LEADING BETTER CARE; Sharing Good Practice
Carolyn Lamb. Team Manager February 2012
SNBTS Edinburgh
NEW MOBILE DONATING CENTRE
DETAILS OF IMPROVEMENT
- What was the particular problem that this case study is about?
The bloodmobile had reached the end of its working life and finance became available in 2009 to build a new trailer and to replace the tractor unit.
I was not involved in the financial procurement or the purchase of the tractor unit but became involved in the internal design of the trailer.
- How was this identified?
The old bloodmobile worked reasonably well but the problems which had already been identified included lack of confidentiality, poor donor flow, lack of adaptability, heating and cleanliness issues.
Whilst designing the interior, we attempted to address as many problems as we could.
- What tools and techniques were used?
Together with one of the Donor Carer Drivers, I used a mock-up floor plan of the bloodmobile built at Ellen’s Glenn to redesign the interior. We made very careful measurements of the area and used masking tape and empty boxes to re-create realistic working spaces.
After the trailer was built, I had a visit to Lothian Daf to look at any snagging problems and assess any new equipment needed.
The drivers were trained in the set-up procedures and weekly maintenance procedures.
A small team which included me, ran a practice session on the day before the first day the bloodmobile was used then I was assigned as session manager on the first day.
The team were encouraged to make comments and suggestions which were then incorporated into a ‘Hints and Tips’ sheet for the next team on board.
The following week, we had a visit from two of the Glasgow team managers to aid their introduction of their new bloodmobile.
4. What is the situation now?
The bloodmobile has been in use for 4 months now. As the trailer has been used many of the snags have been addressed. For example, unfortunately, the bed area was built smaller than specified but the bed layout had been changed to compensate.
The drivers are becoming more practiced at setting up and dismantling the trailer and have discovered and dealt with a few problems along the way.
The staff are adapting to the slightly different donor flow although some are still resistant to change!
- How is the change sustainable?
Both Edinburgh and Glasgow’s bloodmobiles are now in use. Most staff have had the opportunity to work on board. All the drivers are now fully trained. We use a diary/communication book to communicate further snags or suggestions.
MEASURABLE OUTCOMES
1. What are the donor benefits?
Donors benefit by having a larger more comfortable waiting area. Confidentiality is improved with the two interview rooms.
Tea area now has a dedicated rest bed. (Prior to this, ill donors were placed on a donor bed or laid along the tea seating).
There is a disabled access lift with a doorbell to alert staff to assist disabled donors.
Entry and exit stairs are safer and more stable and have better lighting.
2. What are the staff benefits?
The staff have a much larger working area and are not cramped. The improved heating and lighting makes a much more pleasant working environment
Dedicated issue table means that the staff have easy and safer access for issuing packs and labels.
Tea area is larger and help is more easily available.
There is a lift available to lift equipment in and out of the trailer although this has not been used yet.
3. What are the organisational benefits?
Donor flow was improved by creating two interview rooms, moving sealing/linking into its own room and having a dedicated issue area. The waiting area was increased and a rest bed was created in the tea area
We had no fixed furniture in the donating area. This means that this large empty space can be used for whole blood donor beds or may be used in the future for apheresis.
The materials used in the building were chosen with reference to ease of cleaning and infection control. The corian worktops are very smooth easily cleaned.
- How did the staff feel before /during and after the improvement?
The staff were initially very positive as the old bloodmobile was obviously too old and not suitable and were looking forward to a brand new environment.
There have unfortunately been a few major problems such as the reduced size of the donating area and smaller but annoying snags for example, the staff microwave has been sited in the wardrobe which means that the wardrobe must be emptied prior to staff meal break.
The finishing of the doors and cupboards is not compliant with infection control and are of poor quality. Some are already broken
Many of the staff are disappointed that details of the planning carried out initially by the driver and me at Ellen’s Glen have been overlooked.
However, as these problems are gradually overcome, the staff are becoming happier with the bloodmobile again.
- What lessons learnt and what would you do differently the next time?
I would have liked to be more involved at the building stage as I could have foreseen many of the snags and problems. If I am involved in anything similar, I would be more assertive and insistent that donor staff are involved at all stages.
I would have like a much more defined ‘snagging’ procedure with input from both me and driver.
If this situation arises again, I would insist on being involved in the actual moving of equipment to make sure that nothing is misplaced and the organisation of storage is better.
I would have preferred to be session manager for the first five or so sessions to train and re-assure the staff and be on hand to answer questions.
The drivers are absolutely essential to the bloodmobile so driver training and input should have had a much higher priority.
- What plans are there to spread the improvement?
Both Glasgow’s and Edinburgh’s bloodmobile are in use. The team managers continue to discuss possible ways of improving the environment and the service, e.g. revising the bed layout.
All problems are communicated by memo to avoid repeat mistakes, e.g. we recently discovered that the tractor must not be removed whilst the pods are deployed to avoid settling and twisting of the pods.
CONTACT INFORMATION
Carolyn Lamb. Team Manager
Lauriston Place
013 536 5360
07704 862 498