The RIC Hub Bevan Exemplar

Community of Practice

Development of a Community of Practice within General Medicine at Withybush General Hospital

The department of General Medicine occupies the majority of inpatient beds. Chronic health and social care system wide flow constraints have led to a position of in excess of 30 surge beds and 20-30 medical patients remaining in the Emergency Department (ED) whilst awaiting inpatient beds. This places a vast amount of pressure upon the General Medical team as well as the hospital as a whole.

Chronic workforce challenges, particularly across nursing & medicine, mean that the existing teams are overstretched to deliver care to more patients over more areas. Vacancies and skill mix are of significant concern. The risks to patient safety through overcrowding in the ED are well documented with delays likely to negatively impact on patient outcomes. The inability to provide the desired level of care frequently leaves staff with moral injury and concerns for their professional registration.

We are very fortunate to have motivated and passionate teams who are committed to providing the best care possible whilst continuously reviewing opportunities for improvement. Traditionally, these teams meet within their own professional structures and rarely come together to share experiences and ideas.

We are committed to fostering and developing an open and proactive culture where experiences and concerns are discussed, and ideas cultivated and nurtured. Pressures on the NHS, and its staff, have never been higher with Withybush Hospital being no exception. Such emergency pressures present increased risk to patient & staff safety as well as staff well-being. Developing a ‘safe space’ where colleagues can meet, interact and share experiences will serve to bring the wider team together to discuss experiences and concerns, agreeing a collective way forward to minimise safety risks and improve well-being

This project will bring together identified teams, including nurses, doctors, therapists & support workers, within the directorate to form a Community of Practice where discussions can take place, experiences and ideas shared. This will then form the basis for agreed safety improvement projects, through innovation, to be developed and implemented through a shared vision and goals.

The community of Practice will agree how it will meet and ‘ground rules’ to ensure that all feel safe and respected. With this in mind, particular points of focus remain uncertain as these will be determined by the community once established.