Here are a few of the improvement projects we have underway in the organisation. This is not a comprehensive list but we aim to keep this page as up-to-date as possible.
In the meantime, we really welcome your views and questions about the projects so please leave these in the comments section below.
‘IMPROVING SURGICAL WARD ROUNDS’
Aim: To reduce variation in the Colorectal ward round practice; reducing errors and increasing patient safety by ensuring patient communication and experience is improved.
The project has been launched by the Colorectal team with the aims of improving the patient experience and increasing collaborative multi-disciplinary working and communication. Mr Bearn and the Colorectal team felt that the patient experience of ward rounds could be improved and that there were concerns that patients were being ‘lost’ within the paperwork. The project set out to establish whether ward rounds are meeting the needs of patient, but also doctors and the whole MDT.
IMPROVING THE TIMELY IDENTIFICATION AND TREATMENT FOR SEPSIS IN ED
Aim: To improve the timely identification and treatment for sepsis in ED to ensure i) 90% of majors patients attending ED are screened for Sepsis every quarter in 2016/2017; and ii) 90% of patients presenting with Sepsis are administered intravenous antibiotics within one hour of arriving at ED every quarter in 2016/2017.
Sepsis is recognised as a significant cause of mortality and morbidity in the NHS, with around 32,000 deaths in England attributed to Sepsis annually. Of these some estimates suggest 11,000 could have been prevented.
Achievement of improved screening and treatment of patients for Sepsis in the ED is both a CQUIN goal and a key quality improvement objective of the organisation in 2016/2017..
IMPROVING THE TIMELY IDENTIFICATION AND TREATMENT FOR SEPSIS IN ACUTE INPATIENT SETTING
Aim: To improve the timely identification and treatment for sepsis for inpatients by ensuring i) 90% of patients meeting the criteria for Sepsis were screened for every quarter in 2016/2017; and ii) 90% of patients identified with sepsis who were administered intravenous antibiotics within the appropriate timeframe, every quarter in 2016/2017.
The project team plan to design and implement a revised Sepsis Screening and Action protocol and proforma based on the latest national guidance. The team will also carry out a ward-based teaching programme and raise awareness of Sepsis on the inpatient wards.
IMPROVING COMPLETION OF AND LEARNING FROM, MORTALITY REVIEW FORMS WITHIN MEDICINE
Aim: To improve the process of reviewing mortalities, completing the forms and learning from the outcomes by ensuring i) 100% of mortality review forms are completed for each ward; and ii) Learning is recorded at monthly/quarterly mortality review meetings and cases are discussed at the bi-monthly QUASH meeting by all specialties.
IMPROVING ANTIBIOTIC STEWARDSHIP AND ENSURING ANTIBIOTIC REVIEW WITHIN 72 HOURS
Aim: To improve the number of antibiotic reviews carried out within 72hours and documented in the medical notes and to ensure a review within 72 hours for at least 90% of antibiotics prescribed.
The Microbiology and Pharmacy teams are aiming to reduce inappropriate and overuse of antimicrobials in-line with a national drive to reduce total antibiotic consumption measured as defined daily doses (DDDs) per 1000 admissions. The focus of this project is improved antimicrobial stewardship and ensuring antibiotic review within 72 hours.
TRANSFORMING CARE OF THE LAST DAYS OF LIFE
Aim: To establish a consistent, organisational approach to provide excellent individualised care of adults in the last days of life
Driven by National guidance (NICE), CQC expectations and results of a National Care of the Dying Audit 2013, there is a need to change how we provide care to our patients in the last days of their life. A Trust wide approach is required that delivers a cultural shift, moving to a “Priorities Approach” Recognise, Communicate, Involve, Support, Plan and Do.
IMPROVING DISCHARGE INFORMATION FROM URGENT AND EMERGENCY CARE
Aim: To ensure safe transfer of care to primary care for all patients who have attended urgent care by improving the completion and quality of discharge summaries from Adult and Paeds ED.
The Francis report emphasised the need for better information. Clinical information should be shared from the hospital to primary care in a manner that ensures that patient care is safe, accurate and timely.
The project team plan to establish a working group (to include primary care representatives) and will review data quality of current discharge data set, and will work with the team to make measurable improvements.
IMPROVING MEDICAL HANDOVER
Aim: To improve multi-professional communication of patient care between shifts by implementing twice-daily handover seven days per week; and increasing the confidence of the Junior Drs in the processes for communication of sick patients across shifts.
Keogh Standard Four describes the shared responsibility to ensure that safe continuity of information and responsibility between shift changes takes place. The project team plan to meet this challenge by reviewing and updating the Medical Handover Policy, trialling a new handover process and improving through PDSA.