Open and Honest Care in your Local Hospital The Open and Honest Care: Driving Improvement programme aims to support organisations to become more transparent and consistent in publishing safety, experience and improvement data; with the overall aim of improving care, practice and culture. Report for: Gateshead Health NHS Foundation Trust October 214
Open and Honest Care at Gateshead Health NHS Foundation Trust : October 214 This report is based on information from October 214. The information is presented in three key categories: safety, experience and improvement. This report will also signpost you towards additional information about Gateshead Health NHS Foundation Trust's performance. 1. SAFETY Safety thermometer On one day each month we check to see how many of our patients suffered certain types of harm whilst in our care. We call this the NHS Safety Thermometer. The safety thermometer looks at four harms: pressure ulcers, falls, blood clots and urine infections for those patients who have a urinary catheter in place. This helps us to understand where we need to make improvements. The score below shows the percentage of patients who did not experience any harms. 95.3% of patients did not experience any of the four harms in this trust. For more information, including a breakdown by category, please visit: http://www.safetythermometer.nhs.uk/ Health care associated infections (HCAIs) HCAIs are infections acquired as a result of healthcare interventions. Clostridium difficile (C.difficile) and methicillinresistant staphylococcus aureus (MRSA) bacteremia are the most common. C.difficile is a type of bacterial infection that can affect the digestive system, causing diarrhoea, fever and painful abdominal cramps - and sometimes more serious complications. The bacteria does not normally affect healthy people, but because some antibiotics remove the 'good bacteria' in the gut that protect against C.difficile, people on these antibiotics are at greater risk. The MRSA bacteria is often carried on the skin and inside the nose and throat. It is a particular problem in hospitals because if it gets into a break in the skin it can cause serious infections and blood poisoning. It is also more difficult to treat than other bacterial infections as it is resistant to a number of widely-used antibiotics. We have a zero tolerance policy to infections and are working towards eradicating them; part of this process is to set improvement targets. If the number of actual cases is greater than the target then we have not improved enough. The table below shows the number of infections we have had this month, plus the improvement target and results for the year to date. C.difficile MRSA This month 3 Improvement target (year to date) 24 Actual to date 13 For more information please visit: www.website.com
Pressure ulcers Pressure ulcers are localised injuries to the skin and/or underlying tissue as a result of pressure. They are sometimes known as bedsores. They can be classified into four grades, with one being the least severe and four being the most severe. This month 11 Grade 2 - Grade 4 pressure ulcers were acquired during hospital stays. Severity Grade 2 Grade 3 Grade 4 Number of pressure ulcers 1 1 Pressure ulcer numbers include all pressure ulcers that occured from 72 hours after admission to this Trust. So we can know if we are improving even if the number of patients we are caring for goes up or down, we also calculate an average called 'rate per 1, occupied bed days'. This allows us to compare our improvement over time, but cannot be used to compare us with other hospitals, as their staff may report pressure ulcers in different ways, and their patients may be more or less vulnerable to developing pressure ulcers than our patients. For example, other hospitals may have younger or older patient populations, who are more or less mobile, or are undergoing treatment for different illnesses. Rate per 1 bed days:.72 Falls This measure includes all falls in the hospital that resulted in injury, categorised as moderate, severe or death, regardless of cause. This includes avoidable and unavoidable falls sustained at any time during the hospital admission. This month we reported 4 fall(s) that caused at least 'moderate' harm. Severity Moderate Severe Death Number of falls 4 So we can know if we are improving even if the number of patients we are caring for goes up or down, we also calculate an average called 'rate per 1, occupied bed days'. This allows us to compare our improvement over time, but cannot be used to compare us with other hospitals, as their staff may report falls in different ways, and their patients may be more or less vulnerable to falling than our patients. For example, other hospitals may have younger or older patient populations, who are more or less mobile, or are undergoing treatment for different illnesses. Rate per 1, bed days:.26
Communication 2. EXPERIENCE To measure patient and staff experience we ask a number of questions.the idea is simple: if you like using a certain product or doing business with a particular company you like to share this The answers given are used to give a score which is the percentage of patients who responded that they would recommend Patient experience The Friends and Family Test The Friends and Family Test (FFT) requires all patients, after discharge, to be asked: How likely are you to recommend our ward to friends and family if they needed similar care or treatment? We ask this question to patients who have been an in-patient and/or attended Acccident & Emergency (A&E). Both scores (if applicable) are below; In-patient FFT score* 96 % recommended This is based on 1662 responses. A&E FFT score* 94 % recommended This is based on 383 responses. *This result may have changed since publication, for the latest score please visit: http://www.england.nhs.uk/statistics/statistical-work-areas/friends-and-family-test/friends-and-family-test-data/ Total Patients Surveyed: 196 October 214 Average Patient Score /6 Q1 When you reached the ward, did you get enough information about ward routines e.g. mealtimes, visiting, doctors ward rounds? 5.3 Q2 When you had important questions to ask a member of staff did you get answers that you could understand? Q3 If your family or anyone else close to you wanted to talk to a doctor did they get the opportunity to do so? Q4 Have you been involved as much as you wanted to be in decisions about your care and treatment? Q5 Have you found someone to talk to about your worries and fears? Total score for communication 5.9
Compassion Care Q6 Do you get enough help from staff to eat your meals? Q7 Do you get enough help from staff with washing and dressing? Q8 If you pressed the call bell, did staff respond promptly? 5.9 Q9 Did the staff do everything they could do to help control any pain you were experiencing? Total score for care Q1 Do the staff looking after you have a caring and compassionate attitude? Q11 Do you feel you are treated with respect? Q12 Do you feel you are treated in a friendly manner? Q13 Are you given enough privacy and treated with dignity when discussing your condition or treatment? Total score for compassion Total overall score 5.9
A patient's story This month we would like to share this story from one of our patients. I wanted to share one of the most positive experiences I've ever had using the maternity services at the QEH during the birth of my first son 2th-21st October 214. I want to thank the staff on reception for organising a TENS machine quickly and for giving advice in a professional manner. Thank you to the staff on the assessment suite on shift who examined me 3 times over a 24 hour period, who were kind, patient and helpful not only in person, but over the phone when I was in pain and crying. Thank you to the staff on the delivery suite, namely my miracle worker midwife, health care, sister and consultant. For what was the most distressing and upsetting experience physically and with complications, it doesn't shadow the high level of care, empathy and communication given to me by the staff. Thank you to the staff on the post natal ward who make the best cups of teas, answer call buttons quickly and who are so free and generous with their help and advice on breast feeding, which I struggled with. A big thank you to the midwife who was a big part in my recovery on the ward, as well as the health cares and the lovely student who looked after us. I have my health and my beautiful son because of their hard work that day. I am a district nurse myself and I am hard to please when it comes to giving a high standard of care! I will recommend the QEH maternity services to anyone. Thank you Guys, you re all miracle workers. Staff experience The following responses were received from 153 staff on our inpatient wards I would recommend this ward/unit as a place to work Strongly Agree 52.9% Agree 27.5% Neither agree nor disagree 11.1% Disagree 5.9% Strongly disagree 2.6% I would recommend the standard of care on this ward/unit to a friend or relative if they needed treatment Strongly Agree 6.8% Agree 26.1% Neither agree nor disagree 11.1% Disagree 1.3% Strongly disagree.7% I am satisfied with the quality of care I give to the patients, carers and their families Strongly Agree 6.1% Agree 28.1% Neither agree nor disagree 4.6% Disagree 6.5% Strongly disagree.7%
3. IMPROVEMENT Improvement story: we are listening to our patients and making changes This month we would like to share the improvement work we have been undertaking to ensure our patients do not miss any doses of their medications. Medicine doses may be frequently omitted or delayed in hospital for a variety of reasons. Whilst only a small percentage of these occurrences may cause harm, for a particular group of medicines known as Critical Medicines it is particularly important to recognise that harm that can arise from the omission or delay of these. Examples of Critical Medicines include medicines for treating Parkinson s disease, epilepsy, diabetes and those for preventing or treating blood clots. We know from clinical incidents recorded on DATIX, our incident reporting system, that some patients were not receiving doses of Critical Medicines. Last year began a programme of work to improve our performance in this area. We were able to demonstrate by the end of the year that we reduced the percentage of missed doses of these medicines from 11% down to 2.5% and we are aiming to further improve on this year. In addition we are also focusing on reducing missed doses of Tinzaparin. Tinzaparin is an anti-clotting medicine given by injection to help prevent the development of deep vein thrombosis (when a clot forms in a deep vein within the leg) or pulmonary embolism (a blood clot that has come away from its original site and becomes lodged in one of the lungs). Whilst last year 95% of patients received their prescribed doses of this medicine, 5% did not; therefore we aim to reduce this to at least 2% by March 215. Below are two tables showing how well we are doing with these important areas of patient safety. Supporting information We will continue to focus on and audit this important area of patient safety on a monthly basis.