How can you implement change when you haven’t even got time to decide what the changes need to be?
Hospital at Night (H@N) is an out-of-hours way of working that has been implemented across many acute trusts since 2003. It aims to improve efficiency, free up junior doctor time, meet Working Time Directive requirements; and ensure the night-time clinical environment is safe, delivers effective care and demonstrates value for money.
One hospital trust had failed on several occasions to implement H@N owing to a lack of sufficient time, focus, energy and buy-in, so it called on TEN objectivity and change management expertise to mobilise the project, design the solution and engage clinicians.
"The trust had failed to implement Hospital at Night owing to a lack of time, focus, energy and buy-in, so it called on TEN's objectivity and change management expertise to mobilise the project, design the solution and engage clinicians."
TEN interviewed senior stakeholders, reviewed relevant hospital documents and tested ideas and thoughts in workshops. We recommended introducing a new integrated leadership role to oversee all operational matters out of hours and provide clinical leadership and team coordination. This helped the trust establish exactly what it needed to do and how to do it.
Further analysis of demand and activity ensured the team possessed the right competencies and adhered to the right processes to meet patient needs. This included defining H@N’s hours of operation; agreeing ownership of the project; determining line management; agreeing which clinical areas to include; deciding the accountabilities and competencies of the new teams and individuals; and highlighting which changes were needed to support implementation.