be the change

MASLD Dietetic Pathway

Development of a Dietetic Pathway for Metabolic Dysfunction Associated Steatotic Liver Disease (MASLD)

Enhancing the Presentation of Data for Clinical Governance

The Clinical Effectiveness team highlighted a problem that the information presented within clinical governance reports was insufficient to enable teams to identify areas for improvement or highlight causes for concern. The team worked with local Divisions to develop run and Statistical Process Control (SPC) charts that give much clearer information and provide greater assurance. Feedback received has demonstrated that the new format has stimulated more focused discussions within the meetings.

Hot Clinics in General Surgery to Reduce ED Attendance

The ASPH Accident and Emergency department (ED) has seen an increase in patients who present with surgical problems that are not hyper acute, but some of these patients are unwell and cannot wait for an outpatient appointment.

Frailty - Everyone's Business

The 2021 Getting it Right Frist Time (GIRFT) report identified that 53% of patients over 75years attending Emergency Departments (ED) are admitted to hospital. Once admitted, these frail patients run the risk of getting over medicalised, subsequently staying longer in hospital and increased risk of nosocomial harm; deconditioning, further frailty and dependence for health and care needs and increased morbidity and mortality. The ASPH Frailty Team set out to test some changes to improve early identification of frailty patients within ED and early intervention from the dedicated team to facilitate same day or under 24hr discharge.

Reducing Decision Making Times for Women on the ASPH Fertility Pathway

Over the last few years the Fertility Services at ASPH have been developed to create a well recognised service for women. However, with increasing demand, the team were encountering problems with tracking and managing expectations.

Paediatric Dietetics Outpatients: A review of existing practice

The Paediatric Dietetics department at St Peter’s Hospital provides both inpatient and outpatient service. The outpatient department sees approximately 60 patients per month for a range of clinical conditions. At the start of the project in March 2019, the DNA rate was 15 – 20%, which represents a significant number of missed appointments. The majority of appointments offered at this time were face-to-face with only a small proportion of ad-hoc telephone appointments. The aim of this project was to ensure optimal use of clinical time and resources for Paediatric Dietetics Outpatients by investigating the incidence of DNA’s and to establish whether the capacity of follow-up appointments available met the demand required.

Improving the Consistency and Quality of Ward Handovers

Good handovers are essential to allow continuity of care in shift-based work, recognition of unwell patients and effective prioritisation of jobs. Poor handover can lead to preventable patient harm, particularly when handing over to a weekend team.

Better Nutrition in Care Homes: BeNCH

Malnutrition is a common concern within Care Homes with up to 42% of Care Home residents at risk (1). In NW Surrey there are over 2500 Care Home beds for older people across 48 Residential or Nursing Homes. Disease related malnutrition can lead to complications . Optimising nutritional care within Care Homes is essential, particularly given the additional challenges of COVID-19.

Improving paediatric preassessment

The team on Oak Ward felt that the admission process for children prior to their elective surgery was too busy and often chaotic and invariably did not include essential play preparation. This could lead to incidents of children panicking in the anaesthetic room, negatively impacting on the experience of children, parents and staff.

Reducing the risk of 'missed fractures'

Over a number years, the Emergency Department (ED) team reported a number of serious patient safety incidents relating to a fracture, which following radiological review, was not recognised by ED staff, leading to the patient receiving delayed or inappropriate treatment. The ED team decided to begin a quality improvement project to improve patient safety and communication between clinicians in ED and the radiology reporters. Read more...

Improving colorectal ward rounds

In 2016, the ASPH Colorectal Surgical team felt that the experience that many patients have of surgical, daily ward rounds was poor. The team set out to undertake a quality improvement project with a vision to improve patient experience and increase collaborative multi-disciplinary working and communication, by making changes to the Colorectal ward rounds. Read more here...

Creating a dementia friendly area in outpatients

For patients with dementia, attending an outpatient appointment at Ashford Hospital – navigating the department, waiting for their appointment in an unfamiliar environment and spending time in a very busy, and potentially noisy waiting area – can potentially be difficult and distressing. Read more here

ED Assembly

The Emergency Department (ED) Assembly is a simple method of bringing staff together to facilitate improvement and better team working. It is a platform for effective communication, in which there is no hierarchy and everyone is encouraged to contribute. See their poster here.

Adopt a grandparent

Imagine… you are an elderly patient in hospital; in bed, all day, no social interaction. The nights are filled with the cries of strangers around you, stopping you from sleeping. Can you imagine the effect that this would have on you after 5, 10 or 50 days and nights? Read more here...