Releasing Time to Care helped a Ridge Meadows Hospital unit gain more control of their work.
Unit 3 North at Ridge Meadows Hospital had seen a lot of change, in leadership and structure. Staff sometimes felt like they were spending more time going down hallways and rummaging in the medicine closet than with patients.
With the support of site leadership, nurses Mita Rychkun and Kristen Wright found a way to do something about it. They were part of the first cohort in Fraser Health’s Releasing Time to Care program and are in the midst of working with their unit colleagues on changes to benefit themselves and their patients.
Originally developed by the National Health Service in England, Releasing Time to Care is supported by the B.C. Patient Safety and Quality Council to engage point-of-care staff in leading change to improve care for patients, residents and clients.
Mita and Kristen’s first step, and the focus of the first module, was data collection. They organized an “activity follow” where one nurse was followed by another for a whole shift. At the start of each minute, the follower checked off what the nurse was doing -- charting, direct care, finding medications, rummaging for supplies, and so on.
Their biggest surprise was that they were already spending a larger portion of time doing direct care with the patient than they’d thought. They also used “safety crosses” to track numbers of code whites or falls, for example, again so they could measure the data against the perception, and determine where improvements could be made.
By bringing this data back to their unit colleagues they were able to think about where improvements could be made to give more time for direct care. But beyond data, it was the open communication and collaboration that was the heart of their efforts. With a renewed sense of teamwork, as a group they chose the medication room as one of the best opportunities to make the unit more efficient.
To get a sense of the issue, the duo filmed staff trying to navigate the room with up to five nurses with their medication carts in a space the size of a bathroom, looking for items that weren’t in their sightline. Organizing that space is the focus of their second module, along with continued work toward their long-term goal of changing the way the unit operates.
“We are trying to shift the culture in an environment where budgets are never enough, and trying to shift the idea from ‘if we just had more …’ to ‘what can we do with what we have?’” said Mita.
“Our motto is for us by us,” said Kristen. “It’s all the staff who are present who make the decisions and create the ideas to change what they want, and it’s a great opportunity to be involved in shaping your work.”The deadline for expressions of interest for the second cohort of Releasing Time to Care is Friday, July 28. Interested units or teams are invited to complete and submit the form on FH Pulse.