Aberdeen City District Nurse Collaborative
As part of a change programme led by Thrive, the Community Nursing Teams in Aberdeen City HSCP’s South District were given the opportunity to redesign Community Nursing services. Feedback from patients, community nursing staff and the wider multi-disciplinary team in Primary Care had suggested that the current model of service provision was fragmented, difficult to access, administratively ‘heavy’ and reactive rather than proactive. The service was at odds with the emerging HSCP strategy which looked to see the role of the District Nurse as anticipatory, providing care closer to home, supporting independence, treating acute illness at home and improving management of long-term conditions.
We formed a change team from across the ‘Direct Delivery’ and ‘Practice Attached’ nurses and generated energy and enthusiasm for service redesign. By securing some time-out from their demanding routines we were able to create a collaborative environment where they could share their understanding, insights and ideas.
We introduced a range of co-design tools, leadership and change management approaches that enabled the newly formed ‘District Nurse Collaborative’ to shift from a way of working that was frustrating them, to one that resulted in an exceptional improvement in staff engagement and morale. We supported the nurses to design and deliver improvement in:
Patient experience and patient centeredness
Nursing assessments, enhanced clinical practice and decision making
Effectiveness and efficiency, by releasing time to increase clinical capacity and reducing use of bank staff
Professionalism, autonomy, knowledge and skills and staff morale
The nursing staff said they are working in a more integrated and collaborative way and this came across strongly in a staff survey. Prior to working with us, levels of moral and satisfaction was low amongst the nurses. After, nurses said that they were motivated and satisfied in their work. They felt they had designed services that improved outcomes for patients and allowed them to enjoy their work again.