Posted by: ayrshirehealth | December 16, 2015

5th Vital Sign by @moragmcnulty

Foggy Morningc-O-h-O-rt-7 – part 2

We set off in the early hours of a foggy Wednesday morning, and with me secure in the knowledge that my elderly mother would be safe whilst I was away, with family supporting her.

So the entire point of any trip is to observe and hopefully replicate improvement for the patients we work tirelessly for, ensuring the hours of study come to fruition and that we deliver tangible, practical improvement for all.

I managed to get invited to a two day conference in Galway which allowed more cost saving and we were raring to go. Leadership Conference ‘Showing the Way, Knowing the Way, Going the Way, an excellent conference which asked us to celebrate what we do well within our service and some fascinating insight into care delivered under massive financial restraints.

Google translate allowed me to tweet in Irish in an attempt to thank the organisers in a more personal way.McNulty Tweet

Interestingly they had politicians and journalists speaking who encouraged people also embrace the negativity and use it as a learning point. John's campaign

What Matters to Me’ was discussed at length and appears to have had some fantastic improvement results in the area it was developed in and should be easily transferred and incorporated in to John’s Campaign’.

We heard from a Life coach who discussed the power of music and how it makes you feel, change in tone can change a mood and then asked us to look at two men, one had tattoos and the other looked like a middle class gentleman, most picked the clean shaven conformist thankfully not me as I thought he looked strange and he was in fact the serial killer Ted Bundy!

I am sure everyone is aware of the old adage never judge a book by its cover. So how often do we make immediate decision on a first impression?

Second leg and we arrived in a windy Boston Massachusetts USA

After arriving safely in Boston from Ireland, we headed to the hotel and as was stated earlier we shouldn’t judge on appearance or use the negativity to cloud our judgement. The area was deprived, there would appear to be a real problem with homelessness and we were also alerted to the perceived drug problem within the area. It should be noted that when in fact you turned right out of the hotel there was a vacant parking lot and a Methadone Clinic. Although reassuringly we were informed that they have very little gun crime!

Boston Fire ServiceIt is Sunday our other day off and we are heading into Boston, when we notice two fire trucks with ladders extended and a massive flag, uniformed officers and a piper. The thought is that perhaps it is a funeral. We disembark and decide to go and perhaps pay our respects. We reach the church only to find that there is a Blue Mass for fire and police officers who have lost their lives.

Outside we start speaking to a Fire Chief, he gives us time to speak and in fact he is head of safety for Boston Fire Department.  We have managed to arrange another visit and encourage sharing and teaching and hopefully help in improvement.

IHINext day was very inspiring of to the Institute for Healthcare Improvement and if we are lucky lunch with Maureen Bisognano. So up early and downstairs for breakfast, this is no mean feat and a bit like herding sheep!

The mini-cab we ordered didn’t arrive due to ‘traffic’ but never fear we really are quite resourceful. The tube from the dodgy station will take us to Harvard. We arrived safely and surprisingly on time. Catherine met us at the elevator (yes I know it is a lift but I have gotten carried away) and showed us to the meeting room. The day was packed as we went from meeting to meeting and it was a “working lunch”, no rest for the wicked.

90 day cycles

Some innovations were discussed including a frail elderly project in Jersey that was run in line with the Post Office.

Our day progressed learning how to manage and formulate 90 day cycles for change, as well discussions regarding some of the projects going on and nearing conclusion. We finished discussing end of life care and patient flow.

At the end of the day we received a tour of IHI and the obligatory picture of me in Maureen’s chair and Avilene in Don’s chair. Perhaps we helped Maureen make up her mind to retire! They use inspirational quotes to inspire and motivate staff.

Picture by Margaret Burdge, Boston Daily

Picture by Margaret Burdge, Boston Daily

Next day three of us set off to meet Jo Shapiro, MD Chief, Division of Otolaryngology Director, Center for Professionalism and Peer Support Brigham and Women’s Hospital, Boston.

Allegedly it was 10 minutes away, think someone should have told the cab driver! Slightly late but the meeting was well worth the time spent travelling, with some truly inspirational work regarding the human factors of Health Care working.

We need to incorporate the “5th vital sign”What do you care about most? This needs to be a routine question to patients and family. Patients have a role in their health.

Our Fire Department visit was next and it is clear they face similar challenges to the Health Service. Dave and Greg discussed at length the fact these are relatively new posts, brought about due to increased incidence in cancer particularly, testicular, thyroid and melanoma. We also had a meeting with Dr Jennifer Taylor, Drexel University.

Learning Opportunities

We saw effective use of Go Shadow and technology at our visits and a reverse in how we view emergency medicine. There were treatment Chairs in the Accident and Emergency Department, we need to reset or flip the mindset, not all people attending need to be admitted.

The learning opportunities should not be underestimated and should prove invaluable to the care delivered to the people of Ayrshire.

This week’s blog  was by @moragmcnulty (Morag McNulty), Clinical Nurse Manager, General Medicine, University Hospital Ayr, NHS Ayrshire & Arran.

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