Practical tool | Positively deviant wards | Comparison wards | ||||||
T1W1 | T2W3 | T2W6 | T5W10 | T1W2 | T2W5 | T3W8 | T4W9 | |
Verbal handovers | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ||
Handover sheets | ✓ | ✓ | ✓ | ✓ | ✓ | |||
Safety briefing | ✓ | ✓ | ✓ | ✓ | ||||
Board round | ✓ | ✓ | ✓ | ✓ | ||||
MDT meeting | ✓ | ✓ | ✓ | ✓ | ||||
Ad-hoc meetings | ✓ | ✓ | ✓ | |||||
Ward-based AHPs* | ✓ | ✓ | ✓ | ✓ | ✓ | |||
AHPs write in medical notes* | OT and Physio | Physio | Physio | OT and Physio | ||||
Bedside boards | ✓ | ✓ | ✓ | ✓ | ||||
Ward boards | ✓ | ✓ | ✓ | ✓ | ||||
Patient activities | ✓ | ✓ | ✓ | ✓ | ||||
Cohorting | ✓ | ✓ | ||||||
Intentional rounding | ✓ | ✓ | ✓ | ✓ | ||||
Innovative strategies | Discharge to assess | Dementia care, rotating discharge nurse | Morning routine | Diabetes and sepsis trolleys |
Ward pseudonyms are constructed using T (number)=the NHS Trust identifier and W (number)=the ward identifier.
*Explicit differences between the positively deviant and comparison wards were observed in relation to these two strategies. However, having ward-based AHPs and enabling AHPs to write in the medical notes were not considered to be positively deviant as they will have required implementation at a Trust (organisational) level. Comparison wards within Trusts 1 and 2 are also highly likely to use these ‘tools’.
AHPs, allied health professionals; MDT, multidisciplinary team; NHS, National Health Service; OT, occupational therapy; Physio, physiotherapy.