Rise and demise of the hospital: Backwards is the new forward: time for the heritage hospital

doi:10.1136/bmj.332.7532.52-e

BMJ 2006;332:52-53 (7 January), doi:10.1136/bmj.332.7532.52-e

Letter

Rise and demise of the hospital

Backwards is the new forward: time for the heritage hospital

The first 150 words of the full text of this article appear below.

Editor—May I suggest as a start to Black's transformations¹:

Reinstate a strictly pyramidal shape to the ward managementstructure, in which the sister knows every patient under hercare
Replace teams with a flexible "whole ward" approach toallocatingnursing tasks
Restore a more formal and, by inference,professional relationshipbetween staff when in the clinicalarea—reconsider, forexample, whether it is appropriateto use first names eitherfor staff or for patients
Treatnursing time as our most valuable resource—not tobe squanderedon writing off-duty rotas or over-elaborate nursingrecordsbut to be spent in the company of their patients
Reinstatethe consultant ward round as the focus for the businessof theweek.

My plans for green tiling, shiny floors, and Sunday afternoonmatron's ward round are under wraps until I have had a chanceto pilot them—after all, we have to have a good evidence. . . [Full text of this article]

Richard Neil Harrison, consultant physician

University Hospital of North Tees, Stockton TS19 8PE richard.harrison@nth.nhs.uk