Table 3 Participant quotes ACROSS the care pathway
Quote | ACROSS the care pathway | Pseudonym, PPT Role & hospital pseudonym |
|---|---|---|
1. Communication and Coordination | “I think it will come with somebody taking a lead role … with any team you want everybody to come together, but you need to have a person who clearly leads on this. So having a person in a clinical role who can lead on it along with somebody from management who can lead on it would be useful” | Peter, consultant orthopaedic surgeon, Radford |
2. Communication and Coordination | PPT:” So, I don’t actually know what the targets are, well I was never told them or I was never explained them or anything. I only knew this because I saw one of my colleagues doing an audit, the national hip fracture audit or putting them on the national database, and I was like, ‘oh what's that you're doing’? And then she said, ‘oh yes, we have to operate on them within 48 h if we can, and that’s the national target’. So, I don’t think people are aware unless there's some kind of hearsay or they figure it out. But I think that is a good thing to know if possible … IV: why would it be particularly helpful for you to know about the expected targets? PPT: “So, obviously we’re only there for four months and you could spend a month and a half doing it wrong before you do it right and then you’ve only got two and a half months left trying to do it right. Or for example even as a junior it’s important for us to understand why it’s, from an education point of view, why it’s important to operate on a patient within 48 h, are there risks to not operating on them, what are the complications. Just as an education stand, is it a national target because of money or is it a national target because of patient care or is it a national target because of bed flow in the hospitals like, is there a reason behind this? So in that sense its quite important as well” | Alice, F2 Doctor Maplegrove |
3. Service improvement and clinical governance | “a lot of the drive comes from the hip fracture pathway. That you’re on a bit more of a schedule. Whereas if you haven’t got a pathway, everything’s a bit wishy-washy. But I think the hip fracture pathway does motivate people. Because there is a constant pressure. Because it’s, ‘okay, it’s seven days after their operation, what’s happening? Why aren’t we progressing’? Because we’re an MDT team, you’re not left alone, there’s a constant drive from every member or profession of the MDT to progress that patient … So I think everyone has a bit of a collective drive, but I think that being on that ward and on the pathway is a mega drive. Because it’s constantly evaluated” | Jane, Occupational Therapist, Springhill |
4. Service improvement and clinical governance | “we are always looking at our figures, we are always downloading the NHFD data to see, you know, are there any trends … and then between us we will look at it and go, ‘ooh you know we are getting a few delays here due to DOACs [direct oral anticoagulants]’, that kind of thing, so then we will just remind the team of the DOAC guidelines and so we are very proactive instead of reactive and you know she [HF lead] is always looking at that because we’ve had like letters in the past from the NHFG saying that we’re really, really good and all that kind of thing, I think because she likes that recognition – as do we all – it keeps us working so that we don’t let it all lapse” | David, Orthogeriatric Advanced Nurse Specialist, Springhill |