KEY POINTS:
New Zealand hospitals have borrowed an idea from the world's biggest car maker to save millions of dollars and double the time nurses spend with patients.
Middlemore Hospital is the first in the country to implement the "Releasing Time to Care" scheme, which works with nurses to improve the efficiency of their daily duties.
The scheme is based on a management technique from Japanese car giant Toyota.
Four areas in the hospital are already being changed. Another 16 will follow over the next 14 months.
It is expected as much as $2.50 will be saved for every $1 invested in the scheme, with its cost expected to be recouped by efficiencies after just the first three months. It is also expected the scheme will cut by half how much nurses walk on a daily basis.
Despite the amount of time freed up for nurses, no redundancies would follow, general manager for quality improvement Allan Cumming said.
By improving the working environment, the hospital would become more attractive to incoming staff, and better retain existing staff, he said. "And that will save us money, because staff turnover is a big cost to the organisation."
The scheme worked by examining nurses' tasks and identifying where things could be improved, he said.
Preliminary results had also indicated patient safety would be improved through a decrease in human errors, he said.
Vicki Rawiri, charge nurse of Ward 24 _ the hospital's rehabilitation ward for the elderly and one of the areas currently working through the scheme _ said the project had already changed the ward's atmosphere. Staff were happier coming to work, she said.
"I have watched the change in the patients, and it has been huge. If the staff are happy, then the patients are happy," she said.
Nurses now had time to bring the patients up to their lounge _ a simple task they could not perform just four weeks ago, Mrs Rawiri said. Such changes were bringing nurses "back to the bedside", and allowing them to do what they had trained to do.
An expert on the scheme had been flown out from England, and was working with staff at the hospital at a cost of between $100,000 and $200,000, Mr Cumming said.
Extra staff had been employed to run the changes, costing about $250,000 per year.
Mr Cumming said nurses generally spent about 33 per cent of their time with patients. That figure was expected to double as the scheme was introduced.
There would be no need to employ new staff as a result of the scheme, he said. Nurses would not be doing fewer duties, but cutting out wasted time.
Mr Cumming said it was very unlikely nurses would rebel against lost down time.
"That might be true if that waste we are eliminating is sitting around time. But it's not. The down time that we're cutting out is the running around stuff."
WORKING SMARTER
Two examples of the changes:
* A ward which used to have only two thermometers to share between nurses has switched to disposable thermometers. They cost less and can be stored at each bedside, saving a substantial amount of time each day.
* Storage areas have been cleaned out and reorganised to the nurses' specifications, meaning a search for supplies takes seconds, not minutes.by
