Creating resilience, improving governance, and enabling safe staffing within Anaesthetics and theatre services with Allocate ActivityManager.
Summary
Airedale NHS Foundation Trust implemented Allocate ActivityManager to create resilience, improve governance, and enable safe staffing within their Anaesthetics and theatre services. The system also allowed integration with the bank staff system which enables them to fill the gaps 6 weeks in advance. Plus, with the reduced administration time, it freed up consultant’s time so they could concentrate on delivering patient care.
Background
Airedale NHS Foundation Trust is an award-winning NHS hospital and community services trust providing acute, elective, specialist, and community care for a population of over 200,000 people. The Trust wanted to improve the accuracy and visibility of eRostering across clinical staff, including medics. It needed a system that would provide an overview of location as well as staff rostered to improve visibility, accuracy and support the provision of safe services for patients.
The Trust decided to implement Allocate ActivityManager in July 2021 and started with the anaesthetics department for medics. The Trust intends to roll out to other areas within surgery to include all staff groups. Once the anaesthetic department were embedded and fully operational, we added all other clinical theatre staff. This department was selected due to the complexity of roster and the multidisciplinary team working across eight operating theatres. The Trust felt that if Allocate ActivityManager could support the needs of such a complex department, it would provide a blueprint for further roll out across other areas of the Trust.
Introducing ActivityManager in a complex department
Amanda Limbert, Workforce Systems Manager at Airedale NHS Foundation trust explained it was not just the challenging logistics of the department that needed to be overcome, but also engaging colleagues in the changes required to implement the new system.
”We decided to start with Anaesthetics, because we were going to receive support from Allocate with the first early adopter, and I felt that’s where we needed the most support. I felt if we did the most complex area first, then anything else would be easier due to the lessons we would learn from this area. The collaborative approach involving the support from the executive team , senior clinicians , operational colleagues, clinical colleagues and the rota and roster teams here at Airedale NHS Foundation Trust and the support from Allocate made this implementation a success.
Amanda LimbertWorkforce Systems Manager, Airedale NHS Foundation
The eRostering solution the theatre department had in place only showed who was rostered to work, it didn’t show ‘what’ they were doing or their location. To fill this gap in the system the department has started using a paper print out which was filled in with pencil so changes and cancellations could be easily erased, and the roster modified. However, the changes were not always made accurately and there was no audit trail which made it difficult to forward plan and coordinate the multidisciplinary staff to ensure lists weren’t cancelled.
”This was not only stressful for staff but also increased the risk of lists going down and presented a risk of the record not being up to date.
Amanda knew ActivityManager would give the interoperability theatre staff needed, allowing locations to be included and help ensure consistent safe staffing all in one place. The anaesthetists had traditionally managed their own rosters, so they required significant reassurance to feel confident that a Trust wide system would be fit for purpose and whilst still giving them the local flexibility needed to operationally run the service.
”The benefit is that the system is now managed by administrators with consultant overview, therefore releasing clinical time to provide increased patient care based on job plans.
From July 2021 onwards, Allocate and the Workforce Systems team from Airedale got to work building the system. Airedale’s contract with the previous solution was due to finish on 31st October so the new system had to be ready to go live from 1st November. The team at Airedale engaged with the anaesthetics team to understand their requirements of the system and overcome any challenges. These conversations were revisited through a steering group after each change was made to the system or process to ensure that the anaesthetic team had reassurance that the Trust wide system was fit for purpose.
The team were able to demonstrate how Allocate ActivityManager worked and that a central database would increase interoperability between other systems within the Trust as well as ensuring compliance with safe staffing, providing transparent auditable data and the ability to measure KPIs.
”When they had staffing gaps in the old system, they would ring the temporary staffing department and say these are our gaps. The temporary staffing department would then put these gaps on our bank staffing system and send them out. Next, the temporary staffing department would fill the gaps and then ring back to the anaesthetic department to say what they had filled, and with who, and the anaesthetic department would then add them onto the old eroster system. It was a lot of work by a lot of people and that whole process has been streamlined now that all the systems are interoperable.
Allocate ActivityManager links with bank staffing systems to streamline the eRostering process by flagging up gaps immediately and enabling the central team to fill rosters up to six weeks in advance. As a result, improved fill rates ensure operations are less likely to be delayed due to staffing issues.
”Now we know what the gaps are, we are filling them immediately, 6 weeks in advance!
Learning points and benefits from Allocate ActivityManager implementation
As the implementation was underway, the team had to adapt to a few unforeseen challenges.
”As we started with anaesthetics, we built it with the anaesthetists as the lead. However it became clear part way into the build that it was the surgeons and patient mix that determined what the anaesthetic requirements were, so in hindsight it may have been more beneficial to have started with surgeons. You can have two lead people, but we decided for the ease of everyone who uses the system, to only have the surgeon as the lead, that way everybody knows who the surgeon was. My key takeaway from this is to start with the surgeons!
At times there was resistance to change to a new system. This was overcome by enabling the workforce team to set up Allocate ActivityManager to mirror the look of the previous system to help with the transition.
Whilst it had a familiar look and feel, the audit trail in Allocate’s ActivityManager was much more refined and provided greater governance.
”I feel like we have come a long way, with improvements made to the system by Allocate following feedback from the anaesthetists. The functionality, audit trail, governance and reassurance the system provides is much better that what we had for all theatre staff and service managers.
With a centralised system, we are creating standardised processes across the Trust. This has not only boosted resilience in the staffing process by removing single points of failure but freed up consultants within the department to focus instead on delivering patient care.
”Allocate has been incredibly supportive and helped us on this journey, both in terms of addressing system issues and cultural challenges. Now we are confident in deploying and implementing the system we are planning to roll out to the rest of our medical workforce.
Amanda LimbertWorkforce Systems Manager, Airedale NHS Foundation
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