Productive Ward + Star Wards reduces length of stay by 20%!

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I met Sue Merchant when we were running our London Bridges project, during which Jude Hackett worked closely with a number of London Trusts to help them set up Star Wards. Sue was NELFT’s service improvement manager and simply one of the most impressive, dynamic, warm, committed members of staff I’d come across. It was clear that if any one individual could be pivotal in introducing ambitious and sustainable changes, it was Sue.


Fast forwarding to a few months ago, I was looking through Mental Health Practice and came across an article called How to turn innovations into everyday practice. I paused and thought “Hmm, I’m interested in innovations, let’s see what the article’s about.” To my astonishment, it was all about how Sue and colleagues implemented Star Wards, and the very fab Productive Ward. And the piece was a presentation of the findings of research by Philip Kemp from London South Bank University. How cool is that? Research about Star Wards which I didn’t even have to take an armchair role in!


And it just got better and better! The full article is in the October 2011 edition of Mental Health Practice but here are some of the highlights. Rather than beginning at the beginning, in a nonchalant, detached kind of way, I’m going to plunge straight in with the awesome results of NELFT’s initiative.


The number of recorded incidents fell from an average of 30 per month during the first three months of the first year to an average  of 13 per month during the last three months. And….

the average length of stay declined from 25.5 days to 20.3 days. Wowza!! Other remarkable service improvements included:


  • service users reported being:
  1. offered more information when they arrived on the wards
  2. more involved in decisions about their treatments
  3. more occupied in useful and relevant activities
  4. respected more
  5. more satisfied with the care they received.
  • new group activities  were developed in consultation with service users eg carer support, health and wellbeing, and ‘hearing voices’, and a comprehensive programme of group activities now takes place on each ward.
  • the development of a ward library, a gardening group and a ward-based internet café, and the running of regular movie nights.
  • In the four wards that had implemented the Productive Ward initiative, the total number of hours staff spent in direct client contact had increased from about 21 per cent to about 60 per cent
  • the hours per month in which qualified agency staff were used fell from 95 to 50, while the hours per month in which unqualified agency staff were used declined from 87 to 67.


As for sustainability, here’s what the article said:


Structures and processes have been embedded in NELFT practice and will be extended to all inpatient facilities in the trust. Responsibility for the project practices has been transferred from the Star Wards and Productive Ward leads to modern matrons, and its outcomes have been incorporated into the trust’s performance framework. In other words, the developments have become ‘business as usual’.


NELFT chose a highly structured process for implementing Productive Ward and Star Wards, including programme leads, a pretty elaborate set of regular meetings, externally facilitated action learning sets, ward-based training and away-days. This was in 2009 – 10, and I’ve no idea whether such enormous commitment of staff time would be possible in the current hideous financial circumstances inflicted on inpatient (and all other NHS) care. And it’s worth mentioning that other trusts, hospitals and individual wards have achieved astonishing transformation by introducing Star Wards with little or no additional staffing or complex co-ordination and training structures. (Lagan Valley is a heroic example of this.)


But major kudos and hugs all round to NELFT for embarking on such a thought-through, followed-through and highly effective initiative. And for appointing someone as magnificent as Sue Merchant to head it up.





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