Emma’s Story - 200 Minutes Back
Emma Powderhill is the Ward Manager for Cedar Ward at University Hospital Llandough. She has recently completed 200 Minutes Back, an improvement programme created by Shaping Change that is focused on giving time back to staff so they can maintain their passion to care. We interviewed Emma to find out how 200 Minutes Back had impacted her team and patients...
Tell us how you became a ward manager?
I started my nurse training when I was 18. I grew up on a council estate with lots of drug use, mental health difficulties, and deprivation. I was also a young carer for both of my parents and supported my younger brother. That definitely shaped my decision to become a mental health nurse. I came to Cardiff University and when I sat in the lecture theatre on the first day, I thought ‘I’m going to change the world.’ I wanted to improve patient care and in order to do that I was going to become a ward sister at some point, that was where I thought I would make the biggest difference.
How did you find out about 200 Minutes Back?
had worked in inpatient services for the first 9 years of my career and was part of the review of the inpatient model in 2014 in Cardiff and Vale. I went on to work within the Crisis Teams and in a specialist service. I was aware of a ward manager opportunity on Cedar Ward and was keen to return to inpatient services. I was actually really heartbroken on my first few days in the job as I had a staff team who were suffering and traumatised by their experiences, there was a very high turnover of staff. At one point, there were 13 staff off sick all with work related issues.
I went into overdrive, and now I recognise that I became part of the problem, desperately trying to fix the situation but exhausting myself.
Our team was talk of the town because we were failing. We were criticised because we didn’t know why people had come in, why they were moving to treatment wards, and why we weren’t able to support them. It was a really difficult time. I went on a search to find help and in the process, I came across Shaping Change at Cardiff and Vale UHB. The team introduced 200 Minutes Back and that’s when things started to change.
How did 200 Minutes Back help you address the problems your team were facing?
We worked through the programme and developed our values and vision as a team where everyone contributed. We wanted to prioritise staff well-being and patients. Not a single member of staff was taking a lunch break and all qualified staff were staying on longer than they should have been. Staff were really anxious outside of work and we needed to support them during the day to day work so they could go home and see their families. We wanted staff to feel valued and protected so they could do their best. We also wanted patients to get the best care they could get and our vision for them was to be able to give hope to those who have none.
We then worked on building an empowered team so that there isn’t that reliance on one leader. We adjusted routines and adapted working processes to become more efficient. We worked on getting all parts of the team on board, consultants, managers, executives etc so that this would contribute towards the vision.
We set fixed times for ward rounds and didn’t compromise on these in order that staff would have a break. We went from now staff being able to take their lunch break to now 80% of staff having full, uninterrupted lunch breaks.
The team also reduced the number of medication errors by 60% by stopping interruptions during medication rounds, reorganising medication charts, and undertook a process called 5s (Sort, Set in Order, Shine, Standardize, and Sustain) during the programme to creating an organised, functional medication room.
How is life on Cedar Ward different now?
The staff team is always evolving, we are continuing to find time to take our breaks. Our relationships with our MDT and neighbouring wards has improved. People want to work alongside us. Crucially, we have reviewed our nursing 1:1 data and recorded 1:1s have doubled, proving that we have released time to sit alongside our patients and support them. Staff absence from work has reduced with main reason for absence currently season related.