Name: Annalie Baker
Role: Lead Surgical Advanced Clinical Practitioner at South Warwickshire University NHS Foundation Trust
Introduction:
I had the privilege to lead and develop the Surgical Advanced Clinical Practitioner team at South Warwickshire University Hospital Foundation Trust. Over the last 6 years I have grown the team from initially myself and one trainee to now three, qualified surgical advanced practitioners and three trainees at various stages of their Masters (MSc) pathway.
As part of the introduction of the advanced practice team we have led and developed a successful surgical Same Day Emergency Care (SDEC) unit. This was through designing and undertaking multiple Plan Do Study Act (PDSA) cycles and working with key stakeholders to develop admission avoidance pathways.
Benefits of the role:
- Development of Surgical SDEC/Surgical Assessment Unit (SAU) within the Trust
- Working closely with the Emergency Department (ED) to streamline and pull patients to SAU to facilitate flow and improve patient pathways
- Advanced practice model embedded into team as valued members of extended surgical team
- Consistency during resident doctor change over periods
- Support and teaching for resident doctors, new to surgical speciality
- Advanced practice team leading on audits and development of clinical guidelines to support service development
- Improved and more timely access to Peripheral Inserted Central Catheter (PICC) line insertion for patients requiring Total Parenteral Nutrition (TPN)
- 20%’ non-clinical’ time for the advanced practice team to enable development in all pillars of advanced practice with opportunities and support to explore change ideas, develop leadership experience and teach in a variety of settings
“Supporting the surgical advanced practice team to have individualised job plans enabling them to develop in all four pillars of advanced practice“
Key Examples of the Pillars of Practice:
Clinical:
- Working as an integral part of the extended surgical team in the SAU and SDEC, and also ED when required
- Clerking, prescribing, requesting investigations for surgical patients seen in SAU and in ED
- Independent decisions to admit and discharge patients
- Support elective ward rounds and ward cover
- Undertake local anaesthetic abscess drainage.
- Provide PICC line service insertion for surgical patient requiring TPN
- Carrying out incisions and drainage of abscesses under local anaesthetic
- Taking West Midlands Ambulance Service and 111 rereferrals and triaging appropriately
Leadership:
- Lead and line manage the surgical advanced practice team, supporting their development
- Lead for multiple PDSA change cycles to develop and set up the SAU/SDEC within the hospital
- Involved in workforce strategy and development
- Developing Standard Operating Procedures (SOPs)
- Author for SAU Standard Operating Procedures
- Development of Robotics Surgical Care Practitioner (SCP) workforce strategy
- Development of direct access pathways for West Midlands Ambulance Service (WMAS) and 111 to surgical SDEC
Education:
- Formal and informal education and supervision for resident doctors, medical students, nursing staff & trainee advanced practitioners
- Advanced Life Support (ALS) & General Instructor Course (GIC) instructor.
- Visiting Lecturer for MSc Advanced Practice course at two local universities
Research:
- National Confidential Enquiry into Patient Outcome Death (NCEPOD) case note reviewer for ‘Twist & Shout’ report
- Presented improvement project as a short paper at the International Association of Surgeons of Great Britain conference (ASGBI)
- Contributor of research papers following local trust involvement
- Designed and undertaken local audits
- Collaborated on multiple research studies