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Development of Dissection procedures

Category:         Scheme best supporting New Ways of Working and Training

 

Name:               Brian Thornton

Job Title:           Histopathology Services Manager

Organisation:    Nottingham City Hospital NHS Trust

Email:                bthornto@ncht.trent.nhs.uk

Telephone:        0115 969 1169 ext 34255

 

Key team:          Biomedical Scientists (BMS) in the Histology Department, Garry Thompson Chief BMS, Robert Hughes Senior BMS, Jane Pizer Senior BMS, Rita Makanji Senior BMS, Glynn Donovan Senior BMS, Consultant Histopathologists

 

Title:                  Development of dissection procedures (extended roles - biomedical scientists)

 

WHY CHANGE ?

  • National shortage of Consultant Histopathologists.
  • National shortage of Biomedical Scientists.
  • Changing workforce.
  • Wanted to improve the following for Biomedical Scientists: knowledge, skills, motivation and job satisfaction, recruitment and retention of staff.
  • Wanted to improve the quality of service (standardisation vs. best practise).
  • Wanted to assist the medical staffing problem by skills transfer. The aim being that medical staff become less involved with process and dedicate more time to diagnosis for which they are trained.
  • This work was timely for the NHS plan, The Royal College of Pathologist guidelines on BMS dissection also Royal College pilot sites for BMS dissection.
  • Wanted to improve staff morale

 

HOPE TO ACHIEVE ?

  • As much of the above as possible
  • Refer also to the box above for details

 

WHO / WHAT BENEFIT?

  • Ultimately the patients as we manage our resources in a better way.
  • Medical staff gain benefits (more time for diagnosis)
  • Biomedical staff gain benefits (more interesting /satisfying / financially rewarding role due to additional responsibility)

HOW DID WE DO IT?

 

  • Consultant Histopathologists trained Biomedical Scientists in dissection procedures thereby relieving the medical staff from some of these procedures to spend more time on diagnosis.
  • The Biomedical Scientists prepared standard operating procedures, training logbooks, audit procedures, competency documentation to be authorised by the medical staff.

 

WHO HELPED AND CONTRIBUTED?

  • Trent Workforce Taskforce (provided initial funding for project), which is now a routine procedure.  (Refer to Sharon Pickering).
  • Notts City Hospital Trust (gave go ahead for work).
  • Clinical Director (Dr Jane Johnson).
  • Laboratory Service Manager (put together bid, liaised with Trent Taskforce, presentations and posters).
  • Chief and Senior Biomedical Scientists in Histology who developed this together with the medical staff.
  • Royal College of Pathologists (guidelines).

 

HOW DID YOU KNOW WHEN IT WAS ACHIEVED?

  • When the medical staff were confident with the Biomedical Scientists to dissect the different categories of tissues unsupervised (obviously this was after an appropriate period of training / supervision / competency checks and audit).
  • Culture change for all staff concerned.
  • Agreeing a standard procedure as many staff were involved.
  • Initially getting training time allotted (mainly due to general workload pressure).
  • The department computer system.
  • OVERCOME BY?
  • General communication within the department.
  •  
  • Recruitment - we attracted a BMS to the department.  They were aware that we were embarking on this work.  This helped to recruit.
  • We think this is a win -win situation for both Biomedical Scientists and Consultants.

 

NEXT STEPS

  • Audit is being refined.
  • The BMS staff are now concentrating on the more complex dissections (categories D, E according to Royal College Guidelines).
  • We hope to reward staff for this additional responsibility.
  •  
  • The department as selected as a Royal College of Pathologists pilot site for BMS dissection.
  • Prior to this Garry Thompson / Dr Jane Johnson presented our project work to the Royal College of Pathologists.
  • Staff from this dept have been involved with meetings with IBMS members.
  • The Institute of Biomedical Science and the Royal College of Pathologists are working on a National training logbook and examination process for BMS dissection and will be available in 2004.
  • We have presented this project as follows: Within the Trust as part of Healthcare Science awareness week (Simon Brewer from WDC present), at the East Midlands Conference Centre Nottingham (Workforce Taskforce learning event - Sharon Pickering) NHS leaning event at Derby University.  Garry Thompson has also made presentations on the IBMS conference circuit and internationally at Kentucky - the National Society Of Histotechnology.