Innovation “It’s all about the teamwork - our team calls
itself ‘Team Awesome’. All our nurses, ODPs and anaesthetists are all on board with HIT days. It is about involving everyone and making it a friendly environment to work in. We have never had any issue with scrubs volunteering to come in on the weekend for the HIT day. We get donuts for everyone and make it an event. They are not getting a lot of extra money for doing these HIT days, but everyone is happy to be involved. When we beat the world record, everyone celebrated and sent the news to their families. They were really proud to be part of the team and of our achievements. We got the waiting list down by an impressive 25%! “We are not asking staff to stay late. When we performed the 12 cases in one day, the last case was finished at 6pm. You don’t want staff to feel fatigued or that they don’t want to do a HIT list again.” To ensure success on the day, the HIT days
require careful selection of appropriate cases - complex procedures cannot be performed as they may take more time. The surgery needs to be quick and standardised. The HIT day usually takes place on a Saturday and the team works much like a pitstop team in Formula 1 – the goal for the theatre team is to work together as seamlessly and efficiently
as possible, and preparation is key. The patient attends an appointment with the Consultant to discuss the surgery; then they attend a prehabilitation clinic a week to ten days before the surgery. The nurse specialist talks to the patient about what to expect, about their recovery, the removal of their catheter, and sees if they have any questions. The Trust contacts the patient 48-72 hours prior to the surgery to check that everything is ok. As a result of this process, there are less than 4% cancellations on the day. “Some cancellations are unavoidable – the patient may get the flu, for example. But when we do a HIT day, it is very rare to have a cancellation at short notice,” commented Mr Abou-Chedid. The Trust is now aiming to undertake a HIT day once a month, to further
reduce the waiting list for cancer patients.
Self-removal of catheters An important aspect of the protocol has also been the self-removal of catheters – this has been a UK first at the Trust. This means patients who are referred from across the South East do not need to return to hospital for the removal of their catheter seven days after their operation. Patients are shown how to remove the catheter using a dummy and are also provided with a leaflet and an instruction video online. On the day of the removal, a nurse calls the
patient to check that everything has gone well and to reassure them. As well as saving patients’ time and clinic time, money on fuel and parking, and reducing footfall in the urology clinic, the
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