January 2013 - University College London Hospitals

Inside Story
January 2013
Eva fever at UCLH – pages 3
AND
Spot the difference – page 2
PLUS
Tackling winter pressures – pages 4 & 5
Inside Story is the UCLH staff magazine
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news
Spot the difference – clean and safe care!
Can you identify the 12 differences between these two
pictures?*
We all aim to provide our patients with a clean and safe
environment in which to receive their care, however at times
ownership and responsibility of cleaning duties can be
blurred:
Nursing and clinical staff are responsible for cleaning up
bodily fluids and to clean/disinfect patient equipment.
Domestic and housekeeping staff are responsible for
cleaning and disinfecting the general patient area.
Aileen Taylor, infection control nurse, advises: “It is
important to remember that the environment can harbour
invisible threats to the patient, such as norovirus (known
as the winter vomiting bug), Clostridium difficile spores
and MRSA. Therefore cleaning and disinfection is of great
importance if we want to ensure our patients’ wellbeing.”
UCLH has recently changed its disinfectant product for
cleaning the general environment. Tristel Fuse is being
phased out and a new disinfectant – Diff X – is being added
to all cleaning processes. Based on peracetic acid, it can be
used for both general cleaning and for terminal cleans.
Nursing and clinical staff will still have access to Tristel Jet
for their near patient equipment cleaning and disinfection.
*Answers on the back page.
Soaring number of cancer patients get help and support
The support and information service
has already helped more than 10,000
patients at the University College
Hospital Macmillan Cancer Centre
since it opened eight months ago.
The service has proved a lifeline for
patients like Charles O’Hanlon.
“I used to see the name Macmillan
written on the door and think ‘that’s
not for me, that’s for people who need
palliative care’. But now I am a huge
fan. The service is with you throughout
your cancer journey and afterwards.
The people here are amazing. It is
almost like they are part of my family.”
Patients can discuss vital decisions
about treatment with support service
staff, receive counselling and use
complementary therapies.
Steve Richards, Charles O’Hanlon and Hilary
Plant, head of the Macmillan support and
information service
Kat Lewis, information specialist,
said: “We have seen 9,000 more
people than at the same time last year
in the old building, which is simply
fantastic...but we are aiming for 100%
of patients.”
Contact us
If you have any information you would like included in Inside Story, or on Insight,
contact: Communications Unit, 2nd Floor Central, 250 Euston Road, London NW1
2PG. Email: communications@uclh.nhs.uk, Tel: ext 79897, Fax: ext 79401.
Currently 20% of patients access the
service.
Jess Tudor-Williams, Cancer Division
general manager for UCLH, said she
was proud of what the service, staff
and volunteers had already achieved
and looked forward to it being
integrated with other UCLH services.
Steve Richards, England Director for
Macmillan Cancer Support, added:
“By 2030 there will be four million
people in the UK living with cancer.
We need to fundamentally change the
way cancer care is delivered and the
UCH Macmillan Cancer Centre is part
of that vision.”
Charlotte Williams from London
Cancer Integrated Cancer System,
said it was a ‘fantastic example’ of
how the NHS and voluntary sector can
work together.
Front cover: Radiotherapy
radiographers Jaymisha Patel and
Sophie Cole with Eva Longoria
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news
Hollywood glamour at UCLH
A-list celebrity Eva Longoria brought
a touch of glitz to the radiotherapy
department when she met staff and
young patients.
The star of Desperate Housewives
was in town to host the Noble Gift
Gala in aid of the Eva Longoria
Foundation, the Caudwell Trust and
UCLH charity Fight for Life, which
raises money to buy equipment for the
radiotherapy department.
Eva’s visit was very low key at her
request and she spent some time
meeting staff, patients and visitors
at the department before going on to
host the gala the next day.
She tweeted a few pictures of her visit
and said she had had a wonderful
time meeting ‘amazing angels’. She
looked totally at home in the small
radiotherapy play room, making
Christmas decorations.
Julia Solano, radiotherapy services
manager, said: “Eva brought some
real Hollywood sparkle on her visit
to the radiotherapy department.
The children, their families and our
staff had a wonderful time. Eva
spent a great deal of time talking to
the children about their treatment,
she posed willingly for so many
photographs making it a very special
occasion for all involved.”
The global initiative, set up by UNICEF
and the World Health Organisation,
offers practical and effective ways
to improve care for all mothers and
babies.
against a wide range of serious
illnesses including gastroenteritis
and respiratory infections in infancy,
as well as allergies and diabetes in
childhood.
Midwife Angie Ellis said:
“Breastfeeding protects babies
“We also know that breastfeeding
reduces the mother’s risk of some
cancers – although mums might be
more interested in hearing that it is
easier, cheaper and simply less hassle
than bottle feeding!”
Fight for Life fundraiser Yvonne
Delane, who was instrumental in
bringing Eva to UCLH, said: “We
were very happy to show Eva round
and tell her about the work of Fight
For Life and the UCLH radiotherapy
department. We were also very
honoured that she chose us as
partners for the Noble Gift gala.”
Baby friendly is best
UCLH has won international
recognition for the high quality support
it gives to new mothers to encourage
them to breastfeed.
UNICEF awarded the trust full Baby
Friendly status after its assessment
highlighted best practice.
Sue Ashmore, the initiative’s
programme director, said surveys
show most mothers want to breastfeed
but don’t always get the support they
need.
Some of the Maternity Care Unit team with a baby patient
She added: “Mothers at UCLH can be
confident that staff provide the highest
standard of care.”
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tackling winter pressures
What do you do if the number of patients needing acute hospital care exceeds
the number of beds available? In the winter months in particular, the UCH tower
comes under particular pressure.
This month, we feature two new services which have the potential to be popular
with patients, ensure nothing holds up their recovery and which use our acute
inpatient beds more wisely.
Recent work on our patient profile showed a significant proportion (16%)
no longer required acute hospital based care, with almost half (47%) of all
inpatients experiencing some type of delay. The Trust’s Flow programme was
launched to address this.
Jubilee ward opens
Jubilee Ward – a UCLH service at St Pancras Hospital – opened its doors to
patients this month to ease the pressure on acute beds in the UCH tower. And
matron Josie Gladney, ward sister Rebecca Maud, deputy ward sister Vania
Barbosa and the rest of the team were there to greet them.
Vania Barbosa with patient Peggy McGrath
One of the first to arrive was Peggy McGrath who transferred from T10 in the
UCH tower. She said little but smiled a lot. “Do you like it here?” She smiled
again and gave the thumbs up.
Another patient described the traditional style wards and lounge area as
‘homely’, adding ‘it’s nice here – cosy.’
The 17 bed ward is a UCLH service delivered by our staff and is suitable for
those patients who are medically stable and no longer require an acute bed. The
majority are elderly and are waiting for inpatient rehabilitation, for equipment to
be installed in their home or for a residential or nursing home placement.
Vania said: “It’s a very different atmosphere from UCH and we hope the
environment will be more like the patient’s own home. They can wear their
own clothes, go for a walk in the garden if the weather is fine, and watch TV in
the lounge. It’s much more relaxed and with less rigid routines and helps them
make the transition from an acute hospital setting to home.”
Patients suitable for transfer are identified by our nurse consultant for acute care
and a consultant in elderly care. They are seen on the ward by a UCLH junior
doctor, whilst remaining under the care of a UCLH consultant, who regularly
reviews the patient.
Jubilee Ward is operating on a 24 hour, seven day per week basis. The ward
is led and managed by T7 ward sisters, the matron for medical specialties and
supported by the nurse consultant for older people. UCLH nurses and nursing
assistants complement the team.
If you think you have a suitable patient for Jubilee Ward, please contact
Anne Schlattl on 07930 844150
Staff nurse Robert Vicente, nurse consultant Vicki Leah, deput
matron Josie Gladney
Insight features a number of other potential solu
guidelines based on the traffic light system for im
tower matrons taking on extra responsibility to m
patient transfer team to help ward staff discharg
term, the Flow programme could free up 60 inpa
You can click the tower performance button on th
more information.
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tackling winter pressures
Happy to be home!
Desmond Broggy was one of the first to benefit from Hospital@
Home (H@H) – a new service where patients are cared for at
home whilst remaining under the care of UCLH via a ‘virtual
ward.’
Nurse Caroline Johnson escorted him and a friend to his home
near Holloway Road.
Mr Broggy (pictured above with nurse Caroline Johnson) left
UCH following surgery to remove a tumour in his larynx which
has left him with difficulties when speaking and swallowing. The
Hospital@Home team then provided nursing care in his home
until he was able to be discharged from the care of UCH.
Caroline said: “Desmond needed medication management and
advice. We also set up his equipment (suction machine, nebuliser
and feeding pump) and made sure everything was in order. Some
equipment was delivered by the district nurse and the rest was
brought home with the patient from the ward. We had already
assessed Desmond using the equipment before he left hospital.
“He seemed very happy to be back home and to see his son. He
was the perfect patient!”
Caroline made a return visit the following day to check everything
was running smoothly and discharged the patient with the district
nurses in the patient’s home.
“Desmond and the district nurses were given my contact number
and could contact me or my colleague via text at any time if they
had any concerns.”
Mr Broggy texted to say: “The whole service was lovely. Thank
you.”
If you think one of your patients would benefit from Hospital@
Home please contact team lead nurse Linda Huggins on
07415 606414.
Hospital @ Home
Leah, deputy ward sister Vania Barbosa, ward sister Rebecca Maud, and
ential solutions to an on-going challenge. These include new
stem for imaging, pharmacy and therapy service requests,
sibility to manage patient flow and efficient use of beds, new
f discharge patients safely – and many more. In the longer
up 60 inpatient beds by March 2015.
button on the right hand side of the Insight home page for
Popular with patients who prefer to recover at home
rather than in a hospital bed.
Patients must be on an agreed care pathway and can be
promptly readmitted to a UCH hospital bed if necessary.
Hospital @ Home, works as part of the Discharge Support
Team, and has immediate access to senior medical staff.
The service is currently available to patients who have
undergone general medicine, breast surgery, colorectal
surgery, hip or knee arthroscopy, abscess removal and
now includes patients with IV lines
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our trust
Top of the docs
Pictured l to r: Dr Giles Kendall, consultant neonatologist; Dr Sian Harding, consultant neonatologist; Professor Donald Peebles, consultant
obstetrician; Olivia and Humphrey; Leah Healy, neonatal nurse (foreground); Dr Pranav Pandya, director of fetal medicine; Dr Judith Meek, consultant
neonatologist. Photo courtesy of Mark Harrison.
UCLH staff have been named among
the top 100 children’s doctors by the
Times magazine.
The Times explains that their list is not
exhaustive, but offers a glimpse at the
pioneering doctors and surgeons who
are transforming children’s lives.
The magazine included a feature by
grateful mother Olivia Gordon who
focussed on the work of the UCLH
fetal surgery team:
A fighting chance
After her first pregnancy ended in
a miscarriage, Olivia Gordon was
being ultra cautious second time
around. She didn’t paint her nails, eat
forbidden food or go anywhere near
smokers.
Then came the devastating news: her
29-week-old baby had an extremely
rare condition which meant he had
to be operated on in the womb
immediately. Otherwise he would die.
The condition is known as hyrdops
fetalis, which affects around one in
3,000 pregnancies and is often fatal.
It means that the body’s lymphatic
system, or drainage, fails. Olivia’s
baby was breathing in amniotic fluid
but not processing it. His organs were
being crushed, restricting his growth,
as the fluid built up inside him.
But thanks to the fetal surgery team
at the University College Hospital
Elizabeth Garrett Anderson Wing –
one of a few such centres in the world
– there was hope.
Following diagnosis at Olivia’s local
hospital, Professor Donald Peebles,
a consultant obstetrician and head
of research in maternal and fetal
medicine at the EGA Wing, performed
a ‘pleuroamniotic shunt’ treatment –
inserting a fine tube into Olivia’s belly,
into her womb and into her son’s chest
to drain the excess fluid.
Olivia recalls: “I cried out, not so much
in pain as in surprise. It felt wrong; the
antithesis of protecting my baby.”
But the reality was overwhelming. “If
we didn’t [agree to the treatment] our
baby was likely to die. If we did … the
procedure might induce premature
labour, heart failure for the baby and
infection. But he might live.”
The procedure wasn’t a total success.
But a week later she was told by
Pranav Pandya, director of fetal
medicine at UCLH, that the chances
of survival for her baby had improved
from 50-50 to possibly 90 per cent.
Soon after, Humphrey was born. The
first 24 hours of his life were critical.
He was taken to the neonatal unit,
‘one of the best in the world’ but where
doctors could count on two hands the
number of babies they had treated
with this condition.
Olivia recalls: “Visiting Humphrey for
the first time, I longed to hold him but
could only stand and look. He was
only stable enough to come out of
the incubator for us to hold at the end
of the week for 40 minutes, by which
time I barely dared touch him, such
was his vulnerability … then when I
entered his ward, I was enveloped by
a terrible sadness of finding him in this
lonely place.”
She describes the nurses as ‘not only
gentle and compassionate in their
handling of Humphrey but incredibly
kind to our whole family’.
The care she and Humphrey received
from consultants Dr Giles Kendall, Dr
Sian Harding and Dr Judith Meek was
‘extraordinary’. Slowly, overcoming
complications and with more surgery,
he got better until Olivia and her
husband Phil were able to take
Humphrey home – five months after
he was born.
Olivia has christened the medics
who have treated her son as ‘Team
Humphrey’, and says they have left
her with ‘an abiding love of the NHS…
without [them] we wouldn’t have a son
at all’.
This is an abridged version of Olivia’s
article which appeared in The Times
magazine on December 15.
Our nine top doctors were:
Dr Simon Choong, consultant
urologist; Professor Mehul
Dattani, consultant paediatric
endocrinologist; Professor Peter
Hindmarsh, consultant paediatric
endocrinologist; Dr Rachael
Hough, consultant haematologist;
Dr Jeremy Lavy, consultant ENT
surgeon; Amanda O’Donnell,
consultant paediatric dentist;
Pranav Pandya, consultant in fetal
medicine and obstetrics; Professor
Donald Peebles, consultant
obstetrician; Professor Russell
Viner, adolescent physician,
clinical director for paediatrics and
adolescents.
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our trust
What on earth’s an accountant doing here?
Trust accountant Rebecca Ainslie
swapped figures and finance for an
action-packed day in a hospital ward
to gain insight into the pressures
experienced by her clinical colleagues.
The visit was part of a shadowing
programme to encourage members of
the finance team to observe doctors
and nurses at work and see how
resources and equipment are used.
Rebecca, who has written a blog
about her experience, said: “The
morning (on T8) started with the
nurses’ handover. It was a busy
morning as the shift had started with
several new patients admitted due to
high numbers in A&E and the closure
of T10 due to norovirus. Part way
through the meeting the ward sister,
my companion for the day, was called
out to an emergency, a patient had a
cardiac arrest.
“I’d been there 15 minutes and already
there was a patient emergency, how
can I compare this to my emergencies
of having two minutes to upload a
journal?!”
Every month Rebecca meets the
ward sisters on T8 to discuss financial
performance and offer support.
She added: “But how can I possibly do
this without spending a minute on the
ward? Finance should be engaged,
we should be on the ward seeing the
pressures first hand, understanding
why our ward sisters need our support
but not our constant interference with
questions.”
Rebecca also spent a morning
shadowing on T12 south, an
adolescent ward and once again she
was impressed.
“I was inspired by their ability to
deal with the many challenges they
face on a daily basis,” she wrote.
“This programme has given us the
opportunity to take advantage of
this enthusiasm and build strong
relationships across staff groups within
the trust. By working together we can
make a difference.”
The shadowing programme is open to
all finance staff who are provided with
Rebecca Ainslie with ward sister Charlotte Parsons and a patient
clear guidance beforehand to ensure a
safe and productive session.
If you are interested in applying please
talk it over with your line manager
first and then contact Judy Walker at
judith.walker@uclh.nhs.uk .
Judy would also like to hear from other
wards that are interested in hosting
shadow sessions.
To read the blog in full go to the
QEP Insight page where Rebecca
is guest blogger of the month.
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the back page
Secret Lives
Have you ever wondered what
it would be like to be the pilot in
command of a commercial airliner?
Well now you can, by being very
nice to Mark Taglietti (pictured
right), recently appointed head of
ICT service delivery and vendor
management.
For as well as being a qualified
private pilot, he owns a full sized
Boeing 737 flight simulator in
leafy Chiswick, which he built from
scratch.
“It was extremely technically
challenging but more than worth the
time, money and sleepless nights.
The joy of landing at the world’s
most challenging airports under
extreme pressure due to engine
or hydraulic failures, lack of fuel or
extreme weather is a real thrill.”
Mark spent many years flying
‘virtually’ using a simulator on his
home computer before gaining his
full, non-virtual private pilot’s licence
in 2010.
“But I wanted to experience what it
might be like to fly a passenger jet
rather than a single engine piston
Cessna or Piper Warrior.”
So he got to work sourcing,
fitting, and testing thousands
of components. The simulator
based in a business park is used
for assessing pilot capabilities,
undertaking stress management
courses, and taking the public
on joy flights. It can simulate
global scenery, seasonal weather
conditions and emergency
procedures and can land at more
than 1,000 international airports.
“Approaches into international
airports, such as the old Kai Tak
airport in Hong Kong or Paro airport
in Bhutan can be very challenging.
People are extremely focused and
show signs of stress and anxiety,
including increased heart rates,
sweating etc. A significant number
have almost fallen over when
they leave the cockpit due to the
perceived sense of movement.”
So, if you ever find yourself in a reallife emergency and ‘can anyone here
fly a plane?’ comes over the tannoy,
hope that Mark is on board.
“I think I would relish it. I have my
Private Pilots Licence, fly a Piper
Warrior Single Engine Aircraft, and
have at least 500 hours in the 737 so
I am fairly confident I could take the
controls of this, and other aircrafts
in flight and land either at the
destination airport – or an alternative
one.”
Phew!
New Year honour for chief nurse
The Queen’s
New Year
Honours List
was a cause
for celebration
with chief nurse
Katherine
Fenton among
the great
and the good
recognised for their outstanding
achievements and service.
Reducing harm to patients is always
uppermost in her mind: she led the
development of the NHS Institute
for Innovation and Improvement
national nursing and midwifery high
impact actions aimed at reducing
the risk of harm.
Katherine was awarded an OBE for
services to nursing.
Alongside David Wherrett,
workforce director, she led the
development of our new values
which were launched in 2012 as
part of the Making a Difference
Together campaign.
She said: “I will be accepting the
award on behalf of all the dedicated
nurses out there. It is great for our
profession to be publicly recognised
for the care and commitment we
give to patients.”
Sir Robert Naylor, UCLH chief
executive, said: “I am delighted that
Katherine’s fantastic contribution to
the NHS has been recognised. I am
sure that everyone at UCLH will join
me in congratulating her.”
Archives
Two char-ladies (house cleaners)
from The Middlesex Hospital, c.1935
Spot the difference answers:
1. Uncovered commode at patient bedside with
cleaning label left on 2. Patient notes on bed
3. Clinical waste (disposable gloves and syringe
wrapper) on floor 4. Clinical waste bag attached to
patient table 5. Domestic and clinical waste on table
6. Untidy and soiled linen on patient bed 7. No
alcohol gel dispenser (with gel) attached to bed
8. Oxygen mask hanging over patient light 9. Used
intravenous giving set trailing floor 10. Used urine
bottle on patient table 11. No patient notes holder
attached to bed 12. No urine bottle holder attached
to bed.
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