Occupational Therapy News OTnews April 2019 | Page 31

SERVICE REDESIGN FEATURE
dividing activity between ‘direct clinical care’ and ‘supporting
professional activity’.
Team leaders and therapy service managers have been trained in
job planning. The tool is completed by team leaders in collaboration
with their staff, and consequently, all clinical staff for occupational
therapy, dietetics and physiotherapy at NUH have a job plan.
Service improvement tools, such as ‘Plan, Do, Study, Act’ (PDSA)
cycles were used initially with trial teams, and then during a phased
roll-out to develop and improve the tool. ‘Productivity champions’
(senior clinicians) were recruited and trained to support with the job
planning training and to support teams during roll-out.
Confirm and challenge groups involving leaders, peers and
managers were used to evaluate and critique job plans, using an
open, supportive and transparent culture. Team leaders presented
their job planning learning document, to capture key themes of short
and longer term improvements for productivity.
Completed job plans have enabled leaders and managers to have
visible evidence of activity, and be able to quantify clinical available
© GettyImages/elenabs
Occupational therapists in project lead roles
Patients are at the heart of all improvements and transformations.
Using staff who ‘work on the shop floor’ provides realistic
understanding of processes and cultures.
Occupational therapsits are well placed to work in project
management roles. Some of the key skills that are transferable to
this role include communication skills, engaging people, building
relationships, using goal setting and having a vision, group
facilitation skills, teaching and training, organisation and planning,
problem solving project issues, and risks and using leadership skills.
Evaluating the transformational change project
Technology was used to create an inhouse job planning and
performance reporting tool, using Microsoft Excel. This was
designed to align with NHS Improvement recommendations,
hours (time available), compared with activity dashboards (what
activity has been done).
For the first time, teams can describe their productivity, measure
their performance over time, and manage their resources with
evidence.
Several themes have been captured to identify how teams are
working productively, as well as how teams can improve further.
These themes have been presented to the management team and
have been prioritised according to importance, time needed and who
can make the transformational changes.
This work has been presented to the divisional leadership team, as
well as external contacts from NHSI and Health Education England.
Themes collated to improve productivity include:
• process;
• unwarranted variation with patient referrals;
• reducing duplication, such as paperwork, training and
teaching;

travel
between clinical areas, including car parking issues for
•
community teams;
• non added value activity (use of evidence based practice
versus ‘because we’ve always done it that way);
• redeploying staff quickly when capacity is reduced;
• key performance indicator targets that change priorities;
• IT systems not joining up and the need for more IT facilities and
training.
Themes that centred on people included:
• trusting each other’s clinical opinion and reducing duplication in
assessments and treatments;
• sharing and spreading good practice;
• culture change – that is, what do staff and patients expect?;
• risk aversion;
• differences in productivity with rotational versus static staff;
• that senior staff are more productive clinically, but need to spend
time on non-clinical activities; and
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