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.
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.
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.
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.
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.
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.
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.
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.
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...
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...
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
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.
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...
A project to ensure the safe transfer of care to primary care for all patients who have attended urgent care by improving the completion and quality of information in ED discharge summaries by March 2017. Read more here...
A project to improve decision making processes for patients at risk of aspiration on all oral intake, and increasing the percentage of who have documented evidence of a completed metal capacity assessment (MCA). Read more here...
Warfarin is a commonly prescribed high-risk medicine that has the potential to result in significant side effects if prescription and administration are not carefully controlled. Read more here...
The surgical clerking, or the initial documentation of contact with the surgical team, is the primary documentation of the presenting issue, the patients background the diagnosis and subsequent plan… read more
Junior doctors are often the first doctor to be called to see a sick patient, either on an inpatient ward or on-call… read more
A project to assess how well doctors check and replace electrolytes in patients identified at risk of re-feeding syndrome, with the aim of addressing reasons for any poor compliance… read more
Weekend and out-of-hours ward cover is challenging when a team is asked to see patients with whom they are not familiar. We surveyed junior doctors for their views... read more
The team on Aspen Ward – Nurses, Doctors, Pharmacists and Allied Health Professionals (AHPs) were finding locating the patients Drug Chart a problem; this was often a challenge when the patient needed analgesic medications... read more
During the first ‘Be the Change’ campaign, the portering and security teams identified a problem with patients and visitors finding their way around the hospital... read more
The Paediatric wards reviewed compliance with the drugs policy. They highlighted that controlled drug checks were not being performed consistently and as required...
The SPS Newsletter was developed to celebrate achievements across the network and advertise tutorials, events and to include articles of interest mainly but not exclusively relevant to Pathology... read more