Sun Country Health Region is on a mission to implement programming that provides increased patient care time in all of its acute care centres. The Releasing Time to Care (RTC) program, undertaken by the Health Quality Council in Saskatchewan, is aimed at reducing the amount of time spent on wasted activities in an attempt to gain more time at the bedside with the patient. Such activities include excessive paperwork or duplication procedures, time spent hunting and gathering or looking for things, and poor communication between staff and patients.
The program was initially developed and implemented in the United Kingdom. Felicia Watson, Sun Country RTC Project Lead, explained how Releasing Time to Care came to be implemented in Arcola. "The program started out in the UK with the national health service. They developed the program and implemented in into their practices. When the Ministry and the Health Quality Council of Saskatchewan learnt about the program, they actually went and toured some of the sites in England. And they were very excited about it. As a result, the Ministry and Health Quality Council decided together to bring it back to Saskatchewan."
"The program itself is really about a culture change. It is about the ways that the front line staff manage their time and find ways to make their work better, ultimately making things better for the patient. So essentially, the staff members come up with ways to spend more time with the patient"
The initiative itself started about three or four years ago, mainly in the bigger health centres. "That implementation was the showcase period which included the major centres of Regina, Saskatoon, Moose Jaw. From there, the program was implemented during cycle one and two, which included centres such as Estevan and Weyburn. We are now on cycle three with the goal of having RTC implemented in all Saskatchewan acute care facilities by March 2012. The only one left in our region at this point is Kipling, so the implementation process has gone well" said Watson.
"The overarching goal of the program is to increase bedside time with the patients and there are four key objectives that need to be accomplished in order to achieve this. This includes spending more time with the patient, improving patient safety, improving patient experience, and improving the staff experience. And it is up to each individual staffing unit to decide how they are going to meet these objectives."
Chris McKee, LEAN Co-ordinator of Sun Country, said that currently, "only 19 to 23 percent of staff time is spent with the patient when the aim is actually 60 to 70. So it is an opportunity for staff to decide how they will change this. It is staff directed, not management directed. So it is teams of staff that are coming up with the solutions. Managers are just there to support the staff."
The Arcola Health Centre has four staff members that have led the initiative including two RNs and two LPNs. Their efforts, alongside a team of nurses and all other hospital staff, are overseen by their manager Joanne Hollingshead. The vision statement, which was developed by the staff of the Arcola Health Centre, is "striving to provide excellence through teamwork and patient/family centered care in an environment that embraces change to continually improve our quality of care."
One of the key factors of the program is that in order to be as successful as possible, all departments at the hospital are required to work together. This is reiterated by the diversity in the modules that are implemented which includes ward rounds, shift handovers, patient observations, admission and planned discharges, meals, medicines, nursing procedures and patient hygiene.
The staff members that have received training in the Releasing Time to Care program include Tammy Wilson, Kelly Brown, Wendy Hase and Dianne Wilson. Their training has included a one-day training session in Estevan thus far. Wilson said they "had a really great team there that motivated us and got us going on this program." While the next set of training is not until September, Wilson stated that the reason for the early training was useful. "They wanted pre-implementation training to get the staff motivated and the vision statement developed and out there in the hospital. The more we get involved as a staff, the better it will be for us and essentially for our patients."
When asked whether she expects a lot of changes, Wilson stated that the facility already runs with a focus on the patient. "I feel that what we do here is a team approach, and that the patient is always the centre of the process. Every department and every outside department that comes in is an additional spoke of the wheel and we all roll along to make this hospital and unit work together."
The Arcola Health Centre is currently in the data collection phase of the program which will allow the unit to identify what they can work on. The staff is given three to four months to complete their groundwork before moving on to the two follow-up workshops in September. Ultimately, the goal is for the RTC program to no longer be a program, but a way in which the staff work on a routine basis.
