Steady stream of bad press stories

Janice SigsworthProfessor Janice Sigsworth took up her post as director of nursing at Imperial College Healthcare NHS Trust in 2008, coming to the Academic Health Science Centre from the Department of Health. As deputy chief nurse (England), she worked extensively to modernise nursing careers and on the nursing contribution to the Department of Health’s Next Stage Review.

I am not sure if I’m the only one, but the whole focus of improving patient care and the patient experience seems to have fallen at the feet of the ward sister or charge nurse.

In many ways this is true, but is it the answer to the steady stream of bad press stories and the sad and distressing relative’s stories published by the Patients Association?

The NHS Institute, inventor of ‘Productive Ward’, gives ward sisters and charge nurses the tools and techniques to challenge their practices and help staff spend more time at the bedside caring for patients. Here at Imperial College Healthcare Trust the Productive Ward has been well received by clinical staff as a way of improving practice and care.

But is this enough? My own experience and early outcomes from our Productive Ward programme show that it is the bigger systems, processes and environments of care that we need to get right, as well as the work of the individual staff themselves. By this I mean how beds are managed; how doctors work, when stores are delivered, how well bank and agency systems run, how quickly ‘take home’ tablets get to the ward once the doctor has ordered them. I am sure you can think of many more.

So it’s not as simple as sorting out the ward sisters and charges nurses, we have to get the whole organisation lined up behind them and the patient to truly deliver a good patient outcome and experience.

Staff survey results are a helpful balancing act: broadly, if staff are content and happy in their work then you generally find content patients. So let’s focus on the systems as rigorously as the staff themselves, otherwise I fear both will fail.