Background Day services provide a crucial role in hospice care, providing a wide variety of support for palliative patients (Stevens, Martin & White, 2011. Palliat Med. 25:153). The pandemic closed the face-to-face services offered, and online interactions did not have the same uptake (Swann, Easton, McGuinness, et al., 2021. BMJ Support Palliat Care. April 29). Early 2022 saw a significant downsizing of staff from 13 to 6 members. Rebuilding our services needed a different management approach and a strong focus on teamwork (Kaushik & Guleria, 2020. Eur J Business Management. 12:12).
Aims To rebuild focused, streamlined and effective day services. To fully utilise the skills and strengths of the small staff team.
Methods Keeping morale high and working effectively together was key (Wilson-Evered, Härtel & Neale, 2001). Regular supervision, monthly team meetings, and collaborative work practices encouraged a high degree of problem-solving. Key skills within the team were used to upscale digital solutions, develop education for patients, and find solutions for bottle-necking of patients within the system.
Results The patient case load was re-evaluated and streamlined into specific support pathways. A loose patient portfolio of over 300 names has been streamlined to 190. A new digital flow of services to track each patient is being established so each team member knows where each patient is on their pathway.
The team has successfully rolled out exercise, education, and wellbeing programmes, fully re-opened the gym and moved to bigger premises, re-started complementary therapies and advance care planning coffee morning sessions. The monthly team meetings have become the highlight of the team’s calendar as support, new ideas, and solutions flow out of these meetings and into action.
Conclusion Moving from a top down to collaborative management approach (Miller & Miller, 2007) has enabled a small team to act decisively and quickly. Regular meetings and communication have engendered a supportive and ‘can do’ attitude with open sharing and willingness to help. Further development in digital streamlining and more consistent patient feedback is in process.
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