maternity

 

 

The Winners

The Best Quality Improvement 

Improving the ECG review process in the Emergency Department by Isabelle Hancock

 

Most Innovative Quality Improvement 

Improving CT cervical spine imaging in the Emergency Department by Alexander Grant

 

Best Quality Improvement Presentation

Improving the ECG review process in the Emergency Department by Isabelle Hancock

 

Best Quality Improvement Poster

TAP IN 24 – Are we performing an ascitic tap in patients presenting with decompensated liver disease and ascites within 24 hours of admission? by Catherine Tanner

 

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GSQIA Awards (15th June 2017)

The 4th Gloucestershire Safety & Quality Improvement Academy Awards and Graduation took place on the 15th of June at 10:00am in the Lecture Hall in Redwood Education Centre, Gloucester.

The award ceremony marked the end of the 7 month, Silver – Quality Improvement in Action programme for 10 members of staff who have been working on 8 different improvement projects across the Trust. This event gave each team the opportunity to share their work and their learnings and for the Trust to recognise and celebrate their achievements. During the ceremony each team shared details of their improvement work with staff from across the Trust, who helped to celebrate their achievements.

Prior to the event, staff had been voting online for the Most Innovative Quality Improvement whilst at the event,  the audience voted for ‘The Best QI Poster’ and ‘The Best QI presentation’, whilst a judging panel awarded the accolade of ‘Best Quality Improvement’. At the conclusion of the programme participants have also graduated as Silver – Quality Improvement Practitioners, recognised by the presentation of a Silver QI pin badge and certificate.

 

Congratulations to all presenters who graduated as Silver – Quality Improvement Practitioners.

In addition to providing an opportunity to share the learning from the improvements, these events form an integral part of the Academy objective to create an ‘Improvement Movement’ across the Trust, with the ultimate ambition of creating a culture of continuous improvement.

 

 

Quality Improvement Projects presented on 15th of June 2017

 

 

 

TAP IN 24 – Are we performing an ascitic tap in patients presenting with decompensated liver disease and ascites within 24 hours of admission?

 

Decompensated liver disease is a common presentation with a high inpatient mortality (10-20%).1 The 2013 NCEPOD report highlighted that the management of these patients was suboptimal.2 Early intervention for complications of cirrhosis can save lives. One of the most serious complications is spontaneous bacterial peritonitis (SBP). Untreated, this carries a mortality of 90%, which falls to 20% with prompt recognition and treatment. 

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Introducing standardised quality nursing metrics throughout all GHNHSFT Outpatient Departments

 

Not all outpatient departments in the Trust routinely complete nursing metrics to measure the quality of the service provided. In my OP areas they are completed monthly  as a matter of routine but unlike the inpatient metrics ours do not reach the Trusts quality committee and it was felt that we were giving them lip service rather than providing really meaningful data.

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Improving the ECG review process in the Emergency Department

 

ST elevation Myocardial infarction (STEMI) is a life-threatening condition, for which prompt recognition and reperfusion (within 120 minutes) reduces myocardial death. Several patient safety reports have flagged up the delays in diagnosis in our Emergency department (ED) and previous audits have confirmed our failure to meet the desired ‘time to ECG’ target of 10 minutes. 

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Improving end of life decisions for frail, elderly patients

 

Woodmancote ward cares for General Old Age Medicine (GOAM) and Endocrine patients. A high proportion of elderly and frail patients in this ward and other acute settings have multiple co-morbidities, are increasingly frail, and many are in the last year of their lives. Clinical decision-making in this group is complex and challenging, and may be delayed. 

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The introduction of a scalp cooling service for chemotherapy induced hair loss at GHNHSFT

 

Chemotherapy induced hair loss is a common side effect of cancer treatment that can have a traumatic and distressing impact on some patients.  Scalp cooling can prevent chemotherapy induced hair loss in some patients receiving certain chemotherapy regimens.  In Sept 2016 the Oncology Dept was awarded a £97,000 grant to purchase 8 Paxman scalp cooling units to implement a scalp cooling service. 

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Developing a PGD competency framework

 

Patient Group Directions (PGDs)are used within our Trust to allow certain groups of registered Health Care Professionals (HCP) to administer medications to an identified group of patients for a specified condition without a prescription on a once only basis e.g  glucagon for an episode of severe hypoglycaemia.

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Improving care for older patients undergoing vascular surgery

 

I was offered the opportunity to work on vascular surgery for a year with the very wide remit of improving the medical care of patients on the vascular unit.  My initial aim was to focus on frail older people to provide comprehensive geriatric assessment (CGA).  There is a substantial body of national data showing the deficiencies of care received by older patients admitted under surgical teams. 

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Improving CT cervical spine imaging in the Emergency Department

 

Only 30% of CT c-spines are performed within 1 hour of recognition of risk factor in Gloucestershire Hospitals Emergency DepartmentsNICE guidelines state ALL CT c-spines should take place within 1 hour of a key risk being identifiedAround 0.5% of the average 2500 patients seen in Gloucestershire Emergency Departments seen each week receive a CT scan of their cervical spine.

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Improving the Identification and Management of Alcohol Withdrawal in a Psychiatric Hospital 

 

Studies of acute psychiatric inpatients suggest that 50% have an alcohol use disorder and over 20% are alcohol dependent. This compares to the general population, where 6% of males and 2% of females are alcohol dependent. Despite this, alcohol withdrawal is poorly identified and managed on psychiatric wards.

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