Front-line health care staff often have rich insights and ideas across a range of dimensions (including how to improve patient care, workplace efficiency, and staff well-being).
At the NHS Nightingale Hospital London (Nightingale), a field hospital established in an exhibition centre to provide additional ventilated bed capacity for London’s COVID-19 patients, we wanted to ensure we could gather these insights without increasing burden on staff. We created the “Bedside Learning Coordinator” (BLC), described further in our recently published paper in BMJ Quality and Safety : Systematically capturing and acting on insights from front-line staff: the ‘Bedside Learning Coordinator’ .
The BLC role was designed to capture staff insights into what was and was not working, and rapidly feed these insights back to the leadership teams to review, triangulate with other data and implement required actions as appropriate. In addition, the BLC undertook focused audits to confirm that implemented changes were successful, satisfactory to staff, and permanent.
The role the BLC played in the learning system at NHS Nightingale Hospital London can equally be replicated in other clinical and operational contexts…Dr Jenny Shand
A tracker tool was used to triage insights into three areas: Fix (requiring immediate action), Improve (suggestions for better ways of doing things that are already done), Change (substantial changes to care that is delivered or a new or different way of doing something that has not been done to date). Insights and recommendations were then taken to the appropriate teams for action. The tracker tool was used to monitor progress.
Over the past 6 months we have been working with Telesoftas to develop a web-based app to streamline the data flows. This will allow BLCs to enter insights directly into a database, see if those insights have already been captured and actioned by searching a tracker/back end dataset, and make it possible for leadership teams to implement changes and track progress.
For teams interested in implementing BLCs in their organisation, it is worth noting:
Embed within a Learning Health System: The BLC is not a standalone intervention, it was embedded in a wider learning health system. This was critical to ensuring insights were triangulated with other data sources, acted on quickly, and the success of the implementation reviewed. A summary of the learning health system can be read in the paper Learning Systems: Managing Uncertainty in the New Normal of Covid-19.
Integrate with incident reporting and other data flows: A unique feature of the Nightingale learning system was the integration of BLC insights with incident reporting and other data flows. This increased the speed of actions that followed incidents.
Relevant throughout healthcare: The role the BLC played in the learning system at NHS Nightingale Hospital London can equally be replicated in other clinical and operational contexts, it is not specific to emergency field settings.
We are delighted to see several hospitals across the NHS adopting the BLC role. Over the coming months we are launching a community of practice to provide an opportunity to share experiences and learn from others.
If you would like to find out more about the BLC role, the web-based BLC app, or join the BLC community of practice, please contact firstname.lastname@example.org.