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Workload Management of Donor Adverse Events Follow-Up

Australian Red Cross Blood Service
Project Added:
13 October 2015
Last updated:
20 October 2015

Workload Management of Donor Adverse Events Follow-Up

Summary

This project identified ways to optimise the use of nursing resources, to meet donor care, customer service and risk management requirements. 

Aim

To ensure 100% of all donor adverse events are followed up within seven days, by 30 June 2015.

Benefits

  • Ensures appropriate and timely donor care, customer service and risk management.
  • Optimises use of nurse resources nationally, including:
    • increased performance reliability and target achievements
    • improved nurse morale, with workloads matched to staff so overburdened teams can reallocate work to available teams.
    • reduced need for increases to nurse staffing and operational costs.
  • Simplifies a consistent process nationally, to enable an efficient handling of workload.

Project status

Key dates

  • Project start: October 2014
  • Process improvement changes: January 2015
  • Project end: 17 July 2015

Status

Sustained - The project has been implemented, is sustained in standard business.

Background

There was a change introduced at the Australian Red Cross Blood Service in June 2014, which led to a significant increase in total workload for medical service nurses. It was estimated that the Australian Red Cross Blood Service would be able to absorb this work within existing staffing levels, but it was more than estimated. 

By October 2014, there was a 57% increase in nurse workload and nurses were struggling.  Because they were increasingly busy, the number of donor adverse events that were not followed up within seven days of registration increased. Management and nursing staff were concerned that this was impacting negatively on donor care, customer service and risk management.  Nurse morale was also falling, as there was a perception of inequity in the workload between different state teams and nurses. Management were very concerned that nurses would not be able to continue working under such conditions and to the required performance levels.

Implementation 

  • Introduced daily manual allocation of adverse event follow-up workload, to match state team staffing levels.
  • Developed and introduced a simplified, leaner business process for all state teams, reducing variation and complexity.
  • Documented a new process map and training guide to support consistency and maintenance of new processes for new and existing staff.
  • Introduced a process improvement to provide follow-up bruising incidents by letter rather than phone, as per customer feedback via a donor survey.
  • Identified administration tasks performed by nurses and moved these tasks to administration teams.
  • Introduced workload targets for nurse teams, with monthly workload allocation reports that allowed nurses and their managers to monitor performance and understand expectations.

Implementation site

Medical Services, Australian Red Cross Blood Service

Partnership

  • Clinical Excellence Commission (CEC) Clinical Leadership Program
     

Results

The performance of adverse event follow-ups was monitored, comparing results of the following before and after project implementation:

  • percentage of adverse events remaining open more than seven days after registration on the DAE IQ database, with a target of 0%
  • feedback from the nurses on levels of workplace satisfaction and morale.

Results

  • September 2014: Approximately 5% of events remained open for longer than seven days.
  • October 2014: Manual allocations of workload commenced.
  • November 2014: Approximately 1% of events remained open for longer than seven days.
  • January 2015: A new, simplified process and improved national allocation of workload commenced.
  • February-June 2015: Approximately 0% of events remained open for longer than seven days, illustrating the success and robustness of the new processes.

Feedback from nurses was positive and suggested they found the new process simple and easy to use. Nurses reported that the new process reduced stress, as they were clear on follow-up workload expectations on a day-to-day basis. The workload allocation reports also led to a few nurses lifting their performance, due to heightened awareness of expectations for team contribution.

Lessons learnt 

  • Engagement of the overburdened nursing teams was pivotal: the initial workload analysis required them to keep logs of their activity for 10 days, on top of their already challenging workload. 
  • Identifying the main factors contributing to low morale helped determine the points of focus to maximise acceptance. For example, ‘unfair’ workload. 
  • An initial quick fix of the workload inequity was imperative, to earn and maintain support for the additional changes introduced over the subsequent months.
  • The project was well received by leaders in other divisions of Australian Red Cross Blood Service, who have requested information about the initiative. The workload management model will soon be implemented for adverse event follow-up performed by doctors and may be considered for use in administration teams.

Contact

Julie-Anne Bates
Medical Services Manager SA/NT
Australian Red Cross Blood Service 
Phone: 08 8422 1294
jbates@redcrossblood.org.au

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