Background How often have you heard comments from colleagues about time pressures and unmanageable workloads? In order to redress this situation with a focus on effectiveness, efficiency and quality we took the decision to innovate the way in which our Community Palliative Care Team (CPCT) delivered supportive end of life care.
Aims This is a work in progress, with the aim of becoming one team, facilitating further integration of approach in delivering and responding to patients and healthcare care professionals.
Methods A review of working hours was undertaken, facilitating long days as well as traditional 9–5 and annualised hours for one CNS; with 9–5 worked on call at weekends. Specific roles were designated to cover triage, routine telephone contacts and a CNS as emergency responder: all roles were shared. Visits are scheduled by CNSs across the team, on the days people are working. No individualised case loads. Initially, the service was split into two areas to embed the new working routine and allow for any issues to be identified. Electronic patient records and iIPads facilitate remote working negating the need to return to base across the day.
Results The new mode of operandi has had a significant impact across the community service. Team case loads have resulted in a 15% increase in routine visits across the day/evening, with improvement in responsiveness to urgent visits, average increases in telephone contacts with patients up 40% and to HCP up 19%. The team self support and manage their work with a marked reduction in working late, absence and improvement in morale. A shared team approach has reduced patient dependency on individuals, patients are reassurred that there is a named team supporting them, facilitated increased knowledge of all current patients, and supported the team as patients are reviewed by other CNS colleagues, reducing the risk of assessment/treatment variation.
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