Musgrove Park, Taunton, Somerset is a medium sized District General Hospital, serving a population of 340,000 people.  Its Diagnostic Imaging (DI) department offers a wide range of diagnostic tests as well as interventional radiology.  It also provides services at a number of community hospitals.

Over the past 24 months DI has made significant changes to the way it staffs its services.  These changes were driven by many factors including the need to introduce a 24/7 Interventional Radiology (IR) service.  The Royal College of Radiologists has stated that all Trusts should ensure that there is access to elective and emergency IR services (RCR, 2007) and this has been on the NHS improvement agenda as part of its drive to improve access to diagnostics.  In 2010 the DoH published a document stating that the quality of IR services out of hours must be the same as that excepted within normal working hours.

These factors, the increasing clinical need and requirements of the Trust’s commissioners caused the DI department to look at alternative ways of providing the service.  Elizabeth Ladd, Imaging Lead explains.  “Whilst trying to find a solution to IR we needed to look at the provision of CT out of hours (OOH).  We moved to a shift system incorporating most of our work into contracted hours spread over the whole week.”  As part of this process an on-site CT radiographer 24/7 and a 24/7 IR service were introduced.  This culminated with the introduction of the stroke pathway allowing direct access to CT for suspected stroke patients.  Elizabeth continues,  “This has allowed us to provide a much improved service to patients and referring clinicians.

“As part of the work we were undertaking we decided to apply for the Imaging Services Accreditation Scheme (ISAS), as for us this would demonstrate that we were running a high quality service.”

Musgrove Park with patient

Jointly owned by The College of Radiographers (CoR) and The Royal College of Radiologists (RCR), ISAS was specifically developed for UK organisations providing diagnostic imaging services within both the NHS and private sector.  To ensure impartiality of the scheme, the Colleges licensed The United Kingdom Accreditation Service (UKAS) to manage and deliver ISAS on their behalf.

Benefits

ISAS accreditation offers a number of benefits to patients, commissioners and the hospital itself as Karen Bentley-Hollins, Associate Directorate Manager explained.  “We knew that undertaking a project such as ISAS would cause additional work but would also be of huge benefit to the department and the hospital.  However, we did not realise just how numerous and how significant those benefits would be until we were successful in achieving accreditation.”

The first noticeable benefits became apparent right at the start of the application process, and helped the DI department organise its knowledge sharing systems as Julie Kitchener, Senior Admin Manager outlines.  “When we started the ISAS project it gave us the opportunity to pull together all our documentation and organise it in a more concise way.  This led to us developing a more organised and purposeful central information system on our shared computer drive.  All staff were then able to access a cross-section of information that was both relevant and informative to their day to day working practices, for example Governance/Risk, Policies, Audit, Quality, Radiation, Training Records etc.”

The ISAS Standard promotes best practice by comprehensively addressing four key areas; patient experience, clinical effectiveness, patient and staff safety, and efficient use of resources.  This encourages applicants to analyse each aspect of their department from multiple viewpoints.  Julie said,  “The way ISAS is structured with each criterion gives you the opportunity to focus on those areas that need improvement, standardise working practices and cross-reference information which streamlines processes.  As well as our main department at Musgrove Park, we have four community x-ray departments which were included in the ISAS accreditation.  By working together we were able to improve our communication with the community hospitals and ensure that processes and policies covered all sites.  This helped to build better working relationships and made our communications stronger, making us feel like a more united team. We all had the same aims and any feelings of exclusion were removed.  In turn, this also helped improve our communication with other departments within the same commissioning group.”

Rather than being merely a certificate to hang on the wall, ISAS assessment is a continual process, delivering long-term and ongoing benefits.  Karen said,  “ISAS is not just about reviewing or creating documentation, it also encourages us to continue to monitor our practices and we found that revising our audit programme and improving it was very successful.  We can now clearly demonstrate that actions were discussed and longer term resolutions put in place, clear visibility of the hard work we had been carrying out.”

The ability to simply demonstrate its competence has provided the DI department with wider benefits, particularly regarding confidence, as Elizabeth explains,  “In the current financial climate “Any Qualified Provider” (AQP) is a factor we all have to take into account.  Obtaining ISAS helps the Department/Trust compete with private providers as it is a highly regarded accreditation.  It also gives confidence to the users of our service and staff that we comply with best practice.  Their recommendations also serve as good evidence when submitting business cases for improvement.”

Reviewing the entire ISAS accreditation process Karen concludes, “We would recommend the process to anyone and we are now moving to embed ISAS into our everyday culture.  The sense of value and worth of gaining accreditation cannot be stressed enough.  The entire team were part of the process and we were all delighted to achieve ISAS accreditation.  Moving forward this is one of the ways we see our service going from strength to strength.”

Musgrove Park outside

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