• care;
  • improvement;
  • lean;
  • literature review;
  • nursing;
  • patient experience;
  • productive ward;
  • quality and safety;
  • releasing time to care;
  • staff development

Aims and objectives

This systematic review provides an overview of the literature published on Releasing Time to Care: The Productive Ward between 2005 and June 2011.


Releasing Time to Care: The Productive Ward programme was developed by the NHS Institute for Innovation and Improvement and launched in England in 2007. The programme comprises thirteen modules that aim to increase time for direct patient care, improve the patient and staff experience and make changes to the ward environment to improve efficiency.


A systematic literature review.


The terms ‘Releasing Time to Care’ and ‘Productive Ward’ were applied to key healthcare databases; CINAHL, Medline, Science Direct, ProQuest, Health Business Elite, British Nursing Index, Embase, Health Management Information Consortium and PsychInfo. All papers were read and subject to a quality assessment.


The literature search identified 95 unique sources. A lack of research on The Productive Ward programme meant it was necessary to include non-empirical literature. In total, 18 articles met the inclusion criteria. Seven key themes were identified: the patient and staff experience, direct care time, patient safety, financial impact, embedding and sustainability, executive support and leadership, and common barriers and determinants of success. It also highlighted areas that require further exploration such as long-term sustainability of the programme and consistent data measurement between organisations.


The review tentatively reports how The Productive Ward programme has been used to transform nursing practice for the benefit of patients and frontline staff, and how it resulted in cost savings. The literature review identified a potential positive results bias in the current literature whereby favourable outcomes were reported.

Relevance to clinical practice

This paper summarises the types of evidence and current literature on The Productive Ward providing a reference for frontline staff implementing the programme.