Implementation of Releasing Time to Care - the productive ward

J Nurs Manag. 2009 Jul;17(5):647-54. doi: 10.1111/j.1365-2834.2009.01026.x.


Background: This paper describes the implementation of the NHS Institute for Innovation and Improvement Productive Ward - releasing time to care programme. It will discuss the benefits and key successes and provides advice for those wishing to implement the programme. In Lord Darzi's Next Stage Review, he advocates an ambitious vision of patient centred - clinician led, locally driven NHS. The Releasing Time to Care programme is a unique opportunity for everyone working within the NHS to improve effectiveness, safety and reliability of the services we provide. Whilst being situated within a National Health Service policy environment learning from this work can be translated nationally and internationally, as the principles underpin the provision of high quality care.

Evaluation: Evaluation is currently in relation to each of the 15 modules rather than as the programme as a whole. It uses various methods including audit, observation, activity follow through, satisfaction surveys and process mapping. Each month data is colated for each of the 11 metrics which has shown a reduction in falls, drug administration errors and improvement in the recording of patient observations.

Key issues: One of the key issues is that an essential component for the success of the programme lies in the tangible support of the Trust Board/Board of Directors. Evidence shows that this programme improves patient satisfaction as it enables the provision of an increase in direct patient care by staff and subsequently improved clinical and safety outcomes. Ward Sister/Charge Nurse development includes Leadership, Project management and Lean Methodology techniques.

Conclusion: The Releasing Time to Care programme is a key component of the Next Stage Review. It will create productive organisations by being a catalyst for the transformation of Trust services, enabling staff to spend more time caring for patients and users. This release in time will result in better outcomes and subsequent improvement with patient and staff satisfaction and experience of the NHS as well as a cultural change for the workforce.

Implications for nursing management: Releasing Time to Care, also known as the productive ward, offers a systematic way of delivering safe, high quality care to patients across healthcare settings. The Institute for Innovation and Improvement, have devised a programme of 15 modules based on 'lean' methodology. It has been widely piloted and in January 2008 was rolled out as a national initiative with 50 million pound pump priming money. Evidence shows that the programme can improve patient satisfaction as it enables the provision of an increase in direct patient care by staff and subsequent improved clinical and safety outcomes. The programme has to be implemented in a structured manner in order to assure its success and release the benefits. Core to this success is Board level commitment. Board members need to sign up to and understand the concepts of the programme and their role in supporting the ward staff. The organisation needs to understand the benefits that the programme will bring to the organisation as well as the challenges. The Board needs to understand that the programme is focussed on improving the quality of care for patients and not an opportunity to reduce costs.

MeSH terms

  • Education, Nursing, Continuing
  • Efficiency, Organizational
  • Empathy
  • Health Care Reform / organization & administration*
  • Hospital Units / organization & administration*
  • Humans
  • Nurse Administrators
  • Nurse's Role
  • Nursing Evaluation Research
  • Nursing Staff, Hospital / education
  • Nursing Staff, Hospital / organization & administration
  • Outcome and Process Assessment, Health Care
  • Patient-Centered Care / organization & administration*
  • Pilot Projects
  • Program Development
  • Program Evaluation
  • Quality Assurance, Health Care / organization & administration*
  • Safety Management
  • State Medicine / organization & administration*
  • Time Factors
  • Total Quality Management / organization & administration*
  • United Kingdom