The idea

Use the Well Organised Practice module from PGP Quick Start to help reduce the number of interruptions during patient consultations.

Too many interruptions

The practice conducted an audit over its two sites which in total has 24 consulting rooms, to identify the number of interruptions taking place during consultations, and how much time was being wasted when a clinician (GP or nurse), had to go in search for items.

• In total clinicians were being interrupted 32 times per day during their sessions, this mainly effected 2 nurses who conducted their consultations in rooms where most of the clinical stock was stored.
• Over 3 hours a day were being lost due to clinicians having to leave their consultation or rummage around their rooms looking for equipment or stock.

The data demonstrated to the team the problem was worse than originally anticipated.  Furthermore, feedback from GPs showed the interruptions were stressful and making their sessions overrun.

Identifying the causes

The team explored the root causes and found a number of contributing factors.

• Equipment borrowed from different clinical rooms was not being returned after use e.g. GPs’ blood pressure machines were often going missing.
• There was no routine stock-up system, so when items ran out on trollies in the clinical rooms staff would have to step out during consultations to stock up on items they needed for that consultation.
• Work spaces were not organised in a consistent way over the two sites making it difficult for staff who worked over both to find items.

The team recognised that making changes to the workspace and stock-up system would help both clinicians and patients.

A more organised workspace

A GP, nurse lead and member of the admin team brainstormed ideas that led to a number of changes that were made across both sites.

• All clinical rooms now have identical desk trays that hold equipment required for consultations e.g. thermometer, ear scope, blood pressure machine. Each section of the tray is labelled and clinicians are required to return equipment to its place after use.
• Each clinical room now has a fully stocked trolley that holds the most frequently used items during consultations e.g. speculum, gloves and swabs. Twice a week a healthcare assistant and student nurse check the trolleys and make sure they are well stocked, at the same time they will check if there are any other items in the room missing that need to be stocked e.g. couch roll.
• Input was gained from staff on the changes being considered before they were fully implemented and became standard across both sites.

Impact

• The number of interruptions during consultations has significantly reduced with clinicians having no interruptions at all most days.
• 16 hours of clinical time per week has been released through less interruptions and time previously wasted searching for items. The time released has helped sessions run more smoothly and to time.
• Patients are receiving a more seamless consultation and getting uninterrupted time with their GP or nurse.
• Clinicians are feeling less stressed and frustrated as everything they need is in its place, helping them deliver a more organised consultation.
• As the practice moves towards working in a Primary Care Network this is an example of efficient working it will look to share and embed with other practices, helping to gain efficiencies across the network.

“We have been wanting to do something about our workspace for a long time.  The changes made have had such a positive impact and helped reduce stress clinicians were previously feeling.” Johra Alam, GP, Churchill Medical Centre

“The work we have done has been hugely satisfying, by making small changes across both our sites we have a more organised and standardised workspace that is working better for our clinicians and patients.” Catherine Edmunds, Lead Nurse, Churchill Medical Centre

If you would like to find out more about how you can access the Productive General Practice Quick Start programme, visit our ‘Releasing time for care’ web page.