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Eve Mitchell

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About Eve Mitchell

  • Rank
    Starter

Profile Information

  • First name
    Eve
  • Last name
    Mitchell
  • Country
    United Kingdom

About me

  • About me
    I created Establishment Genie - a NICE endorsed safe staffing workforce planning and benchmarking tool - out of frustration at workforce and staffing decisions in health and social care driven by financial imperatives rather than focusing on quality and safety outcomes that are best for our patients and staff and are ultimately more cost effective.
  • Organisation
    Creative Lighthouse Ltd
  • Role
    Director

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  1. Content Article
    Case study examples The following case studies show how trusts have been using the tool. Roles and responsibilities of staff have been reviewed and new workforce plans have been co-designed with staff at the frontline to deliver new ways of working that put the patient at the centre of care – whatever the setting. The Hillingdon Hospitals - Safety Supervision and Savings.pdfThe Hillingdon Hospitals - Ward Reconfiguration for Safety.pdf GIG Cymru NHS Wales - Residential Nursing homes Case Study.pdfChelsea and Westminister Hospital Case Study - Empowering Staff.pdf GIG Cymru NHS Wales - District Nursing Principles Case Study (1).pdfBerkshire Health Community Nursing Case Study.pdf Organisational benefits Integrated care levels, costs and common language enables clinical and corporate leads to collaborate and meet the requirements of a next-generation health and social care workforce: Precise staffing profiles and options appraisal support CIP development and budgeting. Gap analysis compared to budget and standards for exact hours and WTE requirement for each band. Uplift for leave is specific to each role and expected joiners, avoiding blanket uplifts that may not fit the needs of the unit. Governance and control underpinned by agreed, costed roster templates, with ready reckoners to keep within range. Improved recruitment and retention with evidence of staffing levels and support. Outcomes track quality, with benchmarking to assure. Clinical benefits Professional judgement in workforce planning is supported by this NICE-endorsed tool: Planning care levels and WTE for expansion, efficiency, reconfiguration and new service models. Evaluating alternative shift models to reorganise, invest or save. Modelling skill-mix and impact of new roles. Understanding and validating variation. Challenging peaks and troughs in cover to improve safety, release capacity and release cost savings. Benchmarking and triangulation of patient care levels, with outcomes for correlation. Mapping other staff group input across each setting. Background on 'Establishment Genie' Creative Lighthouse was founded in response to frustration at the focus on financially led decisions in health and social care management that did not consider the safety and care of patients or staff. We set out to build a platform that would allow all management groups in the healthcare sector to collaborate on safe staffing and financial governance. Creative Lighthouse self-funded the development of a unique workforce-planning tool under the brand name ’Establishment Genie’, endorsed by the National Institute of Health and Care Excellence (NICE) in 2017. In April 2017, the Creative Lighthouse team were awarded a grant from Innovate UK to continue to develop the tool to include all settings of care in the knowledge that patient safety and workforce planning is not only the responsibility of acute services, but of all providers and commissioners of care. This is a critical aspect of enabling the improvement of quality and patient outcomes in a cost effective way, whilst providing data driven analytics to support professional judgment. About the author I am a healthcare professional with over 15 years’ experience working in and consulting to public and private health and social care organisations. I have worked with a variety of health and care sector clients in the delivery of complex change, from transformational change and organisational design process to programme leadership and execution. I am passionate about the safe staffing agenda, recognising that in order for any organisation to ensure appropriate care and evidence for professional judgement, there must be consistency in approach and a way of linking staffing levels to quality outcomes that can then be benchmarked within and across organisations. This passion resulted in the birth of ‘Establishment Genie’.
  2. Community Post
    Many organisations, like East London NHS FT (ELFT), publish information about their staffing in terms of 'fill rates' - the difference between planned and actual staffing - and also using 'Care Hours Per Patient Day' (CHPPD). However, as can be seen by the published data, this doesn't really tell us very much about staffing capacity or capability, more whether there were more or less staff on the units than planned in the roster - and in the majority of cases in ELFT this shows that the units were 'over-filled' with staff i.e. more staff than planned were distributed to each area. So, this begs the question whether the plan was right in the first place? If we wind our memories back to the Keogh Mortality Review, there was a recommended ambition that "nurse staffing levels and skill mix will appropriately reflect the caseload and the severity of illness of the patients they are caring for and be transparently reported by trust boards." It is hard to see how data on over- or under- filling against a roster gives transparency to the board if they do not know what was being filled in the first place, or on the acuity and dependency of the patients being cared for. The NQB guidance, first published in 2013, was updated in July 2016 with additional guidance to help organisations think about their workforce to include questions and inclusion of outcome measures and measures of patient safety https://www.england.nhs.uk/wp-content/uploads/2013/04/nqb-guidance.pdf We need to remember that the purpose of the recommended bi-annual establishment review is to ensure that the Executive Board is satisfied that nursing and midwifery staffing is set at an appropriate level to deliver safe care. This does not mean that we should not monitor our fill-rates and CHPPD monthly, but does mean that we need to be sure that our workforce plan is appropriate through understanding and comparing our levels of care both internally and with peers, looking at our outcome measures, and through thinking about the training and skills that are required now and into the future so our staff both within and outside of organisational boundaries have the skills, capability, capacity and support to deliver great, safe, person centred care whatever the setting.
  3. Content Article Comment
    Many organisations, like East London NHS FT (ELFT) publish information about their staffing in terms of 'fill rates' - the difference between planned and actual staffing - and also using 'Care Hours Per Patient Day' (CHPPD). However, as can be seen by the published data, this doesn't really tell us very much about staffing capacity or capability, more whether there were more or less staff on the units than planned in the roster - and in the majority of cases in ELFT this shows that the units were 'over-filled' with staff i.e. more staff than planned were distributed to each area. So, this begs the question whether the plan was right in the first place? If we wind our memories back to the Keogh Mortality Review, there was a recommended ambition that "nurse staffing levels and skill mix will appropriately reflect the caseload and the severity of illness of the patients they are caring for and be transparently reported by trust boards." It is hard to see how data on over- or under- filling against a roster gives transparency to the board if they do not know what was being filled in the first place, or on the acuity and dependency of the patients being cared for. The NQB guidance, first published in 2013, was updated in July 2016 with additional guidance to help organisations think about their workforce to include questions and inclusion of outcome measures and measures of patient safety https://www.england.nhs.uk/wp-content/uploads/2013/04/nqb-guidance.pdf We need to remember that the purpose of the recommended bi-annual establishment review is to ensure that the Executive Board is satisfied that nursing and midwifery staffing is set at an appropriate level to deliver safe care. This does not mean that we should not monitor our fill-rates and CHPPD monthly, but does mean that we need to be sure that our workforce plan is appropriate through understanding and comparing our levels of care both internally and with peers, looking at our outcome measures, and through thinking about the training and skills that are required now and into the future so our staff both within and outside of organisational boundaries have the skills, capability, capacity and support to deliver great, safe, person centred care whatever the setting.
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