Quality & Safety Ambitions Colin Ovington, Chief Nurse Kam Dhami, Director of Governance 1
What is Quality ? Patient Experience of care Effectiveness of Safety of care Care provision 2
Continuously improving the quality of care provided our overarching aims Our patient promises are consistently Through an accountability framework Creating the right Getting fundamental ensure fundamental standards are delivered across all our services and delivered in a standardised way, reducing culture with values that our staff report that ours is a safe standards right variability in practice. organisation in which they would put patients first Through a culture and behaviour which choose to be treated, within a health strives for best practice, service and social care system that is development improvement plans will be integrated in place to ensure best practice. All feedback from patients, whether Hearing the voice of doctors in training at every level of the organisation for it is concerns voiced on the ward at Medical education Effective complaints improving the learning from complaints the time, or complaints made once and training and incidents, ensuring they have the handling they are back home, will make a knowledge, skills and attitudes that equip difference. These will be taken them as champions for safety throughout seriously and lessons learned. their career. Everyone working in the Trust will be honest, open and truthful in all their Patients can be confident of receiving Compassionate, caring Openness, transparency dealings with patients and the public. the highest quality, knowledge based and committed and candour Organisational and personal interests care, delivered consistently with must never be allowed to outweigh nursing compassion by caring and competent the duty to be honest, open and nurses. truthful. A culture where older patients are Ensuring a culture where the quality Accurate, useful and Caring for the valued and listened to and are of data is viewed as important by all treated with compassion, dignity and relevant information staff providing as well as those using elderly respect. data with a known framework and assurance systems in place for delivering accuracy 3
The CQC’s new hospital regime To get to the heart of the patients’ experience the CQC inspection panels will try to answer five questions about an organisation’s services What do you think? Services organised to avoid harm occurring to Is it safe? patients Services delivered in line with national guidelines Is it effective? and achieve good outcomes for patients. Direct staff / patient interactions are caring Is it caring? The organisation meets the needs of patients Is it responsive to people’s needs? (e.g. access, comfort, letters to patients etc.). Is it well-led? At trust level, service level and ward/team level 4
Quality Improvements in our annual plan Indicator Target 2012/13 Current Position 1 Emergency readmission rates 10.9 9.5 9.06 2 A&E re-attendance 5% 7.89 6% Patient seen within 4 hours 95% 92.5 94.54% 3 Complaints per 1000 episodes No national target 0.52 0.46 4 VTE assessment rate 95% 91.5 95.5% 5 Sickness & Absence rates 3.15% 4.45 4.26% 5
Cultural Quality Improvements 1 MaPSaf (Manchester Patient Safety tool) 2 Leadership assessment and development at all levels of the trust 6
We will always achieve ten out of ten Our approach to prevent harm Proposed Standards 1 We will use Positive patient identification using three unique identifiers 2 We will assess every patient for their risk of developing a pressure ulcer and put in place the appropriate preventative measures 3 We will assess every patient for their risk of falling and ensure that the correct preventive measures are in place 4 We will assess every patient for the risk of developing venous thrombo-embolism and ensure the correct prophylaxis is prescribed where appropriate 5 We will ensure every patient has a base line set of observations carried out by a registered nurse including at least one record of height and weight 6 Every patient will have their medicines checked and reconciled against a definitive list and have any allergies clearly documented on their prescription chart 7 Every patient will have their mental capacity assessed and where required referral for further assessment 8 Every patient will have their pain assessed against a visual analogue scale and offered analgesia if required 9 Every patient will be screened for MRSA and give decolonisation treatment if required 10 Every patient will have their nutrition and fluid needs assessed and given access to appropriate nutritional advice 7
Contracting for Quality and Innovation (CQUIN) Our plans for the new year starting 1 st April 2014. Proposed CQUIN for 2014 Current measures • Safety thermometer • 94% harm free • Pressure sore prevention • 1 grade 4 ulcer • Blood clot prevention • 95.5% • Falls – inked to sedation and blood pressure medicine • 24 with harm • • Sepsis 5% trajectory on track • Not measured yet • Referral time to treatment for therapy services • Friends and family test • 73% on wards • 44% in ED • Dementia • Met for two months • Pain • 90% improvement on trajectory • • Readmissions 13.69% Speed up sending letters to GPs after an outpatient appointment • Letters to GP’s after an inpatient discharge • • Requires a baseline Safeguarding referral patterns 8
Patient Knows best Our plan to improve patients experiences of care in our system We do need to work up a better engagement and experience strategy which is wider reaching and more inclusive of our diverse population Our Nine Promises 1 I WILL make you feel welcome 2 I WILL make time to listen to you 3 I WILL be polite, courteous and respectful 4 I WILL keep you informed and explain what is happening 5 I WILL admit to mistakes and do all I can to put them right 6 I WILL value your point of view 7 I WILL be caring and kind 8 I WILL keep you involved 9 I WILL go the extra mile 9
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