Geographical dispersion of team
Currently the dermatology department is split across two Belfast trust sites, the Belfast City Hospital (BCH) and the Royal Victoria Hospital (RVH). As management for dermatology is based on the BCH site, it can be difficult to have meetings/one to ones with the RVH staff. Most of the communication is done via email and occasionally telephone. Management try to get over to the RVH at least three times per week. It can also be difficult when implementing new methods of work in the workplace. Instead of training one group of secretarial staff, they get trained separately which can be time consuming. This impacts all staff in dermatology based across both sites, although mostly the RVH staff. There are times they will only have a manager present for one-two hours, three times per week, and often this will be a group meeting, not one to ones. RVH staff don’t have the same opportunities as the BCH staff would have by having a manager on site such as an open door policy. The long term goal for dermatology is to move to Musgrave Park Hospital (MPH) where they can work as one team and be more effectively managed.
Recently digital dictation was introduced to the dermatology department across both sites. It was decided that the consultants would each get their own personal work blackberry and that the junior doctors/nurses would use a static device that is connected to the computer. There are eleven staff in total using these static devices. In the office there are only two computers to be shared between eleven members of staff. In outpatients there are only four computers for the same amount of staff. This means that every day the doctors have to spend their time waiting for a free computer. As time is limited already, sometimes doctors/nurses have to stay behind the clinic to carry this out, or alternatively have to leave the work for another day. This mainly impacts the doctors as they have a working backlog if they cannot get a free computer. It impacts the secretary as she could be waiting for her work to be sent for several days and it can be difficult to keep track off when not in her office. It could also be said at times that the patient is impacted with this. If the doctor is planning to send on a referral to another department, this may not be done straight away. For urgent dictations, when there is not a computer available the doctor will revert back to the old system by dictating using a tape and a Dictaphone. The department has requested funding for more computers and static devices to help manage this more effectively and for better time management.
Knowledge of task
Last year the dermatology ward clerk decided to retire. At the time is was decided that an agency worker who had been working as a ward clerk elsewhere would cover this post until it went to scrutiny. Approximately three days before the ward clerk was due to retire, the agency staff member was offered a permanent position and so left the trust. The manager chose one of the secretaries to carry out this workload in addition to her current workload. The secretary had three days to learn an entirely new post and job methods. The ward clerk wrote out all her duties and how to do them, but due to time constraints the secretary was not up to speed with the work at all by the time it came for the ward clerk’s retirement. The secretary was told to do her best with what she was taught. The main party impacted in this was the ward. The secretary did not know how to do a lot of the things and initially a lot of mistakes were made. Also in the rush to train the secretary the ward clerk forgot to show her how to do some duties, and therefore coding and discharging were missed. It impacted the secretary as she struggled to do both workloads and her secretarial workload...