Tuesday 28th April 2015
Mac Voice, the magazine for Macmillan professionals: Spring 2015
Angela Jeff used the Listening into Action approach to improve services for people with colorectal cancer
The Listening into Action (LIA) approach is a process that helps frontline staff break down barriers to improve their own services. Using this approach, I identified that a different way of working was needed to minimise appointments for people with bowel cancer
prior to surgery, and to structure nursing team members’ time more effectively. I thought a ‘one-stop’ clinic, similar to those at many centres for people awaiting joint replacements, might be the answer.
The first part of the process was to create a case that a change of working was needed. This involved sending an online survey to the teams involved, and to the people with bowel cancer who had used the existing service. The results revealed 10% of respondents who had undergone surgery said some of their worries and concerns were not addressed. Meanwhile, 43% of staff identified barriers to seeing patients pre-operatively, which included trying to work around other appointments.
I created and led a steering group of the main teams involved. At the steering group meeting, it was clear our initial vision for change could actually lead to a far better service improvement than we had expected. We identified who else would need to be involved in order to achieve this. The next step was a ‘staff conversation’ trying to bring together various representatives from teams to discuss barriers and make suggestions.
With many ideas from a number of teams a plan developed. It would be a Friday afternoon clinic and everyone having surgery the following week would be given an appointment to attend. Nurses who potentially needed to attend the clinic included the stoma care nurse specialist, the surgical nurse practitioner, the pre-op assessment nurse for final blood tests, and the research nurse. This was a great opportunity for me to have dedicated time to perform the Holistic Needs Assessment (HNA) with this group of people with cancer. A suggestion was made that further information could be provided in the format of a DVD to demonstrate which other team members may also be involved in the care of the person with colorectal cancer.
A one-stop clinic, now named the Bowel Surgery Awareness Clinic, has been running since January 2014. Links were made with a local college who took on the project of filming the individual teams for the DVD. This is currently in the process of being edited.
A combined team information booklet is in draft form at moment. We hope this will provide written information that is enhanced through a joint approach. The HNA has been implemented for this group of people with cancer using paper format. In future, East Cheshire NHS Trust will be linking with Macmillan to use the electronic HNA (eHNA).
Email Angela Jeff, Macmillan Colorectal Nurse Specialist, East Cheshire NHS Trust
Further information on LIA can be found on the Listening into Action website.