Whether it’s the nursing manger, or the CNSs or the RNs or medicine, allied health, it is about communicating and being collaborative”. Another way of describing the conduit function was, “it’s more being a focus person or liaison”. I keep coming back to the whole service see more thing, thinking about how the service has to change and modify and even if that’s the way the service is delivered or the

change in product or all those sorts of things”. Running “quality” programs was consistently referred to as part of system work. This ranged from regular audits to evaluations triggered by specific identified events. Most work had a quality and evaluative framework. While some participants discussed research as part of their regular routine, the majority discussed research as an added extra that was time consuming and detracted from “the patient focus”. Many participants spoke of not feeling adequately prepared to conduct independent research,

but being confident in the Bosutinib mouse conduct of audit and quality review. The system work had a heavy focus on patient safety, but also included elements of efficiency such as patient flow and resource utilization. “I guess it’s all that resource management and trying to make sure the technology that we purchase is appropriate and not just toys for the boys”. The participants had a strong sense of saving lives and monies. There was some system work looked at as being less productive and this too was part of the role. “It almost feels like there’s a lot of arse covering, like tick the box, it’s like for accreditation, tick, tick, tick, tick, in essence what does that mean? System rescue included notions of troubleshooting and ‘just-in-time’ service development. “When they get into hot water (Nursing Unit Managers and educators) and they

are like, this is out of my depth, I’m not comfortable, I need you to come and do a debrief or talk about how we are going to manage this, I can reorganise my day and come up and do that”. This troubleshooting has clear links to particular patients or groups of patients. “Well yesterday a patient wasn’t able to be turned onto his belly. He wasn’t able to ventilate so they called me over to help with that, to troubleshoot what was going on and what was wrong. It’s a matter of Wnt inhibitor just getting him back onto his back and to oxygenate him. It can be that sort of thing”. At other times the flexibility to do environmental scans allows early identification of potential problems. This can be anywhere within an admission. “It’s a good example, the discharge one; when they arrange home oxygen and say they’ll send the person home to wait for oxygen. You have to really argue with the doctors to keep a patient in hospital until the home oxygen is in the home because they’d be happy to actually send them home, wait until Monday morning”. Problems can be actual or potential, those yet to occur. “I also pick up problems and I actually lead it. Yeah, I pick up and flag it and then I’ll take it on board”.