Nye s Improvement News Highlight in this Issue: Success at the NHS Wales Awards Also in this issue: Achievements in IQT Bronze Out & About with Improving Quality Together with Janice Barrett, Lead Nurse - 1000 Lives ABCi Modelling Unit IQT Bronze Christmas Competition Issue 03 October 2014 Dear All Welcome to the 3rd edition of Nye s Improvement News. It has been a busy summer at ABCi with visits from the Health Foundation, the Home Office, a team from Limerick and Professor Mike Carter from Toronto. They have been interested in how we are integrating Operational Research (modelling) into our work and how we are using Quality Improvement methods with clinical teams. In terms of IQT, we are now well passed the 2000 mark for IQT Bronze training and teams are still contacting us for training. The modelling team have been in Lisbon presenting at the Operational Research Applied to Health Services Conference (see John Frankish s blog ) and they have developed several new internal statistics and healthcare modelling courses which are proving very popular. In terms of some of the work going on across the organisation we were delighted at Aneurin Bevan HB s success at the NHS Wales awards and some of the IQT Silver projects completed in the past few months have been inspirational. The list of silver projects is too long to mention here but they are all listed on the ABCi intranet site. I commend you to read Esther Philpott s and Tanya Strange s blogs on the ABCi blog page to gain a sense of their experience of delivering change. The second cohort of the Enhanced Leadership & Management Programme started in September but due to its popularity and the fact that it is clear that it does not suit everyone we shall, working with colleagues in Organisational Development, also be developing a leadership course with an emphasis on leading, developing and using improvement methodologies in multidisciplinary teams. Benna Waites, Co-Head of Psychology, has joined the ABCi team for 1-day a week and will be supporting this programme. Can I also take this opportunity to let you know that Robert Duncan, ST5 plastic surgeon from ABMU, has joined us as our Welsh Deanery Leadership Fellow for one year and will be working with ABUHB on developing our services for older people. In this edition we have some of our usual sections, Jan Barrett writes about Sepsis, and following on from her inspirational presentation at the Nursing & Midwifery Conference Rhiannon Jones describes her experience as a patient in Your Voice Matters and the modelling unit describe some of their new courses and review the Masters students celebration event. Hope you find it an interesting and enjoyable read and if anything captures your interest ABCi are always happy to meet with you. Danny Antebi - Director - ABCi
ABCi next steps for IQT Person completed IQT Bronze Jessica Roberts, Staff Nurse, A&E - RGH Lawrence Tamalong, Ward Manager at the Royal Gwent Hospital was the lucky winner of our Summer IQT Bronze Campaign. Lawrence's name was chosen at random by the Chairman, David Jenkins using a random number generator. See details on our Christmas IQT Bronze Competition that will be run throughout November/December 2014 on the back of this newsletter. IQT Bronze Training The IQT Bronze level will help you take a new look at the work you do and find ways to make it even better. It s suitable for staff across every discipline, including non-clinical functions, and at every level. Have you completed yours? So, whatever you do in ABUHB, and however much responsibility you have, you will gain foundation level knowledge of quality improvement through the Bronze level e-learning modules. IQT Bronze Level includes: Four e-learning modules (each about 30 minutes long). A focus on a person-centred approach. Introduction to the Model for Improvement. If you don t have access to e-learning, you can also gain the Bronze level through classroom training email lucy.bennett@wales.nhs.uk or call 01633 431731.
Out & About with Improving Quality Together featuring Janice Barrett, Lead Nurse - 1000 Lives If you could save a life every day would you? WHY DOES SEPSIS MATTER? Sepsis is one of our biggest killers! Shocking, since so few people are aware of it, but sepsis claims 37,000 lives every year in the UK and costs the NHS 2.5 billion a year. This equates to 1800 deaths in Wales at a cost of 125m (UK SEPSIS TRUST). Within ABUHB sepsis is a major contributor in 15% of all hospital deaths. Sepsis probably accounts for 10% of ambulance admissions to our Emergency departments and 3% of the patients treated in the ED. In our critical care units sepsis is the major cause of death and accounts for almost 50% of bed days. Excluding critical care areas, annually, for every 500 beds in the organisation there are approximately 300 cases of sepsis costing 6m. As a condition which crosses boundaries between specialities and professions, fixing sepsis at an organisational level is complex. In ABUHB we want to bring about change across the organisation with the aim of reducing mortality and realising savings from improving the recognition and treatment of sepsis. WHAT ARE WE TRYING TO ACHIEVE? A culture where all clinical teams, are aware of patients who might be at risk of deterioration from the moment that they are admitted- at the start of and during each shift, at nights and weekends. Potentially sick patients are identified early, a change in status is communicated to the whole team and frequency and type of observations for those patients to be common knowledge. WHAT HAVE WE DONE IN ABUHB? Established outcome measurement by outreach team score to door data base. Admission, Recognition, Response and sepsis six bundles measured via Fundamentals of care database Education programs -via Rapid Response Acute Illness Learning Set (RRAILS), ALERT, MONITOR, ILS, Drs Induction, Band 5 induction Mortality reviews.- Focused on learning about sepsis -staff need to act swiftly when recognising sepsis even if this is before blood results are returned to ensure use of sepsis 6 bundle Sepsis prevalence survey 06.02.14 in ABUHB - study carried out on 1159 patients in RGH, YYF and NHH.Whole hospital (excluding Critical Care but including ED and MAU) -Sepsis Prevalence 1.6% Implement Human Factors and standard operating procedures to improve process reliability; e.g. deteriorating patient policy which includes escalation jump policy, safety briefings, SBAR, standardised documentation, PSAG boards and sepsis response bags. Newport GPs working with MAU RGH. NEXT STEPS.. Continue raising awareness to improve team working and patient outcomes Continue to work with the 1000 lives plus team and participate in the RRAILS collaborative. Comply with the Welsh Government tier one target Ensure all areas have in place the RRAILS process and outcome measures using the care metrics. Link with other causes of harm - AKI etc now being integrated into training. For more information about sepsis please visit: http://www.1000livesplus.wales.nhs.uk/world-sepsis-day http://sepsistrust.org/meet-the-team/sepsis-uk-core-team/terence-canning/
ABCi Modelling Unit Development and delivery of training courses in Excel, modelling techniques and problem solving skills for NHS staff. The team has delivered 2 training courses and an additional four are in due to commence. These will equip NHS staff with a number of key skills to enable them to analyse data more efficiently and develop an understanding for the role of modelling in health and social care. At present over 80 staff have been trained on the Excel Skills course and 25 on the Modelling in Healthcare course. Excellent feedback has been received from staff that have attended these course for example: Thank you. Very thorough, well paced, can't wait to start using excel skills at work more efficiently For details on up and coming courses please go to: http://howis.wales.nhs.uk/sitesplus/866/page/55818 Personally this course taught me lots of useful things that I can take back and use in work. Probably one of the best courses I've ever been on with regards to usefulness. Masters Event Wednesday 10th September 2014 On Wednesday 10th September 2014 Aneurin Bevan University Health Board hosted a collaborative event between ABCi and the School of Mathematics. Five 5 students from the School of Mathematics have been working hard to complete their Masters qualifications in the Health Board with support from the ABCi team. The purpose of the event was to celebrate the work that they had completed over the past 12 weeks. L to R Lingchen Meng, Ruth Davies, Jiahao Ye, Sarah Bailey, Isah Mu'azu To view the posters and presentations from the event please go to: http:// howis.wales.nhs.uk/sitesplus/866/page/61641 The students would like to take this opportunity to thank all of the Clinical Divisions who helped and supported them during the period at ABUHB.
NHS Wales Awards 2014 33 Entries Submitted ABCi would like to congratulate all the ABUHB staff whose work to improve patient care has won 4 NHS Wales Awards including the overall winner! Primary care divisional nurse Tanya Strange and her team were given the inaugural accolade of Outstanding Innovation in Care for its unique volunteer service of retired NHS professionals who provide support to older people in care homes. CHAaT is all about respect and dignity, it enables older people to have a voice and control about the care they receive, and it also helps the care homes to make improvements and celebrate what they do well. The Care Home Ask and Chat (CHAat) service, which provides a confidential ear to enable older people and their families to talk about their experiences and raise any concerns, also scooped the Citizens at the Centre of Service Re-Design and Delivery award, supported by Wales Council for Voluntary Action. The award for Developing a Flexible and Sustainable Workforce supported by Royal College of Nursing Wales in partnership with Velindre Cancer Centre for the creation of the first ever acute cancer service for patients in a South Wales hospital. 9 Entries Shortlisted Janet Kelly and her Team won the Promoting Clinical Research and Application to Practice Award, supported by British Medical Association Cymru Wales. This was for a project that asked children with physical disabilities what they wanted from specialised seating and how it could be improved to better meet their needs. Helen Price, from the University of South Wales, who is a student nurse at Aneurin Bevan University Health Board was awarded the first ever Students Improving Patient Safety and Quality award. Helen s project was around improving patient care and dignity by decreasing the use of inappropriate continence aids also won an NHS Wales Award. The Project was undertaken on a 28 bed care of the acute medical ward, specialising in the care of the elderly in Aneurin Bevan University Health Board. If you have any ideas for next years awards contact ABCi on 01633 431731 or email lucy.bennett@wales.nhs.uk
Name: Your voice matters.. Rhiannon Jones Service User I ve been a patient with the mental health services on and off for a few years. I have been a recovering ED patient for the past two years. I am 30 years old, and have had my eating disorder since I was very young, and it was most severe from my teenage years onwards. My recovery has been quite successful and I ve been a healthy weight for a year now, due to the help I received from the eating disorders services, without which, I wouldn t have recovered as successfully as I have. I had tried to recover before alone, and always failed. I have now been given the amazing opportunity to help the services voluntarily with my comics, I ve been in a video sharing my story, and am part of a nursing conference and it s been really helpful to my recovery. It s given me focus and constantly gives me hope which I hope to pass on to other patients. Tell us a little about your time as an inpatient? Did you have any concerns about the service? Not particularly. I had problems accessing the services I knew I required previously. I had mostly been suffering with Bulimia, and although I was always underweight, it wasn t a cause for concern as it was when I was finally admitted to the ED services a few years later at my lowest weight. I felt like I was told by GP s that because my weight wasn t that low, that I didn t have a problem so I could continue as I was. When I was admitted to the eating disorder services two years ago, I felt that all of the care I received was excellent, and tailor made to fit me, and I never had any concerns. Would anything else have improved your experience Aside from being able to access the services sooner, the only improvements I can think of are to do with me, and being more honest with my treatment team from the beginning. It s especially difficult to be honest because my eating disorder has always felt so shameful, and something to be kept hidden, and after being told I didn t have that big of a problem due to my weight previously, it was another excuse to keep my illness a secret. Do you think more could be done to improve the care you received? The GP I had when I was admitted was excellent, he was caring, knew exactly what to do and say, explained everything carefully, took everything I said seriously and saw me every other day until I was passed onto the ED team whom he contacted while I was sat there in his office. I would hope that all GP s are now like him and not like the first ones I saw years previously. Were you involved in the decisions that were made about your care? Did you feel fully involved in those decisions? I was lucky enough to be in a position where I was able to be involved with all of my care. I was actively encouraged to take part in the decisions about my treatment, and it was one of the most important aspects of my recovery. I was able to learn when I needed help, and what kind of help I needed, and learning when I could cope with less care with the use of care plans. I am much more able to ask for help when I need it now because of this for my co morbid mental health problems, for instance, if I need help from the Home Treatment Team, I am much more able to ask for it. Given that my problems are mental health related though, I would have understood if I was left out of some decisions, for instance, I didn t immediately agree with being given medication, but now I know it was the right thing to do, and I still take them today.
Nursing & Midwifery Conference 2014 ABCi had the great honour in being part of the Conference Committee #peoplefactor2014. Here are copies of the winning posters and presentation from the day. Overall Poster Winner Margetts Award Winner Fiona s poster presentation won the award because: Greatly addressed an area that is of high importance to the Health Board Poster got the message across in a visually impactful way A simple idea that will benefit both patients and organisation For Highly Commended and Runners-up Posters and presentations from the day please view the dedicated pages on the intranet Oral Presentation Winner donating his prize money to Jacks Fund The teams poster presentation won the award because: Demonstrates the difference it makes to the care of the older adult as staff are freed up giving them more time to spend with patients Was visual and comprehensive L to R Denise Llewellyn, June Thomas and Phil Hill Phil Hill, Nurse Practitioner within the Out of Hours Service, presented with June Thomas, the mother of Jack. They won the best oral presentation award, providing a highly emotional and emotive true story to promote the presence and utilisation of Automated Electronic Defibrillators (AED s) in all public places. Their presentation, entitled remembering Jack, outlined what happened to Jack who was a fit, energetic, funny & loving 15 year old, who sadly and totally unexpectedly died as a result of an undetected heart defect. Phil & June highlighted their campaign Jack s Law which is currently being debated in Plenary, Welsh Government to have AED s across Wales in all Public Places. There wasn t a dry eye in the house following their presentation. To view more information about Jack and the watch the video go to: http://www.rememberingjack.co.uk/
The triplet s first attempt at process mapping fell apart when they realised none of them could hold a pen!!!!! Congratulations Pain Team, NHH L to R Clair Watkins, Tim Watkins ABCi, Tim Bough receiving the certificate of behalf of the team (plus Joanne Prosser & Claire Hayward) And finally. Have you completed your IQT Bronze training? To be in with a chance of winning our next prize of a Christmas Candy Tree you will need to have to completed your IQT Bronze training by 15th December 2014. This can be accessed via the ABUHB internet/internet (search IQT Training) or contact lucy.bennett@wales.nhs.uk for details of classroom style training. Full competition details will be posted on the intranet. ABCi would like to thank all those who contributed to our 3rd newsletter. If you have an article, comment and/or an idea for future editions of Nye s Improvement News please send them to: lucy.bennett@wales.nhs.uk or call 01633 431731. If you have anything you would like to see in a future edition, for example: Locality, division or service news in relation to Quality, Improvement or Innovation IQT Bronze/Silver Improvement stories Patient Stories in relation to improvement/innovation Please follow us on: @ABCiab