Clinical

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Leading Better Care Vicky ThompsonNational
Programme Leader Senior Charge Nurse Role,
Clinical Quality Indicators Releasing Time to
CareNHS Scotland
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Role Framework
Exemplar Job Description KSF Outline
Links
Releasing Time to Care
Activity Analysis
SCN ROLE
CQIs
Workforce Planning
Educational Framework
Development Needs Analysis
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Policy Context
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By the end of 2010

• Senior Charge Nurses in hospital settings will be
  working in the context of the revised role
• The majority of in-patient areas to have Clinical
  Quality Indicators in place
• The SCN will be the visible embodiment of
  clinical leadership in NHS settings, coordinating
  patient care, and inspiring the nursing/midwifery
  team

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Improving Patient Care at the Bedside
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• Clearly define this key role and ensure that SCNs
  are visible and accessible to patients and their
  carers.
• LBC establishes a national framework for SCNs
  working in hospital settings across NHS Scotland.
  
• Empowers Senior Charge Nurses to be clinical
  leaders and guardians of safety and quality in
  their area.
• Developed through extensive stakeholder
  involvement including patient / client input.

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• Four key dimensions for the Senior Charge Nurse
  role
• Ensuring safe and effective clinical practice
• Enhancing the patient experience
• Managing and developing their teams
• Contributing to the delivery of organisational
  objectives
• Supported by Clinical Quality Indicators (Falls,
  Pressure Ulcer Prevention Food, Fluid
  Nutrition)
• The revised SCN role is applicable to nurses and
  midwives working in hospitals in all clinical
  specialities, and is supported by the NES
  Education and Development framework, a National
  Programme Leader and a Board-level facilitator
  network. 
• Significant and essential links to the Releasing
  Time to Care initiative

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The vision from Leading Better Care

• We will have strong clinical leadership
  delivered by empowered Senior Charge Nurses who
  are the guardians of quality and clinical
  standards for the patients under their care.
• Paul Martin
• Chief Nursing Officer

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Why Change?

• If you always do what youve always done, you
  will always get what you always had
• Albert Einstein

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Do we all see the same thing?
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Supporting Frameworkand Tools for Implementation
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Framework for Implementation
Implementation of Senior Charge Nurse Role
Educational Framework
Safe and Effective Clinical Practice
Enhance Patient Experience
Manage and Develop Performance of the Team
Effective contribution To Organisational
Objectives
Workload and Workforce Planning Tools
e QIPS CQIs
Release Time to Care Productive Ward
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SCN Role Framework
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Supporting Framework

• Competencies and KSF outlined
• Working Document
• For current SCNs and their managers
• Talent Spotting use as framework for
  development

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Implementation of the new role

• Crucial in leading and delivering the high
  quality care that our patients and the public
  expect.
• Transition of SCNs to the revised role is a
  phased process that has Executive level support
  from NHS Board Nurse Directors across Scotland
  and is overseen by a national steering group.
• The work of NHS Boards is supported by a funding
  package provided by Scottish Government Health
  Directorates. Board-level Clinical Facilitation,
  plus the delivery of education and development
  packages and one to one facilitation for Senior
  Charge Nurses will provide additional support

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• Many Boards are also offering action learning for
  their SCNs. In addition, educational and
  developmental initiatives are supported by the
  NHS Education for Scotland (NES) Educational
  Framework and resources.
• Cohorts of SCNs are already developing into these
  roles across NHS Scotland and the initiative
  targets the implementation of this role for all
  SCNs working in hospitals by the end of 2010.
• From recent information provided by NHS Boards we
  know that there are around 2000 SCNs in Scotland.
  Of them, around 1545 will be included in the
  revised role and around 700 are already
  undergoing development or working to the outline.

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Clinical Quality Indicators - CQIs
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Why did we need Clinical Quality Indicators?

• Audit Scotland (2002) reported on limited
  availability of information on impact of nursing
  on quality
• Audit Scotland (2007) acknowledged progress but
  challenges for national quality indicators
• Identify nurse specific measures that have impact
  on quality of care and patient experience

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CQI Progress

• Three CQIs developed
• Falls
• Food, Fluid and Nutrition
• Pressure Area Care Prevention
• Data capture and reporting systems being
  developed locally nationally
• Further CQIs in discussion for specialist areas,
  eg midwifery, mental health, etc

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Clinical Quality Indicators

• Change of culture
• Data collection and analysis skills
• Quality improvement skills

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Data, data and more data

• Expect poor results initially
• Use it as a tool to engage staff and improve care
• If its not documented where is the evidence of
  care delivered?

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Impact on Quality
Implemented revised SCN Role
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CQI Compliance trends
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Synergies with other national programmes
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Supporting Development
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Supporting Development

• National Programme Leader
• Network of Clinical Facilitators
• Steering group chaired by Executive Nurse
  Director
• Commitment from Scottish Government, QIS and NES

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Leading Better Care
Scotlands Executive Nurse Directors Group (SEND)
Leading Better Care Implementation Group
Releasing Time to Care Facilitator Network
eQIPS / CQI Development Group
Leading Better Care Clinical Facilitator Network
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Leading Better Care Facilitators
8. NHS Highland Jenny Lobban Project Manager /
Facilitator, 01463 704715
1. NHS Ayrshire Arran Susan Hannah Practice
Development Lead, 01294 323457
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9. NHS Lanarkshire Margot Russell, Practice
Development Specialist Clinical Leadership and
Quality, 01698 723205
2. NHS Borders Kim Smith Practice Development
Leadership coordinator, 01896 827651
3. NHS Dumfries Galloway Maureen McCrae Unit
manager, specialist palliative care, 01387 241986
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10. NHS Lothian Fiona Bonnar Linda Conway Lead
Clinical Facilitators, 01506 434274 / 07813
579660
4. NHS Fife Lynn Barker Programme Lead Leading
Better Care, 01592 743505
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11. NHS Shetland Andrea Ridealgh, Senior Charge
Nurse, 01595 743357
5. NHS Forth Valley May Fallon Senior Nurse,
Practice Development, 01324 678528
12. NHS Orkney Moira Sinclair, Charge Nurse,
01856 888244
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13. NHS Tayside Debbie Baldie, Senior Practice
Development Nurse, 01382 660111
6. NHS Grampian Fiona Gray, Programme Manager /
Facilitator,01224 555064
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14. NHS western isles Mary McElligot,
Professional Practice Development Manager ,
01851 708057
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7. NHS Greater Glasgow Clyde Kate Cocozza, Lead
Nurse Practice Development, 0141 201 1695
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National Programme Leader Leading
Better Care Vicky Thompson, 07920 765343
Special Health Boards Golden Jubilee National
Hospital Irene McGachy, Clinical Facilitator,
0141 951 5050 The State Hospital - Sandra Steele
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N
Please note that this diagram is for internal use
only and should NOT be used in any publications
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How do we know if weve succeeded in
implementation?
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By the end of 2010

• Clinical Quality Indicators will provide us with
• Data used for quality improvement as part of
  day-to-day work
• Quality improvement methodology known and used
  regularly by all nurses

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By the end of 2010

• Senior Charge Nurses will be
• Empowered clinical leaders
• Guardians of quality and clinical standards
• Visible, approachable and authoritative

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Contact Details

• Vicky Thompson
• National Programme Leader
• Senior Charge Nurse, Clinical
• Quality Indicators Releasing
• Time to Care
• 07920 765343
• v.thompson_at_nhs.net