The Winners

The Best Quality Improvement 
Improving pain management in the Emergency Department by Elizabeth Martin


Most Innovative Quality Improvement 
Reducing the time waited from referral to consultant appointment in the Sleep Apnoea clinic to less than 11 weeks by Beverley Gray & William Sims

 

Best Quality Improvement Presentation
Reducing the clerking time for patients overnight by Leonard Griffiths

 

Best Quality Improvement Poster
A service improvement project on increasing information about newly started medicines on discharge paperwork by Eleanor Adams

 

Prizes were kindly donated by the West of England Academic Health Science Network and presented by their Senior Quality Improvement Lead, Dave Evans.

 

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GSQIA Awards (8th December 2016)

The 2nd Gloucestershire Safety & Quality Improvement Academy Awards and Graduation took place on the 8th December in Redwood Education Centre, Gloucester.

The awards ceremony marked the end of the 7 month, Silver – Quality Improvement in Action programme for 15 members of staff who have been working on 12 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 8th of December 2016

 

 

 

Implementation of an Emergency Department Patient Safety Checklist

 

Providing good basic care, including timely analgesia and regular observations for patients in Emergency Departments can be challenging.  Variations in our practice had been noted by CQC inspectors and raised by staff and patients.  This QIP to introduce a local standardised checklist for both Emergency Departments has been undertaken as part of a wider regional project supported by  the West of England Academic Science Network.

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Improving Quality of Discharge Summaries and Clinical Coding in Paediatrics

 

Clinical coding is the translation of medical terminology written by clinicians into a coded format. Codes are used for epidemiological purposes, audit, determining service provision and to ensure departments are paid accurately for clinical activity.Coders had identified that discharge summaries from paediatrics frequently contained diagnoses which were unclear or omitted relevant comorbidites. These provide a potential clinical risk for patients and typically result in underpayment for the hospital admission. 

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Improving pain management in the Emergency Department

 

In March 2015 the CQC inspected Gloucestershire Hospitals, including the Emergency Departments. A part of their subsequent report specifically identified pain management as an area requiring action stating ‘..patients within the emergency department should have an assessment of their pain and prompt pain relief administered where necessary..’. This matches the national standards for ED pain management set out by the Royal College of Emergency Medicine.

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Workplace Improvement Team

 

Historically, the trust has tried to allow facilitated time for staff to perform Health and safety duties. However, usually operational commitments always took priority over health and safety. The main catalyst of the problem was the trust wide facility time agreement that stated that staff was allowed 6 hours a month for Health and safety duties. This was a constant barrier between both reps and managers in allowing suitable time.

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Improving the insertion of chest drains in the Emergency Department

 

Chest drain insertion is an invasive procedure performed in the ED. All patients should have a drain inserted in line with WHO checklist standards and as described by the BTS. A trust wide chest drain checklist was available but was not used consistently in the ED as identified by M and M cases and audit. This puts the patients and staff at risk through risk of harm and scrutiny if not following local and national guidance.

Find out more

 


 

 


Action expresses priorities. Taking control of the acutely medically unwell in Gloucester Royal Hospital

 

The variance in time for patient waiting to be seen in the acute medicine department is huge. The Society for Acute Medicine describes a main quality indicator for all AMUs as all patients being seen by a “competent clinical decision maker within 4 hours” If we cannot see patients in a timely manner we cannot provide the correct treatment. In particular I had concern about a specific group of patients who could be categorized as sick by their National Early Warning Score (a total score collating all medical observations such as heart rate etc) being equal to or over 4.

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Reducing the time waited from referral to consultant appointment in the Sleep Apnoea clinic to less than 11 weeks

 

Sleep apnoea is a condition which finds the sufferer having problems breathing overnight due to their airway collapsing. In order to resume breathing they are forced to wake up and this can occur 5-100 times an hour. Imagine being woken every minute through a whole night and then trying to undertake all your normal daytime activities without feeling tired, or even falling asleep.

Find out more

 


 

 


A service improvement project on increasing information about newly started medicines on discharge paperwork

 

If hospitals fail to share correct information with patients’ General Practitioners about changes to medication, it can potentially increase the risk of the GP prescribing incorrect medication after discharge, with possibly severe adverse impact on patients.

Find out more

 


 

 


Improving handovers between the Birth Units and Delivery Suite

 

It is known that ineffective information transfer at handover contributes to unsafe care in maternity (Kings Fund 2012). Standardised handover tools such as RSVP (Reason, Summary, Vital information [signs], Plan) and SBAR (Situation, Background, Assessment, Recommendations) have been adopted locally and regionally to improve information transfer.

Find out more

 


 

 


Reducing the clerking time for patients overnight

 

At Cheltenham General Hospital (CGH), the Emergency Department (ED) becomes a minor injuries unit overnight. This means that several patients that need admission under the medical team are referred in the evening, just as most of the medical doctor team are going home. This leads to a mismatch between patient numbers and workforce. 

Find out more

 


 

 


To create a single, informative patient experience report

 

The Patient Experience Team currently generate several separate reports that are sent to various parties at different times throughout the month. The purpose of these reports is to give an overview of the patient’s experience within the Trust.  We wanted to channel several  areas of feedback into one single cohesive report that gave an accurate overview of the feedback.

Find out more

 

 

 


 

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