to make sure in-patient beds are not used inappropriately. Where possible, patients are transferred back to Day Surgery to ensure effective use of in-patient beds. |
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| Last Updated ( Wednesday, 14 October 2009 13:19 ) |
