BOARD MEETING. Document is for: (indicate with an x) Assurance x Information Decision. Executive Summary

Size: px
Start display at page:

Download "BOARD MEETING. Document is for: (indicate with an x) Assurance x Information Decision. Executive Summary"

Transcription

1 Document Title: Presenter: Author: Contact details for further information: BOARD MEETING Review of Pressure Ulcer Prevalence across DCHS services March June 2012 Kath Henderson, Chief Nurse Michelle O Connor Senior Matron Infection Prevention & Control Sue Dakin, Matron Infection Prevention & Control michelle.o connor@dchs.nhs.uk Date of Meeting: 26 July 2012 Agenda Item No: Document is for: (indicate with an x) Assurance x Information Decision Executive Summary No of pages 8 inc. this one: In order to provide DCHS Board members with assurance regarding the reporting of pressure ulcer activity across all DCHS services, a systematic review of all reported incidents has been undertaken for the period March June This review was conducted over a 4 day period commencing 19 July 2012, supported by the IP&C team and the Governance Information Manager. Data analysis Each pressure ulcer incident reported via the Datix system was reviewed and the following data extrapolated. Total number of pressure ulcer incidents reported in March = 203. (see graph 1 for breakdown) This data provides a refreshed internal baseline for DCHS. Total number of pressure ulcer incidents reported for Quarter 1 = 708 (see graph 2 for breakdown)

2 The review has identified the following anomalies when compared with previously submitted data within the Trust performance report. These are outlined in the table below: STEIS All unavoidable and avoidable Grade 3&4 deteriorated or developed within DCHS care Ambition One Avoidable Grade 2, 3, 4 and multiples deteriorated or developed within DCHS care Month Reported via SHA PMR and Trust Performance Report Actual number of STEIS to date Reported via Trust Performance Report Baseline data (March) April May June Not reported to date Identified reasons for the anomalies are: Duplication of reporting Tissue viability team not being notified of incidents Total excluding baseline data 15 Actual Total excluding baseline data Delay in specialist review and subsequent rejection of incident as not pressure damage During the review a number of incidents were identified as requiring avoidability reclassification Some of the incidents had been wrongly graded or determined not to have developed or deteriorated within our care and should not have been reported onto STEIS Current RCA management process within the tissue viability team 24 Following the review it is now possible to say that DCHS have 24 avoidable incidents for Quarter 1 which is below the agreed trajectory of 27. The trends over the 3 month period indicate that a significant reduction between April and June.

3 Overall summary of activity Graph 1 March 2012 total avoidable incidents within DCHS care baseline, including multiples (Grade 2) total unavoidable incidents within DCHS care, including multiples (Grade 2) total incidents inherited (all grades) 51 STEIS avoidable incidents within DCHS care, including multiples (grade 3 &4) 105 STEIS unavoidable incidents within DCHS care, including multiples (grade 3 &4) rejected incidence eg already reported or not pressure damage grade 1 reported Graph 2 April June 2012 total avoidable incidents within DCHS care baseline, including multiples (Grade 2) total unavoidable incidents within DCHS care, including multiples (Grade 2) total incidents inherited (all grades) STEIS avoidable incidents within DCHS care, including multiples (grade 3 &4) 379 STEIS unavoidable incidents within DCHS care, including multiples (grade 3 &4) rejected incidence eg already reported or not pressure damage grade 1 reported

4 Ambition One Summary The data relating to the monthly number of avoidable incidents across DCHS against the agreed trajectory can be found in the following graph. As can be seen the current incident rate is below trajectory at 3 (trajectory for Quarter 1 is 9) Mar Apr May Jun Jul Aug Sept Oct Nov Dec Jan Feb Mar Grade 3 & 4, including multiples Grade 2, including multiples Trajectory The monthly number of unavoidable pressure ulcer incidents are reflected in the graph below: Grade 3 & 4, including multiples Grade 2, including multiples Mar Apr May Jun Jul Aug Sept Oct Nov Dec Jan Feb Mar

5 Analysis and Trends The implementation of Ambition One and Harm Free Care has increased awareness across services of the need to assess all patients within their care for potential pressure ulcer damage. Whilst this may have resulted in an increase in the number of incidents reported there has also been a reduction in the number of avoidable pressure ulcers. Reviewing the incidents has highlighted some areas of good practice where different community based services and families communicate with each other effectively. There are examples of GPs concerned in the deterioration of patient s health referring patients to the district nursing services for assessment, carers and family members contacting the district nursing services directly for advice and referrals from care home settings asking for advice and support. This approach across the whole of DCHS would benefit patients from incurring a harm or deterioration and would have an impact on the whole health economy reduction in harm. The adoption of this approach would have an impact on the DCHS community services as there is potential to see an increase in the number of inherited cases initially. Inherited cases currently form 53% of the activity and workload relating to pressure ulcers for DCHS services. The following graph provides a breakdown of the inherited pressure ulcer activity during the period from March to June CRHFT RDHFT Nottingham SHH/ Maccelsfield 214 Sheffield 71 QHBT other from home or other community setting DCHS Services

6 In relation to the 10 cases identified within DCHS, there is an anomaly within the Datix reporting system whereby services report incidents transferred to them from another part of DCHS as inherited. This will be rectified as part of the recommendations and a new category referral from another DCHS service included. This will ensure that the discharge processes within DCHS relating to pressure ulcer management are captured as part of the Root Cause Analysis (RCA) process. Financial Impact There will be a financial impact on DCHS if the number of avoidable pressure ulcers is above the agreed trajectory There will be a cost to the organisation and the patient relating to the management of patients with pressure ulcers and the provision of appropriate pressure relieving equipment The large volume of inherited pressure ulcers will have a financial impact on DCHS services, particularly within the community setting. A piece of work exploring long term and sustainable approaches to pressure ulcer management within the wider healthcare community would be of benefit to DCHS and their patients. Links to DCHS Strategy DCHS is committed to providing a clinically effective, high quality service for the whole of the population we serve. Incident Reporting is a key component of the Safety agenda to ensure Harm Free Care is embedded across all services. Recommendations Main themes and recommendations from the review: Recommendation 1. Some patients are extremely complex and may visit more than one service during their journey. This may result in a number of incident forms being completed, relating to the same pressure ulcer episode. A standardised approach to reviewing these incidents is required within the tissue viability team to prevent duplication and misrepresentation of data. Date for implementation 1 August 2012 Recommendation 2. Due to the high volume of incidents, the incident form for Grade 2 pressure ulcers is to be reviewed to provide the information required when deciding if a pressure ulcer is avoidable or unavoidable. This will reduce the impact of repeated requests to clinical services for data, especially those in the community, and enable the tissue viability team to assess the avoidability of incidents in a timely manner.

7 Date for implementation 1 August 2012 Recommendation 3 The bulk of DCHS activity relating to pressure ulcers is inherited from other providers of healthcare and from within the community setting. At present a letter is sent to other providers informing them of the incident. There is limited feedback within the DCHS incident reporting process relating to the discharge information provided by other providers and well as DCHS services. If a question was incorporated into the Datix form then this could be used to inform other providers of improvements required to enable DCHS to care for the patients appropriately on discharge. Date for implementation 1 August 2012 Recommendation 4. Within the community setting most of the pressure ulcer incidence is the result of patients or carers not using equipment correctly or following pressure relieving advice e.g. not sitting in a chair to sleep, changing position every 2 hours, using pressure relieving cushions on chairs. Using the harm free care patient information across the DCHS community proactively to raise awareness of the risk to individuals within their own home may help to reduce the development of pressure ulcers, or encourage individuals to seek help sooner (some cases referred to the community services were grade 3 or 4) Date for implementation 1 October 2012 Recommendation 5. To ensure timely reporting to DCHS Board and management teams of the pressure ulcer incidence, elements of the systematic approach developed during the 4 day review should be incorporated into the current tissue viability systems. This will ensure that the Board is provided with the verified figures and analysis of the previous month s data, with the caveat that there may be complex STEIS reportable incidents which cannot be completed within the new 10 day RCA timescale. These incidents will be exception reported to Board. A review of the July data will be completed by the 3 August Recommendation 6. Ongoing data will be reviewed weekly to provide real time data to the management teams and encourage learning across DCHS services. A detailed analysis of trends and themes will be included in future monthly reports to QSC to provide assurance, identify hot spots within DCHS and enable appropriate resources and actions to be implemented. Date for implementation 1 August 2012 Monitoring Information Brief Summary CQC Compliance Outcome 16, Regulation 10 - Assessing & monitoring the Quality of Service Provision

8 The provision of safe high quality care is an integral part of patient care provided to all DCHS patients Monitor Compliance Monthly progress report against the Ambition Action Plan Collation of monthly reports into a quarterly summary NHSLA Compliance n/a report Assurance Framework Ref: 1.1 Safe High Quality Services 1.2 Clinical Effective high quality services 1.3 Patient experience Other Ambition One Harm Free Care Are there Equality & Diversity implications? Are there Patient and Public Involvement implications? (If no, why) No all patients will be assessed on their individual need with regard to the prevention and management of pressure ulcers. Where advice or recommendations require adaptation to meet patient requirements, whilst ensuring the safety of the patient, this will be documented in the patient notes The development of a communication plan utilising existing patient information will assist in the effective management and prevention of pressure ulcers within the community setting

TRUST BOARD. Jo Furley, Interim Chief Nurse Dr Ben Lobo, Medical Director. Jo Hunter, Deputy Chief Nurse. Mary Heritage, Assistant Director of Quality

TRUST BOARD. Jo Furley, Interim Chief Nurse Dr Ben Lobo, Medical Director. Jo Hunter, Deputy Chief Nurse. Mary Heritage, Assistant Director of Quality TRUST BOARD Document Title: Presenter: Quality Report Jo Hunter, Deputy Chief Nurse Authors: Contact details for further information: Jo Furley, Interim Chief Nurse Dr Ben Lobo, Medical Director Jo Hunter,

More information

The Royal Wolverhampton NHS Trust

The Royal Wolverhampton NHS Trust The Royal Wolverhampton NHS Trust Trust Board Report Meeting Date: 24 June 2013 Title: Executive Summary: Action Requested: Report of: Author: Contact Details: Resource Implications: Public or Private:

More information

BOARD OF DIRECTORS PAPER COVER SHEET. Meeting Date: 1 st December 2010

BOARD OF DIRECTORS PAPER COVER SHEET. Meeting Date: 1 st December 2010 BOARD OF DIRECTORS PAPER COVER SHEET Meeting Date: 1 st December 2010 Agenda Item: 9 Paper No: E Title: Management of Pressure Ulcers Purpose: For Information Summary: This paper provides a report on the

More information

TRUST BOARD 22 December Nursing, Quality & Patient Experience Directorate. TISSUE VIABILITY Update and Ambition

TRUST BOARD 22 December Nursing, Quality & Patient Experience Directorate. TISSUE VIABILITY Update and Ambition TRUST BOARD 22 December 26 Nursing, Quality & Patient Experience Directorate TISSUE VIABILITY Update and Ambition Executive Summary The aim of the Tissue Viability Service is to provide specialist assessment

More information

ENCLOSURE: J. Date of Trust Board 29 February Pressure Ulcer Clinical Improvement Programme. Purpose of Report

ENCLOSURE: J. Date of Trust Board 29 February Pressure Ulcer Clinical Improvement Programme. Purpose of Report ENCLOSURE: J Date of Trust Board 29 February 2012 Title of Report Purpose of Report Abstract Pressure Ulcer Clinical Improvement Programme This paper provides a progress report on our work in support of

More information

PRESSURE ULCER THEMATIC ADVERSE EVENT REPORT - MARCH The aim of this report is to provide NHS Borders Board with a thematic review of:-

PRESSURE ULCER THEMATIC ADVERSE EVENT REPORT - MARCH The aim of this report is to provide NHS Borders Board with a thematic review of:- Appendix-15-35 Borders NHS Board PRESSURE ULCER THEMATIC ADVERSE EVENT REPORT - MARCH 15 Aim The aim of this report is to provide NHS Borders Board with a thematic review of:- Avoidable hospital developed

More information

THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST REDUCING HARM TISSUE VIABILITY PROGRESS REPORT

THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST REDUCING HARM TISSUE VIABILITY PROGRESS REPORT Agenda item A5(iv) THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST REDUCING HARM TISSUE VIABILITY PROGRESS REPORT EXECUTIVE SUMMARY The Tissue Viability Team assists wards and departments to reduce

More information

Sheffield Teaching Hospitals NHS Foundation Trust

Sheffield Teaching Hospitals NHS Foundation Trust Sheffield Teaching Hospitals NHS Foundation Trust @seamlesssurgery Seamless Surgery Team Sheffield Teaching Hospitals NHS Foundation Trust July 2017 PROUD TO MAKE A DIFFERENCE PROUD TO MAKE A DIFFERENCE

More information

Nottingham University Hospitals Emergency Department Quality Issues Related to Performance

Nottingham University Hospitals Emergency Department Quality Issues Related to Performance RCCG/GB/14/123 Nottingham University Hospitals Emergency Department Quality Issues Related to Performance Introduction NUH have failed to meet the 95% 4 hour wait standard for a number of consecutive months.

More information

Mortality Report Learning from Deaths. Quarter

Mortality Report Learning from Deaths. Quarter Mortality Report Learning from Deaths Quarter 3 2017 Introduction In December 2016 the CQC report Learning, Candour and accountability: A review of the way NHS Trusts review and investigate the deaths

More information

TRUST BOARD SAFETY AND QUALITY MONTHLY REPORT SEPTEMBER 2013

TRUST BOARD SAFETY AND QUALITY MONTHLY REPORT SEPTEMBER 2013 TRUST BOARD SAFETY AND QUALITY MONTHLY REPORT SEPTEMBER 2013 1. EXECUTIVE SUMMARY As reported to the Board last month, the reporting on safety and quality to the Trust Board has changed. Each month a summary

More information

Version: 3.0. Effective from: 29/08/2012

Version: 3.0. Effective from: 29/08/2012 Policy No: RM51 Version: 3.0 Name of policy: Learning from Experience Policy A systematic approach to incident, complaint and clai management, analysis and sharing safety lessons Effective from: 29/08/2012

More information

Quality Framework Healthier, Happier, Longer

Quality Framework Healthier, Happier, Longer Quality Framework 2015-2016 Healthier, Happier, Longer Telford & Wrekin Clinical Commissioning Group (CCG) makes quality everyone s business. Our working processes are designed to ensure we all have the

More information

Board of Director s Meeting

Board of Director s Meeting Board of Director s Meeting Meeting Date: 15 November 212 Agenda item: 6.1 Title: Purpose: Summary: Recommendation: Author: Presented by: QUALITY AND PATIENT SAFETY ASSURANCE COMMITTEE To provide an exception

More information

Learning from Patient Deaths: Update on Implementation and Reporting of Data: 5 th January 2018

Learning from Patient Deaths: Update on Implementation and Reporting of Data: 5 th January 2018 Learning from Patient Deaths: Update on Implementation and Reporting of Data: 5 th January 218 Purpose The purpose of this paper is to update the Trust Board on progress with implementing the mandatory

More information

Debbie Edwards Interim Deputy Director of Nursing Gail Naylor- Executive Director of Nursing & Midwifery. Safety & Quality Committee

Debbie Edwards Interim Deputy Director of Nursing Gail Naylor- Executive Director of Nursing & Midwifery. Safety & Quality Committee Report to Trust Board of Directors Date of Meeting: 29 July 2014 Enclosure Number: 7 Title of Report: Author: Executive Lead: Responsible Sub- Committee (if appropriate): Executive Summary: Ward Accreditation

More information

Open and Honest Care in your Local Hospital

Open and Honest Care in your Local Hospital Open and Honest Care in your Local Hospital Report for: Royal Wolverhampton NHS Trust January 2016 The Open and Honest Care: Driving Improvement Programme aims to support organisations to become more transparent

More information

COVENTRY AND RUGBY CLINICAL COMMISSIONING GROUP

COVENTRY AND RUGBY CLINICAL COMMISSIONING GROUP COVENTRY AND RUGBY CLINICAL COMMISSIONING GROUP Report To: Governing Body 11 September 2013 Report From: Title of Report: Purpose of the Report: Jacqueline Barnes, Executive Nurse The Nursing and Quality

More information

4. Risk (Threats or opportunities, link to a risk on the Risk Register, Board Assurance Framework etc) None.

4. Risk (Threats or opportunities, link to a risk on the Risk Register, Board Assurance Framework etc) None. Report to: Management Board Agenda item: 12 Date of Meeting: 22 July 2015 Title of Report: Annual Tissue Viability Report 2014/15 Status: To Note Board Sponsor: Helen Blanchard, Director of Nursing and

More information

Report to: Trust Board 25 th April Enclosure 4. Title Integrated Performance Report March Sponsoring Executive Director

Report to: Trust Board 25 th April Enclosure 4. Title Integrated Performance Report March Sponsoring Executive Director Report to: Trust Board 25 th April 2013 Title Integrated Performance Report March 2013 Enclosure 4 Sponsoring Executive Director Author(s) Purpose Previously considered by Peter Herring Chief Executive

More information

Public Trust Board Meeting 22 November 2011

Public Trust Board Meeting 22 November 2011 Public Trust Board Meeting 22 November 2011 Title Lessons Learned Report Paper Ref 12 PURPOSE (X) Information Strategic Aim Business Plan Objective Approval Decision X 1.2, 3 Assurance X Discussion Purpose

More information

The safety of every patient we care for is our number one priority

The safety of every patient we care for is our number one priority HUMBER NHS FOUNDATION TRUST INFECTION PREVENTION AND CONTROL STRATEGY 2015-2017 1. Introduction Healthcare associated infections (HCAI) continue to be a major cause of patient harm and although nationally

More information

Learning from Deaths Trust Board in public

Learning from Deaths Trust Board in public Learning from Deaths Trust Board in public Date: 30 th August 2018 Agenda item: 2.4 Executive sponsor Professor Des Holden Medical Director Dr Richard Brown Director of Outcomes Report author(s) Jonathan

More information

Ayrshire and Arran NHS Board

Ayrshire and Arran NHS Board Paper 6 Ayrshire and Arran NHS Board Monday 11 December 2017 SPSP Update: Acute Adult Programme Author: Laura Harvey, QI Lead for Acute Services, Person Centred & Customer Care Sponsoring Director: Liz

More information

Workflow. Optimisation. hereweare.org.uk. hereweare.org.uk

Workflow. Optimisation. hereweare.org.uk. hereweare.org.uk Workflow Optimisation Dr. Paul Deffley & Jaivir Pall Clinical Lead & Commercial Lead About Here Not-for-profit social enterprise Membership organisation (our members are local GPs, Practice Managers, Practice

More information

A Successful Health Visitor Retention Strategy - Walsall Healthcare NHS Trust

A Successful Health Visitor Retention Strategy - Walsall Healthcare NHS Trust A Successful Health Visitor Retention Strategy - Walsall Healthcare NHS Trust Health Visiting Local Picture Population of approx 21,000 under 5s 10 Health Visitor Teams across the borough New model of

More information

Elaine Andrews, Assistant Director of Nursing & Safety and Caroline Booton Quality Analyst Jill Asbury, Acting Director of Nursing

Elaine Andrews, Assistant Director of Nursing & Safety and Caroline Booton Quality Analyst Jill Asbury, Acting Director of Nursing Report to: Board of Directors Date of Meeting: 26 th October 2016 Report Title: Inpatient Falls Report Status: Mark relevant box with X Prepared by: Executive Sponsor (presenting): For information x Discussion

More information

Integrated Performance Report August 2017

Integrated Performance Report August 2017 Integrated Performance Report Contents Section Page High Level Dashboard Balanced scorecard 3 Domain Scorecards and Director Commentaries Operational Performance 4 Quality and Patient Safety 9 Workforce

More information

A new integrated model for Care Homes from Walsall CCG/Healthcare NHS Trust

A new integrated model for Care Homes from Walsall CCG/Healthcare NHS Trust A new integrated model for Care Homes from Walsall CCG/Healthcare NHS Trust Sally Roberts - Director of Governance, Quality & Safety. Walsall CCG Katie Welborn Advanced Nurse Practitioner- Walsall Healthcare

More information

NHS performance statistics

NHS performance statistics NHS performance statistics Published: 8 th February 218 Geography: England Official Statistics This monthly release aims to provide users with an overview of NHS performance statistics in key areas. Official

More information

Return on investment Helped service users return home more quickly by reducing delayed discharge.

Return on investment Helped service users return home more quickly by reducing delayed discharge. Macmillan Social Care Coordinator Northampton General Hospital Economic and quality case study Service summary The Macmillan Social Care Co-ordinator is a single post based at Northampton General Hospital

More information

Service Transformation Report. Resource and Performance

Service Transformation Report. Resource and Performance SUMMARY REPORT Meeting Date: 31 May 2018 Agenda Item: 9.1 Enclosure Number: 9 Meeting: Trust Board (Part 1) Title: Author: Accountable Director: Other meetings presented to or previously agreed at: Service

More information

Board Briefing. Board Briefing of Nursing and Midwifery Staffing Levels. Date of Briefing August 2017 (July 2017 data)

Board Briefing. Board Briefing of Nursing and Midwifery Staffing Levels. Date of Briefing August 2017 (July 2017 data) Board Briefing Board Briefing of Nursing and Midwifery Staffing Levels Date of Briefing August 2017 (July 2017 data) This paper is for: Sponsor: Chief Nurse- Dame Eileen Sills (DBE) Decision Author: Workforce

More information

IQC/2013/48 Improvement and Quality Committee October 2013

IQC/2013/48 Improvement and Quality Committee October 2013 Item 9.4 IQC/2013/48 Improvement and Quality Committee October 2013 Pressure Ulcer Prevalence Improvement Plan 1. SITUATION AND BACKGROUND This paper is to update the Improvement and Quality Committee

More information

This annual report covers the period 1 April 2015 to 31 March Quality Account 2015/2016

This annual report covers the period 1 April 2015 to 31 March Quality Account 2015/2016 This annual report covers the period 1 April 2015 to 31 March 2016 Quality Account 2015/2016 Contents Part 1 Chief Executive s Statement 4 Part 2 Priorities for improvement and statements of assurance

More information

Appendix A: University Hospitals Birmingham NHS Foundation Trust Draft Action Plan in Response to CQC Recommendations

Appendix A: University Hospitals Birmingham NHS Foundation Trust Draft Action Plan in Response to CQC Recommendations No. Domain CQC Recommendation Lead Operational Lead Current Status 1 Appendix A: University Hospitals Birmingham NHS Foundation Trust Draft Action Plan in Response to CQC Recommendations Wording in long

More information

REQUIREMENT. Identify a minimum of 4 theme areas which are considered to have caused concern for patients during 2012/13

REQUIREMENT. Identify a minimum of 4 theme areas which are considered to have caused concern for patients during 2012/13 2012/13 SSOTP CQUIN INDICATOR TARGETS INDICATOR REQUIREMENT 1. Patient Experience Milestone 1 (15th working day of April 2012) Identify a minimum of 4 theme areas which are considered to have caused concern

More information

NHS Performance Statistics

NHS Performance Statistics NHS Performance Statistics Published: 8 th March 218 Geography: England Official Statistics This monthly release aims to provide users with an overview of NHS performance statistics in key areas. Official

More information

Standardising Acute and Specialised Care Theme 3 Governance and Approach to Hospital Based Services Strategy Overview 28 th July 2017

Standardising Acute and Specialised Care Theme 3 Governance and Approach to Hospital Based Services Strategy Overview 28 th July 2017 Standardising Acute and Specialised Care Theme 3 Governance and Approach to Hospital Based Services Strategy Overview 28 th July 2017 Background Theme 3 builds upon previous key strategic commissioning

More information

Change Management at Orbost Regional Health

Change Management at Orbost Regional Health Change Management at Orbost Regional Health Our change management journey 1 Medication Change System Meds at Beds 2 The slightly exaggerated before process 3 Project Goals The purpose of the Meds at Beds

More information

Influence of Patient Flow on Quality Care

Influence of Patient Flow on Quality Care Influence of Patient Flow on Quality Care Patients Waiting on Trolleys for an Inpatient Bed Patients who are Medically Fit to be discharged and cared for at Home with Support or in a Nursing Home or District

More information

BOROUGH OF ROSELLE PUBLIC NOTICE ANNUAL NOTICE OF CALENDAR YEAR 2018 WORKSHOP SESSIONS, PRE-AGENDA MEETINGS AND REGULAR MEETINGS

BOROUGH OF ROSELLE PUBLIC NOTICE ANNUAL NOTICE OF CALENDAR YEAR 2018 WORKSHOP SESSIONS, PRE-AGENDA MEETINGS AND REGULAR MEETINGS BOROUGH OF ROSELLE PUBLIC NOTICE ANNUAL NOTICE OF CALENDAR YEAR 2018 WORKSHOP SESSIONS, PRE-AGENDA MEETINGS AND REGULAR MEETINGS BE IT RESOLVED, by the Mayor and Borough Council of the Borough of Roselle,

More information

Evaluation of NHS111 pilot sites. Second Interim Report

Evaluation of NHS111 pilot sites. Second Interim Report Evaluation of NHS111 pilot sites Second Interim Report Janette Turner Claire Ginn Emma Knowles Alicia O Cathain Craig Irwin Lindsey Blank Joanne Coster October 2011 This is an independent report commissioned

More information

SFI Research Centres Reporting Requirements

SFI Research Centres Reporting Requirements SFI Research Centres Reporting Requirements December 2017 Introduction SFI s Agenda 2020 1 strategy aims to position Ireland as a global knowledge leader. A key objective of Agenda 2020 is to develop a

More information

Monthly and Quarterly Activity Returns Statistics Consultation

Monthly and Quarterly Activity Returns Statistics Consultation Monthly and Quarterly Activity Returns Statistics Consultation Monthly and Quarterly Activity Returns Statistics Consultation Version number: 1 First published: 08/02/2018 Prepared by: Classification:

More information

Trust Board meeting: Wednesday 8 th May2013 TB

Trust Board meeting: Wednesday 8 th May2013 TB Trust Board meeting: Wednesday 8 th May2013 Title Pressure Ulcer Prevention Report Status History A paper for information N/A Board Lead(s) Mrs Elaine Strachan-Hall, Chief Nurse Key purpose Strategy Assurance

More information

Integrated Quality Report

Integrated Quality Report Integrated Quality Report Data provided by Patient Services and the Clinical Governance and Risk Department June 2018 Included this month: Health-care Associated Infections Patient Falls Pressure Ulcers

More information

Root Cause Analysis for Pressure Ulceration This tool MUST be completed electronically paper copies will not be accepted.

Root Cause Analysis for Pressure Ulceration This tool MUST be completed electronically paper copies will not be accepted. Root Cause Analysis for Pressure Ulceration This tool MUST be completed electronically paper copies will not be accepted. What is this for? This root cause analysis (RCA) tool is used when a patient acquires

More information

Qu Q a u l a ilt i y t y Ac A c c o c u o n u t n

Qu Q a u l a ilt i y t y Ac A c c o c u o n u t n Quality Account 2010-2011 CONTENTS Statement from the Chief Executive 3 Page Statements from our Service Users 4 Summary of Priorities 6 Summary of Performance 7 Performance Review - Safety 8 Performance

More information

Ann Klein, Wound Care Specialist Brenda Mundy, Manager, Skin and Wound Program. Innovative Strategies lead to a Reduction in Pressure Ulcer Incidence

Ann Klein, Wound Care Specialist Brenda Mundy, Manager, Skin and Wound Program. Innovative Strategies lead to a Reduction in Pressure Ulcer Incidence Ann Klein, Wound Care Specialist Brenda Mundy, Manager, Skin and Wound Program Innovative Strategies lead to a Reduction in Pressure Ulcer Incidence Background Outline Innovative strategies to develop

More information

A must have for any GP surgery. It is like having our own Social Worker, CAB, Mental Health Worker all rolled into one who will chase up patients on

A must have for any GP surgery. It is like having our own Social Worker, CAB, Mental Health Worker all rolled into one who will chase up patients on A must have for any GP surgery. It is like having our own Social Worker, CAB, Mental Health Worker all rolled into one who will chase up patients on the phone and even go out to their houses if needed

More information

Improving Care, Delivering Quality Reducing mortality & harm in Welsh Ambulance Services NHS Trust

Improving Care, Delivering Quality Reducing mortality & harm in Welsh Ambulance Services NHS Trust National Learning Session - 10 th June 2011 Improving Care, Delivering Quality Reducing mortality & harm in Insert name of presentation on Master Slide Reducing Mortality & Harm in the Welsh Ambulance

More information

2016 Safeguarding Data Report THE NATIONAL SAFEGUARDING OFFICE

2016 Safeguarding Data Report THE NATIONAL SAFEGUARDING OFFICE 2016 Safeguarding Data Report THE NATIONAL SAFEGUARDING OFFICE 1 Contents Overview... 2 2016 Safeguarding Returns... 4 Safeguarding Concerns by Age Category... 7 Safeguarding concerns by Gender/Age...

More information

Pathway Resource Centre Care Home Service Children and Young People Meadow Mill Tranent EH33 1DT Telephone:

Pathway Resource Centre Care Home Service Children and Young People Meadow Mill Tranent EH33 1DT Telephone: Pathway Resource Centre Care Home Service Children and Young People Meadow Mill Tranent EH33 1DT Telephone: 01875 610794 Inspected by: Iain Lamb Type of inspection: Unannounced Inspection completed on:

More information

Corporate Services Employment Report: January Employment by Staff Group. Jan 2018 (Jan 2017 figure: 1,462) Overall 1,

Corporate Services Employment Report: January Employment by Staff Group. Jan 2018 (Jan 2017 figure: 1,462) Overall 1, Corporate Services Employment Report: January Employment by Staff Group Jan (Jan 20 figure: 1,462) Jan % Overall 1,520 +58 +4.0% 8 Management (VIII+) 403 +52 4.8% Clerical & Supervisory (III to VII) 907

More information

PROCEDURE FOR SUPERVISION AND PRECEPTORSHIP FOR PROVIDER SERVICES

PROCEDURE FOR SUPERVISION AND PRECEPTORSHIP FOR PROVIDER SERVICES PROCEDURE FOR SUPERVISION AND PRECEPTORSHIP FOR PROVIDER SERVICES First Issued Issue Version One Purpose of Issue/Description of Change To promote competent and safe practice through staff supervision

More information

RTT Recovery Planning and Trajectory Development: A Cambridge Tale

RTT Recovery Planning and Trajectory Development: A Cambridge Tale RTT Recovery Planning and Trajectory Development: A Cambridge Tale Linda Clarke Head of Operational Performance Addenbrooke s Hospital I Rosie Hospital Apr 2014 May 2014 Jun 2014 Jul 2014 Aug 2014 Sep

More information

To Dip or Not To Dip

To Dip or Not To Dip To Dip or Not To Dip a patient centred approach to improve the management of UTI in the Care Home environment FIS 30 th November 2017 #ToDipOrNotToDip #FIS17 Elizabeth Beech on behalf of colleagues National

More information

Warrington and Halton Hospitals NHS Foundation Trust Quality Report

Warrington and Halton Hospitals NHS Foundation Trust Quality Report Warrington and Halton Hospitals NHS Foundation Trust Quality Report 2016-2017 Contents Part 1 Statement of Quality from the Chief Executive 7 Part 2 Improvement Priorities & Statement of Assurance from

More information

Pressure ulcers: revised definition and measurement. Summary and recommendations

Pressure ulcers: revised definition and measurement. Summary and recommendations Pressure ulcers: revised definition and measurement Summary and recommendations June 2018 We support providers to give patients safe, high quality, compassionate care within local health systems that are

More information

Learning from Deaths; Mortality Review Policy

Learning from Deaths; Mortality Review Policy Learning from Deaths; Mortality Review Policy Version: 4.0 New or Replacement: Replacement Policy number: CESC/2012/066 (Version 4) Document author(s): Executive Sponsor: Non-Executive Sponsor: Title of

More information

NHS LANARKSHIRE QUALITY DASHBOARD Board Report October 2011 (Data available as at end August 2011)

NHS LANARKSHIRE QUALITY DASHBOARD Board Report October 2011 (Data available as at end August 2011) NHS LANARKSHIRE QUALITY DASHBOARD Board Report October 2011 (Data available as at end August 2011) INTRODUCTION This paper provides a monthly quality dashboard for NHS Lanarkshire. This is in line with

More information

Quality Accounts: Corroborative Statements from Commissioning Groups. Nottingham NHS Treatment Centre - Corroborative Statement

Quality Accounts: Corroborative Statements from Commissioning Groups. Nottingham NHS Treatment Centre - Corroborative Statement Quality Accounts: Corroborative Statements from Commissioning Groups Quality Accounts are annual reports to the public from providers of NHS healthcare about the quality of services they deliver. The primary

More information

Newham Borough Summary report

Newham Borough Summary report Newham Borough Summary report April 2013 Prepared on 17/04/13 by Commissioning Support team Apr-11 Jun-11 Aug-11 Oct-11 Dec-11 Feb-12 Apr-12 Jun-12 Aug-12 Oct-12 Dec-12 Feb-13 GREE N Finance and Activity

More information

Patient Experience Annual Report

Patient Experience Annual Report Patient Experience Annual Report 1 st April 2016 31 st March 2017 Complaints, Compliments, Concerns, Health Care Professional Feedback (HCP) Author: Amanda Painter, Head of Patient Experience Contact:

More information

NHS DORSET CLINICAL COMMISSIONING GROUP GOVERNING BODY MEETING ADULT AND CHILDREN CONTINUING HEALTHCARE ANNUAL REPORT

NHS DORSET CLINICAL COMMISSIONING GROUP GOVERNING BODY MEETING ADULT AND CHILDREN CONTINUING HEALTHCARE ANNUAL REPORT 9.6 NHS DORSET CLINICAL COMMISSIONING GROUP GOVERNING BODY MEETING ADULT AND CHILDREN CONTINUING HEALTHCARE ANNUAL REPORT Date of the meeting 18/07/2018 Author Sponsoring Board member Purpose of Report

More information

Safeguarding Children Annual Report

Safeguarding Children Annual Report Trust Board Public Safeguarding Children Annual Report Agenda item: For: Summary: Information The annual report for safeguarding children enables the Board to review the activity across the Trust in relation

More information

EDS 2. Making sure that everyone counts Initial Self-Assessment

EDS 2. Making sure that everyone counts Initial Self-Assessment EDS 2 Making sure that everyone counts Initial Self-Assessment Equality Delivery System for the NHS EDS2 Summary Report Implementation of the Equality Delivery System EDS2 is a requirement on both NHS

More information

WOLVERHAMPTON CLINICAL COMMISSIONING GROUP. Corporate Parenting Board. Date of Meeting: 23 rd Feb Agenda item: ( 7 )

WOLVERHAMPTON CLINICAL COMMISSIONING GROUP. Corporate Parenting Board. Date of Meeting: 23 rd Feb Agenda item: ( 7 ) WOLVERHAMPTON CLINICAL COMMISSIONING GROUP Corporate Parenting Board Agenda Item No. 7 Health Services for Looked After Children Annual Report September 2014 -August 2015 Date of Meeting: 23 rd Feb 2016.

More information

Northern Health - Acute Services. Evidence Based Practice Venous Thromboembolism Prevention

Northern Health - Acute Services. Evidence Based Practice Venous Thromboembolism Prevention Northern Health - Acute Services Evidence Based Practice Venous Thromboembolism Prevention (VTE) Jeannette Kamar Christine Lamotte, Liam Carter Improving Patient Safety Preventing and Managing Venous Thromboembolism

More information

The Suffolk Marie Curie Delivering Choice Programme

The Suffolk Marie Curie Delivering Choice Programme The Suffolk Marie Curie Delivering Choice Programme Phase III A report on progress and achievements Date: April 2012 Author: Sandy Barron Project Lead Manager Design and Development - MCDCP 1 Table of

More information

Ruth McCarthy, Associate Director Clinical Governance/IP&C

Ruth McCarthy, Associate Director Clinical Governance/IP&C Trust Board Meeting: 25 April 28 Title: Executive Summary: Items for discussion: Clinical Governance/Infection Prevention and Control Report - April 28 The Clinical Governance Report April 28 comprises:

More information

Reducing Elective Waits: Delivering 18 week pathways for patients. Programme Director NHS Elect Caroline Dove.

Reducing Elective Waits: Delivering 18 week pathways for patients. Programme Director NHS Elect Caroline Dove. Reducing Elective Waits: Delivering 18 week pathways for patients Programme Director NHS Elect Caroline Dove What I will cover 1. Why 18 Weeks is different 2. Where are we now 3. New models of delivery

More information

Safeguarding Children and Vulnerable Adults Update

Safeguarding Children and Vulnerable Adults Update Appendix 3 Safeguarding Children and Vulnerable Adults Update Executive Summary This paper provides the Salford CCG Governing Body with an update report in relation to the work undertaken by the CCG Safeguarding

More information

CHC-A Continuity Dashboard. All Sites Continuity - Asthma. 2nd Qtr-03. 2nd Qtr-04. 2nd Qtr-06. 4th Qtr-03. 4th Qtr-06. 3rd Qtr-04.

CHC-A Continuity Dashboard. All Sites Continuity - Asthma. 2nd Qtr-03. 2nd Qtr-04. 2nd Qtr-06. 4th Qtr-03. 4th Qtr-06. 3rd Qtr-04. PPC1: ACCESS AND COMMUNICATION Element B: Access and Communication Results Item 1: Visits with assigned PCP Continuity data is reviewed each month at our Office Redesign Committee (ORDC). The data is collected

More information

Hospital Cleanliness Report March 2013

Hospital Cleanliness Report March 2013 PAPER: SFT3379 Hospital Cleanliness Report March 2013 PURPOSE: To update the Trust Board on the Cleanliness Compliance against national specifications that support the Clean Hospital Agenda MAIN ISSUES:

More information

Influence of Patient Flow on Quality Care

Influence of Patient Flow on Quality Care Influence of Patient Flow on Quality Care Patients Waiting on Trolleys for an Inpatient Bed Patients who are Medically Fit to be discharged and cared for at Home with Support or in a Nursing Home or District

More information

Quarter /13 Quality Account (Quality and Safety)

Quarter /13 Quality Account (Quality and Safety) Airedale NHS Foundation Trust Board of Directors:23 rd January 213 Title: Quarter 2 212/13 Quality Account (Quality and Safety) Author: Alison Fuller, Assistant Director Healthcare Quarter 2 212/13 Quality

More information

SFI Research Centres Reporting Requirements

SFI Research Centres Reporting Requirements SFI Research Centres Reporting Requirements February 2017 Introduction SFI s Agenda 2020 1 strategy aims to position Ireland as a global knowledge leader. A key objective of Agenda 2020 is to develop a

More information

Safety in Mental Health Collaborative

Safety in Mental Health Collaborative NHS Tayside Safety in Mental Health Collaborative Improving Safety in Mental Health Programme Aims supported by an Improvement Advisor: Dr Noeleen Devaney Support 4 UK organisations to: reduce harm improving

More information

The Royal Wolverhampton NHS Trust

The Royal Wolverhampton NHS Trust Title: Safe Staffing; Planned Versus Actual Staffing by Ward September 2016 data The Royal Wolverhampton NHS Trust Trust Board Report Meeting Date: 31 st October 2016 Title: Nursing Workforce Report Executive

More information

Dudley & Walsall Mental Health Partnership NHS Trust Board

Dudley & Walsall Mental Health Partnership NHS Trust Board Dudley & Walsall Mental Health Partnership NHS Trust Board Date of Board Meeting: 29 th July 2 Subject: Performance Corporate Dashboard Month 3 Trust Board Lead: Jacky O Sullivan, Director of Performance

More information

NHS performance statistics

NHS performance statistics NHS performance statistics Published: 14 th December 217 Geography: England Official Statistics This monthly release aims to provide users with an overview of NHS performance statistics in key areas. Official

More information

Quality Assurance Accreditation Scheme Assignment Report 2016/17. University Hospitals of Morecambe Bay NHS Foundation Trust

Quality Assurance Accreditation Scheme Assignment Report 2016/17. University Hospitals of Morecambe Bay NHS Foundation Trust Quality Assurance Accreditation Scheme Assignment Report 2016/17 Contents 1. Introduction 2. Executive Summary 3. Findings, Recommendations and Action Plan Appendix A: Terms of Reference Appendix B: Assurance

More information

Quality Management Report 2017 Q2

Quality Management Report 2017 Q2 Quality Management Report 2017 Q2 Quality Management Program CMS STAR Ratings Member Satisfaction (CAHPS & HOS) HEDIS Risk Adjustment DHS Member Incident Reporting Member Satisfaction Surveys Pay for Performance

More information

Quality Improvement Scorecard March 2018

Quality Improvement Scorecard March 2018 Mortality: HSMR Nat NB: Each month is a 12 month rolling value. I.e. Mar-16 reports the monthly average of Apr-15 to Mar-16. Performance further improved in October. November data not yet available. Mortality:

More information

Safeguarding Adults. Annual Report

Safeguarding Adults. Annual Report APPENDIX I Safeguarding Adults Annual Report 2009 2010 Authors Neil Boyland Sue Leathers 1. Definition All persons have the right to live their lives free from violence and abuse. This right is underpinned

More information

FOREWORD Introduction from the Chief Executive 2 BACKGROUND 3 OUR TRUST VALUES 4 OUR AIMS FOR QUALITY 5 HOW WE MEASURE QUALITY 16

FOREWORD Introduction from the Chief Executive 2 BACKGROUND 3 OUR TRUST VALUES 4 OUR AIMS FOR QUALITY 5 HOW WE MEASURE QUALITY 16 Contents FOREWORD Introduction from the Chief Executive 2 BACKGROUND 3 OUR TRUST VALUES 4 OUR AIMS FOR QUALITY 5 - Our achievements so far - Our aims for quality 2017 2020 AIM 1: AIM 2: AIM 3: AIM 4: Reducing

More information

Achieving Consensus in Pressure Ulcer Reporting

Achieving Consensus in Pressure Ulcer Reporting Achieving Consensus in Pressure Ulcer Reporting Tina Chambers Chair of Tissue Viability Society 2013-2015 Co-Chair TVS Pressure Ulcer Reporting Group Purpose of Document This document is for all organisations

More information

TRUST BOARD PART I SEPTEMBER 2011 Agenda Item Number: 145/11 Enclosure Number: (1)

TRUST BOARD PART I SEPTEMBER 2011 Agenda Item Number: 145/11 Enclosure Number: (1) TRUST BOARD PART I SEPTEMBER 2011 Agenda Item Number: 145/11 Enclosure Number: (1) Subject: Prepared by: Sponsored by: Presented by: Purpose of paper Why is this paper going to the Trust Board? Key points

More information

Agenda Item The report triangulates staffing levels against appropriate quality measures. The Report is provided to the Board for:

Agenda Item The report triangulates staffing levels against appropriate quality measures. The Report is provided to the Board for: To: Trust Board From: Michelle Rhodes, Director of Nursing Date: 2 nd May 2017 Essential Standards: Health and Social Care Act 2008 (Regulated Activities) Regulation 18: Staffing Title: Monthly Nursing/Midwifery

More information

BOARD OF DIRECTORS 25 OCTOBER 2013

BOARD OF DIRECTORS 25 OCTOBER 2013 AGENDA ITEM: 1.7 TITLE: BOARD OF DIRECTORS 25 OCTOBER 213 RESEARCH & DEVELOPMENT ANNUAL REPORT PURPOSE: Discussion Please tick Approval Information RECOMMENDATION: The Board of Directors is asked to note

More information

Strategic KPI Report Performance to December 2017

Strategic KPI Report Performance to December 2017 Strategic KPI Report Performance to December 2017 Trust Board 25 th January 2018 Strategic KPI summary SROs: All Directors Objective KPI SRO Target Apr May Jun Jul Aug Sep Oct Nov Success Is Deliver A

More information

Status: Information Discussion Assurance Approval

Status: Information Discussion Assurance Approval Report to: Trust Board Agenda item: Date of Meeting: July 2017 Report Title: Safe Nurse Staffing 6 Monthly Assurance Report Status: Information Discussion Assurance Approval X x Prepared by: Sarah Dodds,

More information

Meeting of Bristol Clinical Commissioning Group Governing Body. Title: Bristol CCG Management of Serious Incidents Agenda Item: 17

Meeting of Bristol Clinical Commissioning Group Governing Body. Title: Bristol CCG Management of Serious Incidents Agenda Item: 17 Meeting of Bristol Clinical Commissioning Group Governing Body To be held on Tuesday 22 December 2015 commencing at 13:30 at the Greenway Centre, Doncaster Road, Bristol, BS10 5PY Title: Bristol CCG Management

More information

CATEGORY OF PAPER. Board of Director s Meeting 27/07/2017. J A Mains & V Mccluskey. Key considerations

CATEGORY OF PAPER. Board of Director s Meeting 27/07/2017. J A Mains & V Mccluskey. Key considerations CATEGORY OF PAPER Specific action required (decision / approval) For information / assurance only CATEGORY OF PAPER Specific action required: Provides Assurance: For Information: Report title: Purpose

More information

Enlisted Professional Military Education FY 18 Academic Calendar. Table of Contents COLLEGE OF DISTANCE EDUCATION AND TRAINING (CDET):

Enlisted Professional Military Education FY 18 Academic Calendar. Table of Contents COLLEGE OF DISTANCE EDUCATION AND TRAINING (CDET): Enlisted Professional Military Education FY 18 Academic Calendar Table of Contents STAFF NON-COMMISSIONED OFFICER ACADEMIES: SNCO Academy Quantico SNCO Academy Camp Pendleton SNCO Academy Camp Lejeune

More information

TAMESIDE & GLOSSOP INTEGRATED CARE NHS FOUNDATION TRUST

TAMESIDE & GLOSSOP INTEGRATED CARE NHS FOUNDATION TRUST TAMESIDE & GLOSSOP INTEGRATED CARE NHS FOUNDATION TRUST Report to Public Trust Board meeting of the 29 th June 2017 Agenda Item 7b Title Sponsoring Executive Director Author (s) Purpose Previously considered

More information

Document Details Clinical Audit Policy

Document Details Clinical Audit Policy Title Document Details Clinical Audit Policy Trust Ref No 1538-31104 Main points this document covers This policy details the responsibilities and processes associated with the Clinical Audit process within

More information

TRUST BOARD PART I NOVEMBER 2011 Agenda Item Number: 179/11 Enclosure Number: (1)

TRUST BOARD PART I NOVEMBER 2011 Agenda Item Number: 179/11 Enclosure Number: (1) TRUST BOARD PART I NOVEMBER 2011 Agenda Item Number: 179/11 Enclosure Number: (1) Subject: Prepared by: Sponsored by: Presented by: Purpose of paper Why is this paper going to the Trust Board? Key points

More information