More than forty teams from across BC are participating in Releasing Time to Care (RT2C), an initiative developed by the National Health Service (NHS) in England to empower frontline staff in leading change that will improve patient care. The BC Patient Safety & Quality Council is supporting teams as they work through the module-based self-directed quality improvement program that’s proven successful in other provinces and countries.

The team from Mental Health & Substance Use Adult In-patient Services at Royal Jubilee Hospital launched RT2C in October 2014 and is keen to share their learning and experiences with others across the province. They say that while it took some time for the program to take off in the beginning, things are now moving forward quickly and they’re seeing noticeable improvement on their unit!

Nicola Piggott, Consultant, Quality, Safety and Improvement, joined the team a year ago to provide leadership and coaching about quality improvement, patient safety and RT2C . She says RT2C has given the team renewed focus and energy to improve how the unit operates, laying the groundwork for continuous improvement and sustainable change.

A few members of the RT2C team from Mental Health & Substance Use at RJH: (l to r) Jackie, Fiona, Dr. Dan Boston and Nicola

“What’s been really powerful about this program is that it’s helped the team talk about what they want to improve. It is a culture shift and it takes time, but it allows staff to voice their opinions on how to improve the way we deliver care to patients. Reorganizing the medication room was the first project with RT2C and it’s something staff came up with on their own. They brainstormed ideas as a team to make the room more efficient – RT2C is very frontline driven.”

The team says RT2C develops teamwork and communication skills, improves efficiency and organization and builds capacity for quality improvement. By participating in the program, they foresee better patient outcomes and fewer safety events. Staff also appreciates having more time for direct patient care.

Medication room BEFORE: Staff voted to re-organize the medication room as their first RT2C project.

Jackie Thompson, RPN, says “This program has been a shift in how we function. It gives staff ownership for their jobs and how our work impacts patients. So, instead of being leadership driven it comes from frontline nurses who are in this environment every day. When we reorganized the medication room we removed over 50 items. Now, it’s more organized visually, which saves a lot of time when you’re in a hurry.” 

Medication room AFTER: Over 50 items were removed and supplies have been re-organized. The change is improving efficiency on the unit and giving staff more time for direct patient care.

The team is now participating in the Well Organised Ward or “WOW” portion of the program (second foundation module), which focuses on the physical environment to improve efficiency and organization on the unit, as well as collecting data about quality and safety. Data from BC PSLS is being reviewed, along with findings from a staff satisfaction survey, patient satisfaction survey, patient length of stay, and anecdotal feedback from staff on where they see inefficiencies on the unit.

“Just collecting this kind of data and studying it to improve quality and safety was new for us,” says Crystal Fee, RN. “Looking at data is not something nurses do in their day-to-day work in caring for patients. But now staff are starting to see change coming from that data. Seeing those changes happening is very powerful – it’s creating buy-in with the staff and it’s definitely improving patient care.”

RT2C in action! The Mental Health & Substance Use team at Royal Jubilee Hospital in Victoria, BC.

RT2C white boards give visibility to the initiative and allow staff to see progress on the unit. Patients and visitors also have the opportunity to see how the unit is improving.

Susan Rich, Program Manager, says the beauty of RT2C is that it’s something the organization’s leaders and frontline staff can get behind together. “We’re generating ideas that will have a long lasting impact here and in other areas of the hospital; that’s not always the case with quality improvement projects because sustaining change can be difficult. But with this we have a wonderful partnership with staff on the frontline – those who are generating the ideas and doing the work – and with leadership who supports what we’re trying achieve.”

“RT2C is giving us a way to shine a light on the changes we’re making and that’s positive for everybody,” says Crystal. “We had an incident the other day and it was much easier to find what we needed from the med room in that critical moment. I think that’s why we’re seeing this really take off over the past six months – it’s more in the forefront. There’s a visual awareness of patient safety trends and we’re talking more as a team about how to improve.”

With their medication room now reorganized, the team is looking forward to their next RT2C-driven project!

One of the first tasks in RT2C is developing a unit vision statement. The team voted on a vision statement that was most meaningful and important to them. The artwork was created by patients at Seven Oaks, a tertiary mental health facility in Victoria, BC.

Learn more about Releasing Time to Care