----- Original Message -----
From: "Danny McGeehan" <[log in to unmask]>
To: "Martyn Hodson" <[log in to unmask]>
Sent: Sunday, January 04, 2004 8:26 AM
Subject: The 98% target
> Ray
> I have been totally opposed to this nonsense since it was mooted approx 18
months ago. It is totally unacheivable and >like you our dept. was hitting
targets of 90% last year and we are now going backwards and as low as 70 and
80%. The >reasons are twofold, lack of beds and excess demand on the
service.
lack of beds is a realistic reason, this is the reason most of the breaches
(not covered by the exceptions list) happen where i work, that and tardy
appearances by specialities once referred (unless X ray are having a really
bad day)
blood results were a problem until we stamped our feet hard enough to get
the system the labs use piped up to us ( now get results 'directly off the
analysers' to quote the labs IT bod )
'demand is related to staffing, work rates and the working practices of the
dept
by working practices, the issue of 'Nursing staff waiting for the doctors
to catch up', rears it's head and here are my thoughts on the subject as a
Nurse , it's down to all the 'PDSA' stuff from collaborative etc
-who cannulates in your dept ? ( and , if it's nurses, what percentage of
the Nursing staff are competent?)
-do you have an established policy of 'pre emptive' blood sampling /
cannulation on the basis of groups of presentations ?
- are other investigations ordered premptively ( 12 lead, urinalysis, urine
B-Hcg)
- do you have nurse requested x-rays as well as ENP services ?
- do your Nurses Suture?
- do your Nurses Plaster?
- are notes / previuous A+E records requested pre emptively ?
are the doctors prepared to muck in with 'nurses jobs' if it increases
throughput ? ( , i've had speciality SPRs making up the numbers in (non
trauma team) log rolls before, sadly not every doc is or can be as obliging
as that.
> Unfortunately the nursing staff are now being bullied to prevent patients
breaching as they are being leaned on from higher > management.
usually it's the reverse where I work, we are badgering the bed managers and
Clinical co-ordinators to sort out beds, the higher ups act all concerned
when they have to but i don't think they pressure us, but maybe that's
because when things run smoothly we have proved sustained runs of high 90s
% is achievable
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