Background Like many areas, COVID-19 had a heavy impact on our inpatient and community services (Cross Party Group on Hospice and Palliative Care. Inquiry: Experiences of palliative and end of life care in the community during the COVID-19 pandemic. 2023). With increasing numbers of referrals, complex patients and recruitment challenges we needed to consider how we could work effectively and to release time to care and be fit for the future (Warren. The health and care workforce: planning for a sustainable future. King’s Fund. [Internet]; [posted 2023 November 24].
Aims To understand how the hospice palliative care multidisciplinary teams utilise their clinical time with a focus on identifying any inefficiencies and to evaluate time currently spent on direct patient care.
Methods Activities were self-reported by members of the clinical teams either manually or electronically using a Paper Time Study Worksheet (Institute for Healthcare Improvement. Paper Time Study Workshop [Internet]). Data was collated and themes analysed by the Clinical Quality Team.
Results Over a seven day period 70% of the working clinical team participated in the study, documenting in total a period of 3,133 hours of activity. Activities were categorised into ten distinct areas with subsections to identify the elements of our specialist roles. On average Clinical Teams spent 25% of time on administration (this includes answering work related emails and entering data onto the electronic patient system (EPS)), 20% communicating (both internally and externally) and 17% on management duties including 1:1 sessions/staff support.
Conclusions A large amount of working time is spent on administration, communication and management duties, which may be improved by analysing systems within the service to reduce duplication of work and inefficient processes. A digitalisation strategy is being introduced to consider the use of virtual and AI approaches to care, alongside a LEAN group to focus on email management This work is ongoing but provides valuable information to allow us to further explore and re-evaluate current roles, releasing time to care including utilising volunteers and considering more non-traditional roles within our MDT.
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