NHS Greater Glasgow and Clyde: getting it right one ward at a time

Achieving Staff Buy-in

The Queen Elizabeth University Hospital recognised that getting clinicians on board at the outset was key to a successful outcome. Alisdair took on the task of liaising with clinicians on the Exemplar Wards, and the subsequent roll-out to other wards. He said:

"As in anyone who works in the NHS, consultants can be wary of change and may feel change-saturated, therefore it is important to work with them so they are part of the process. Sometimes in the past, improvement programmes have been framed around targets but there is a degree of cynicism about this from clinicians. However, we are all motivated by a desire to make things better for patients; that is why we are here after all. I spoke to each of the consultants on the Exemplar Ward individually and, during our conversations, we discussed the need to improve patient care, to work more efficiently and manage our time better. We spoke about how the Daily Dynamic Discharge process could support us by helping staff to prioritise and by adding more structure to what we were already doing. I pointed out that it was not about doing more work but about working more effectively. Everyone bought into the process in a slightly different way but the important thing was that they bought into it."

Alisdair also spoke to all of the junior members of staff on the ward. He pointed out:

"Although consultant buy-in is important, it is the junior medical staff and the nurses who make the ward function on a day-to-day basis and we needed them to understand what we were doing and why so they could enact the plan. We wanted them to be completely clear about the rationale for Exemplar Ward and to feel confident enough to make small adjustments to the process when the consultants are not on the ward."

"I really appreciate having the morning board round. I can see exactly what I have to do that day, it brings the whole team together, it encourages better timekeeping and it helps with the smooth running of the ward."

Dr Evelyn Millar, Consultant Respiratory Physician

"We have been clear to stress that improving the number of discharges before noon is the function of a well-structured, well-functioning ward, it is not another target that wards are measured against."

Dr Alisdair MacConnachie,
Consultant Physician and Unscheduled Care Clinical Lead