#Helpingflo

Liz Muskett  (Service Transformation Practitioner, East Cheshire NHS Trust) describes the trusts innovative approach to improving patient flow. 

Eastern Cheshire A&E Delivery Board launched its #helpingflo comms campaign in September 2018 to help explain to staff, patients and the general public how we can all help to maintain flow this winter, and keep hospital beds free for those who really need them.

The campaign came about as a result of taking part in the Action on A&E programme, which focused on engaging A&E delivery boards to help them address the complex challenges faced by urgent and emergency care systems across the north of England. Like many other trusts we expect this winter will be particularly challenging. We also knew from previous years that being involved in the programme, and sharing ideas with colleagues from other organisations, could provide inspiration to help us improve patient flow, our chosen area of focus.  And it did!

Our first moment of clarity came at the programme launch event in May 2018. We were inspired by St Helens and Knowsley Teaching Hospitals NHS Trust who presented their impressive comms campaign. Our train journey home was full of talk about what we could do. We realised that we didn’t necessarily need another initiative to improve patient flow as there was already lots of great work going on in the trust, including the use of the SAFER patient flow bundle and Red2Green days process. What we needed to do was to ‘communicate’ more effectively with staff about winter pressures, escalation and actions that can make a difference for patients and staff. And that’s the beauty of a good collaborative; there is so much to gain in having the opportunity to listen to and learn from others. I doubt we would have had our lightbulb moment if we hadn’t been at the Action on A&E event.

Ultimately we decided we needed a system wide campaign for staff and the general public to support the delivery of effective inpatient flow during winter pressures. Coming to the decision to focus on a comms campaign was the easy bit, deciding on the campaign, a strapline, a theme and something that engaged people was much more difficult. Creativity doesn’t always come easily and oh how we struggled! It took a few weeks for inspiration to strike before we came up with #helpingflo based around a fictitious patient. However, it has proved to be a very engaging concept, particularly as we personalised it with our very own Flo!

Like all good improvement projects to get us started we needed a baseline. Where were we now, what did people already know, and what did they want to know? And so we developed, distributed and evaluated a staff and public survey. With over 500 responses, we learned a lot!

We discovered that although the public had a good understanding about how their actions could make a difference in primary care, such as using pharmacies rather than defaulting to a GP appointment, they were less aware about what could make a difference if they were admitted to hospital; however there was definitely a desire to know more!

From staff across the system we clarified what was already suspected, that not all staff understood the language of operational pressures escalation levels (OPEL). Therefore, improvements were needed in our daily communication of OPEL status. And then there was the ‘and so what’…. staff wanted to know what actions they could take that would help flow when pressures were high.

So that was our starting point. To help our staff we developed training aids, flyers and pocket cards to educate them about OPEL. And to help teams stay informed every day in real time about OPEL, we created resources such as OPEL flash cards for departments, and we are now looking at making our daily trust report more accessible for staff.

Our jewel in the crown is our #helpingflo videos, of which we are very proud! video1  Again, inspired by St Helens and Knowsley we produced 2 videos, one for staff and one for the public, with the purpose of sharing key actions that can make a difference to flow. There was no shortage of staff willing to take part, and no shortage of staff keen to see their colleagues on film! video2

Our Flo was launched at a successful marketplace event in September 2018, with visitors queuing at the door to get in! Over 200 members of staff came along to meet Flo, watch the first showing of the videos, collect OPEL resources and find out about services and initiatives that are supporting flow this winter.

The challenge now is to keep the momentum going, and so we need to ensure the videos are promoted and viewed as widely as possible. Ensuring we take every opportunity for staff to see their video is within our gift, but we also need to make sure the public video is viewed far and wide. So our CCG colleagues are working with GP practices to look at opportunities to air the videos, however we are also approaching businesses and other venues such as physiotherapists and gyms with a request for them to share the videos. We are thrilled that both videos have already achieved over 1200 views on YouTube!

Looking ahead is about how we continue to use #helpingflo to deliver key messages over winter to drive flow and free up beds. This month we have introduced Flo Champions, a little bit of healthy competition where we acknowledge wards who achieve the earliest discharges. We have also extended an open invite to staff to attend the daily capacity meetings to build on their understanding of how and why we declare each OPEL status. We also have plans to get Flo out into the community, meeting the public to raise awareness of the challenges we face and how we can all make a difference.

#helpingflo has been a winning campaign for East Cheshire. Not only were we thrilled to win the Action on A&E Regions got Talent competition, but more importantly it’s proved to be an effective vehicle for sharing key messages that will hopefully make an impact on staff and the public, and go some way to helping us manage the challenges we will undoubtedly face this winter. Thanks Flo!