The number of complaints about the A&E department at Princess Alexandra hospital NHS trust in Harlow – which sees 350 patients a day – has fallen by a third to just three a month while the number of compliments from patients about their care has doubled. Some 95% of patients would recommend the department to family and friends and the department has seen the number of serious patient incidents fall from eight, two years ago, to zero in the last 12 months.
The statistics are testament to the success of the department's transformation in the last year and reflects a change in culture where patient safety comes first. Dr Joud Abduljawad, clinical director for urgent care says: "This is about putting patient safety first and patient care at the heart of everything staff do. It's not about achieving targets."
The A&E now has its first nurse practitioner – similar to the model used in the US – who can take serious cases including patients with chest or abdominal pain who previously would have been seen by doctors. More emergency consultants have been taken on so that there is a consultant in the department 16 hours every day. Following consultation with clinical and non-clinical staff, the department building has been redesigned – there are no longer areas where patients are out of sight of the medical team. "Patients can now see that staff are around," says Lindsay Hanmore head of nursing for urgent and ambulatory care.
But according to Professor Nancy Fontaine the director of nursing and quality, the transformation has been more than doctors and nurses working differently. "There has been a whole staff system approach to develop and transform the department which has included the support staff, porters and domestics," she says.
Hanmore says: "The staff have been involved in the changes; it wasn't 'done unto them'. And I think that has been one of its biggest areas of success."
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