Background The Productive Ward is a National Initiative developed by the NHS Institute of Innovation & Improvement (NHS). Promoting proactive change that concentrates on innovation in practice and on staff having the control to make changes, as stated by the Boshoff (2005). It is different to reactive change, which comes about as a result of needing to modify practice.

The Hospice was invited to be part of the Productive Ward project in order for us to review our systems and processes and enable us to save time that could be used to deliver direct patient care.

Aim To complete the three foundation modules, followed by eight process modules.

Photographs were taken prior to the de-cluttering/re-organisation on the ward. This resulted in time saving as all the equipment for a procedure is kept in the same place, that is, catheterisation – the dressing pack, catheter, catheter bag, stand etc are now located in the same place.

Knowing how you are doing – this provides monthly outcome measures for key performance indicators.

Meal Wastage Action was taken to reduce meal wastage which resulted in significant cost savings.

Stock/Finance Stock is now kept to a minimum, that is, dressings, drug, etc, making it easier to ascertain exactly how much stock the ward is holding, this has also resulted in a tidier store room.

Hand overs Morning handovers were held in the staff room taking up to an hour. The change introduced (with a huge amount of resistance) was to hold the handover in the nurses' office to ensure visibility and swiftness. The intention from my perspective was to speed up and reduce the time/cost of this handover. The handover now takes approx. 15 min.

Overall, the Productive Ward initiative has proved successful with positive outcomes.