Three nurses making a difference

Three clinical nurse specialists are making a difference for complex patients on inpatient waitlists at Waikato Hospital by ensuring their journeys through the hospital system are that much easier.

Val Naidoo, Dean Blake and Amanda Burton are the elective care co-ordinators in general surgery, plastics and orthopaedics. The team came together four months ago under Jo Shea-Kelly, the pilot lead. Ms Shea-Kelly is now the clinical nurse manager for the $130 million Meade Clinical Centre, midway through construction.

The Ministry of Health funded pilot aims to improve the way the hospital manages elective patients across the continuum of care. This means from initial outpatient consultation, being added to the inpatient waitlist, surgery and then through to discharge.

They maintain regular contact with long waiting patients, some of whom, for various reasons, may have waited longer than six months for surgery, said Waikato DHB elective services manager Debi Whitham, pictured.

"They develop strong effective relationships with patients and also hospital staff to facilitate a smooth surgical journey."

The pilot also ensures that waitlist additions have a documented journey prior to them even going on a waitlist.

"This is in line with the Ministry of Health guidelines that say any patient on an elective waitlist is fit, ready and able to have surgery when we offer them a date.

"We all know that we are quite good at inviting patients in for their procedure but we haven't actually planned their discharge. Setting correct patient expectations around length of stay, post-operative mobility, outcomes and even a ride home is one of the successes for patient satisfaction. This is done in partnership with the patients so it's no surprise really," said Ms Whitham.

Their thoughtfulness for the patient even extends to doing things no job description would ever ask for.

"They organised theatre equipment at the 11th hour that if it hadn't been there would have resulted in a cancellation for the patient. They arranged a taxi chit and constant reassurance for a patient waiting more than 1000 days for surgery. She arrived in the taxi in a fretful state but had surgery the next day. Then there was a patient who lives in a hotel so they visited the hotel to assess the environment and then agreed a plan with the patient to have post operative care in the Matariki Continuing Care facility in Te Awamutu."

Other benefits from the pilot include:

• waitlist management
• surgeon awareness in real time of actual waitlist issues
• use of the clinical priority assessment criteria scoring accuracy tool to ensure the delivery of timely equitable treatment
• standardised triaging and planning of the patient journey before they are added to the waitlist to ensure readiness
• identifying clinical override and reviewing its usage
• providing a name and constant contact for the patients on our waiting lists
• sorting out any issues raised as they happen
• discharge plans in place for all complex patients prior to admission
• relationship success within each team.

"The three clinical nurse specialists are closely connected to the services and this allows them to examine and explore the culture and consider better ways of working to maximise patient satisfaction. That has to be good for the patients and their journey," said Ms Whitham.

ENDS