Radiographers in the Blackpool Teaching Hospitals NHS Foundation Trust noticed that some patients were being transferred from A&E to radiology for imaging in chairs, rather than beds, and sometimes wearing their own clothes instead of hospital gowns. This meant that cannulas were often covered under jumpers and shirts, which led to fluid spills and that X-ray imaging was sometimes poor. Not all patients were being given pain relief in a timely manner and in some cases, this also led to delays in treatment.
Radiographers had raised this asan issue previously, but felt that abroader response was needed sothey contacted their Freedom to Speak Up Guardian, Terri Vaselli.
Terri escalated the issue to the AssociateDirector of Nursing from UnscheduledCare, who immediately took action. Staff from A&E, radiographers and senior leaders were brought together to discuss what was underlying the matter.
At the meeting, radiographers and A&E colleagues listened to each other and talked openly about the situation. It soon became apparent that A&E staff were actively promoting the ‘End PJ Paralysis’ campaign. This encouraged patients to stay in their own clothes, to help reduce falls and pressure ulcers and cut the length of time people spend in hospital.
Radiographer colleagues had simply not been made aware of the campaign.
Terri said, “Honest and open dialogue between departments resulted in a deeper understanding between clinical teams to implement change and improve pathways.
“Being able to talk around the table openly allowed better understanding of each department’s functions and rationales. This led to more cohesive teamwork and better patient care.”
As a result, the trust has made a number of improvements including:
- Radiology staff providing written guidance for A&E staff about transferring patients into their care.
- The development of new training packs for new starters in A&E.
- A plan to develop a care improvement group, including radiography staff, to further improve patient pathways.
- Inviting radiology staff to Patient Safety Days to talk to A&E teams about their pathway guidance
- The recruitment of Quality Champions to support radiology and A&E pathways. This will also be rolled out to urgent care to help create more streamlined pathways for patients.
- Staff who spoke up were satisfied with the changes that are being implemented and said that they would speak up again.
This case study was part of our 100 Voices publication which accompanied the 2019 Annual Report.
Case studies are vital to illustrate the good work of Freedom to Speak Up Guardians. We encourage all organisations to share the learning from their speaking up stories.
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