No Surprises

Quality Improvement Poster Download

Background & Problems

Many patients arriving on the Day Unit CGH or SAS CGH had individual care needs that needed to be highlighted to the areas involved in their stay within hospital but these needs had not been highlighted in many cases despite the information being given by the patient in Pre-assessment. This meant that necessary equipment was not made available; reasonable adjustments could not be made in time or their placement on the ward was not conducive with delivering safe care meaning we are less likely to create a good patient experience.

Aim

For 100% of all patients undergoing a pre-assessment have their individual care needs cascaded to all areas involved with their care and the relevant documentation to have been completed - SAS, Day Surgery, Theatres, Recovery and Ward. Time frame 6 months.

Method

After initially collecting data to highlight what percentage of patients are not having their care needs cascaded we introduced a simple tick box sheet to Pre-assessment for them to highlight the relevant information. This would then be picked up Day Surgery/SAS when the notes are checked the day before admission allowing for equipment to be ordered and adjustments to be made. Day Surgery/SAS would then be responsible for disseminating that information to the other areas involved in the patient's. We then re-audited to see if the rate of patients having their care needs cascaded has improved and made suggestions of our next steps.

Results

The results show that there is a definite increase in the number of patients having individual care needs identified in Pre-assessment. Unfortunately the results also show that with the exception of two areas, visual impairment and mobility aids/concerns, there was a decline in the number of patients having their individual care needs cascaded from Pre-assessment to the Day Unit/SAS. Feedback from the ward areas via Julie Harvey is that they are more prepared for patients with additional care needs as they are getting those care needs communicated to them.

Implications

Patient Experience and Patient Safety is greatly affected if the department looking after them have no forewarning of individual care needs that require adjustments in advance. Although there is still significant room for improvement with the communication of these needs between Pre-assessment and Day Surgery/SAS the improved communication between Day Surgery/SAS and theatres/wards has ensured better Theatre Flow and allowed better preparation on the wards. It is something that could be rolled out to other specialities i.e. Orthopaedic but requires those involved in the patient journey to be on board with the improved communication and use of the Alert tick box sheet.