Category: News

Virtual Workshop Q All-Ireland COVID-19 Learning. EVENT FULL.

 THIS EVENT IS NOW FULL. WAITING LIST IS IN OPERATION

Join our virtual workshop Q All-Ireland COVID-19 Learning: Visioning for the Future

Join us on Wednesday 26th August for an All-Ireland workshop on rapid learning and improvement during COVID-19: Visioning for the Future.

Q and the Health Foundation will be delivering this workshop in partnership with Health and Social Care QI (HSCQI) Northern Ireland and the HSE National Quality Improvement team.

Through a mix of presentations and interactive, collaborative group sessions, the workshop will provide you with ideas and inspiration for how to make sense of the learning generated through the COVID-19 pandemic, and how to use this to enable good decision-making now and in the future.

 This opportunity is open to anyone who would like to connect with others to explore and take a QI lens to look to address key challenges at this time so please share this invitation widely.

 We hope you’ll be able to join us on Wednesday 26 August 12.30-2pm

Register here: https://thehealthfoundation.zoom.us/meeting/register/u5Mqf-Cqpj4jHtGEhKw_yFNkDmwqQr7jQEax

After you register you will receive a confirmation email containing information about joining the meeting. 

If you would like to find out more about the Q Community please see https://q.health.org.uk/about/

 

 

 

 

 

 

 

 

HSCQI Hub Update

HSCQI Hub Update

We hope you and your family are keeping well in these unprecedented times for wider society, our Health and Social Care System and the people who depend on it.

 The HSCQI Hub team members are diverting most of their attentions to supporting frontline clinical work and the wider public health functions of the Public Health Agency.  Please contact us individually or via the ihub@hscni.net if we can offer any support particularly for improvement ideas at this time, and we hope to share some initiatives we are involved in due course.

Please note the Scale Up event scheduled for Wednesday the 25th March at the Titanic Museum has been postponed to Monday the 5th October at the Titanic Museum and will be repurposed as a learning event focused on what we as an HSC system have collectively learned from the COVID-19 challenge.  Ideas for how we capture what we are learning or suggestions for contributions on the day are greatly welcomed at ihub@hscni.net or via your contacts with one of our HSCQI Hub team members.

Best Wishes for the challenging weeks ahead,

The HSCQI Hub team

Sandra, Gerard, Dawn, Tracey, Janet, Levette, Jackie, Mark & Aideen

Quality Improvement Awards 2019 Winners

Quality Improvement Awards 2019 Winners                                

The winners of the HSC Quality Improvement Awards 2019 (previously the Safety Forum Awards) awards were revealed at a celebration event in Riddell Hall, Queen’s University earlier this month.  These annual awards celebrate and recognise the innovative and excellent QI work going on across health and social care in the region.

Speaking at the awards celebration, Mark Vignesha Roberts MPH FRCP, Clinical Director, Improvement Hub for HSCQI commented:

‘These prestigious awards showcase the significant, often ground breaking work in Quality Improvement that is going on in all professional disciplines in acute, social and primary care. It is a great opportunity for teams and individuals to share their innovations and projects and for us all to continue to learn from each other.’

In addition to five individual categories, the overall HSC Quality Improvement Award was awarded to the individual/team category winner that has made the greatest contribution to quality improvement and safety in Health and Social Care.

The Building Reliable Care Award was won by Kathy McBride and her team from the Western Health and Social Care Trust for their imaginative project to improve the discharge process for hospitalised children in Altnagelvin Area Hospital. Staff in the hospital working within the Children’s Unit carried out the QI Project with the aim of improving the current discharge process for hospitalised children and their carer’s. 40% of Ward 6 (Paediatrics) patients requiring medication following the decision of discharge were to be discharged home within 4 hours by June 2019. The project achieved more timely discharges, improved patient flow and staff and service user satisfaction.

Winner of the Building Reliable Care. Western Trust

The Innovation/Transformation in Care Award was won by the ‘Bronchiolitis … When less is more’ project developed by Joanne McClune from the South Eastern Health and Social Care Trust.  A multi-professional team from the Paediatric Unit and unscheduled care undertook the QI project to implement NICE guidance; Bronchiolitis in children: Diagnosis and management.  The project involves medical and nursing staff in 3 areas in the Ulster Hospital- Emergency Department, Paediatric Rapid Response and Maynard Sinclair Ward. NICE guidance includes recommendations on diagnosis, treatment and management, admission and discharge criteria. This involved considerable change to medical and nursing practice, a shift in culture and traditional ways of caring for children with bronchiolitis. Traditional clinical interventions e.g. routine suction, bloods, x-rays, bronchodilators and other medications are no longer advised with a lower threshold for oxygen administration and are was focussed on supportive with minimal interventions.

Innovation and Transformatio in Care Winner SET

 

The Partnership/Co-production Award went to Samantha Jennings and her team from the Belfast Health and Social Care Trust for the Shared Haemodialysis Care project. ShareHD is an initiative, supported by the Health Foundation, to encourage patient participation in hospital-based haemodialysis (HD) treatment. HD involves attending hospital 3 times per week for 4 hour treatments. Patients are also required to restrict dietary and fluid intake, take multiple medications, and face a poor prognosis (50% five year survival). Unsurprisingly, patients can be non-adherent with treatment and feel they have lost control. Patient participation in management of chronic illness is associated with physical and psychological improvements.  Belfast City Hospital successfully applied to join Phase 3 of ShareHD. One of th patients who helped shape the service Robin shared his personal story of dialysis at the awards ceremony explaining how taking part in shared care has given him some control, a feeling of self esteem and achievement and a better understanding of his care, powerful words for a life changing project.

Winner of Partnership/ Coproduction Award BHSCT

This year for the first time there was a Primary Care category and the winner was  Aoibhin McGarrity’s Crystal Clear project. It aimed to improve gout treatment so that 75% of patients with gout would have their preventative medication titrated appropriately to achieve a serum urate of < 300. Gout is the most prevalent inflammatory arthritis, affecting 2.5% of adults in the UK. Improving treatment leads to less pain and joint destruction which preserves function and limits time off work. The results demonstrated that now 80% of patients with gout are on a preventer titrated appropriately as per guidance.

Primary Care Winner Aoibhin McGarrity

The winner of the HSCQI Overall Award and winner of the Integrating Care Across Boundaries Award went to Joanne Smylie and her NIAS team whose Frequent Callers Project demonstrated multiagency working to achieve positive outcomes for frequent callers. Frequent callers are those who call 5 times in a month or 12 times in 3 months. NIAS responds daily to individuals with complex needs, often non clinical and not within its area of expertise to manage. Crews are left with the choice of bringing the person to ED or leaving them at home when they often call 999 again as their issue has not been resolved.  Due the demand this put on the 999 system and the fact that these service users had needs which were not being adequately addressed, a small team was seconded to support these patients.  The team began to pilot holistic assessment of the patient and identify the root cause of their issues. Through information sharing and collaborative working with experts from Trusts, their GP and other agencies including the community and voluntary sector they try to help manage their often complex needs.  This project piloted different case management approaches which demonstrated significant positive outcomes. This project rose to the significant challenges of multiagency working and resulted in extremely positive feedback from families and individuals who truly appreciated the holistic approach.

Nias overall Award Winner and Integrating care across boundaries Winner

Each of the 5 Category winners were awarded £800, with the overall winner receiving a prize of £1,600, to be put towards expenses linked with advancing the Teams’ improvement goals.

 

HSCQI showcases quality and innovation to visiting European health experts

HSCQI showcases quality and innovation to visiting European health experts

Conference delegates

The Institute for Healthcare Improvement (IHI) is a global organisation that uses improvement science to advance and sustain better outcomes in health across the world. Last month the Health and Social Care Quality Improvement Network (HSCQI) in Northern Ireland hosted a European IHI Conference in Belfast at the excellent QIIC unit, in the South Eastern Trust. Over 75 delegates from across 33 organisations and 11 European countries attended the Health Improvement Europe Alliance Conference.  The NI Trusts input into the conference programme to showcase some of the innovative work in Quality Improvement in NI Health and Social Care System.

The Western Trust presented on the NI Flow Coaching Academy, a one-year action learning course to train clinicians and managers in team coaching skills and improvement science. The course teaches skills of quality improvement, engagement and social movement. The coaches put their skills into practice by leading Big Room meetings which bring together staff from each step of the patient journey and enables them to assess, diagnose and iteratively test changes to improve patient flow. Coaches actively engage in experiential learning through co-coaching a care pathway team. Coaching pairs are composed of a clinical coach, who works within the pathway, and a flow coach, external to the pathway.

 

Advancing improvement approaches in Primary Care

Dr Caren Walsh, hosted delegates at her Grosvenor Road Surgery (GRS) to see the how the application of QI tools and the fostering of a QI culture over the last 2 years is transforming her GP Practice. The practice is an excellent example of how Primary Care is embracing QI.  The weekly QI meetings involve the whole team and whilst these initiatives have taken place amidst severely limited time and high care demand, the transformation in the Practice (Doctors’ Office) has been noted by the whole team and has resulted in greater productivity, the tackling of many ‘wicked problems’ and the fostering of greater joy and team wellbeing in work.

 

Wellness Recovery Network in South Eastern Trust

wellness recovery network

The Wellness Recovery Network is a peer led support group ran by people with lived experience of various mental health conditions who have been on a journey of hope, recovery and finding a sense of wellness after being in a place of despair.  The Network aims to reduce stigma by promoting and supporting conversations about mental health, recovery and focusing on wellness. During the extremely moving visit the network members of individuals and family members shared their experiences of attending the monthly support group meetings or weekly singing group and the impact these sessions have had on their recovery and wellness.  Some members of the Network have over time moved into now volunteering in the Network.

 

Real Time Patient Feedback informing Real Time Improvement – Belfast Trust

Realtime patient feedback

Belfast Trust showcased their introduction of real time patient feedback in wards and units in the City Hospital.  Each ward/unit is visited twice per month by a Patient Experience Officer who surveys patients and then undertakes the NHS Safety Thermometer Audits (Classic, Medication, Mental Health, Maternity and Paediatric).  The ward is provided with a report within 24 hours.  The patient survey is based around 9 domains which capture the breadth of the patient experience.  Wards can see clearly how they perform in each domain and the free text comments are invaluable for complimenting individuals, reporting examples of staff providing compassionate care and of course suggestions for improvement, which have included reducing noise at night, introducing a kind care bundle, pain relief and medications information.

 

Site Visit to a Northern Ireland Integrated Care Prototype in the Northern Trust

The European delegates visited Antrim Area Hospital to find out more about how Health and Social Care Trusts in NI are commissioned to provide hospital, community and social care services. This distinguishes NI from the rest of the UK, where social care is provided by local government. The arrangements in NI provide advantage in addressing population health issues however such advantage has been limited by the lack of alignment between Trust services and Primary Care, which are commissioned separately, and by limited too by cross sectorial working.  The Integrated Care Prototype for NI seeks to address these challenges by creating an integrated commissioning model, and working with other statutory bodies and communities, with shared decision making and shared responsibilities for population health outcomes.  Examples discussed included Frailty and Diabetes with interaction with service users and carers on the day. This visit gave an opportunity to see what is being achieved first hand and meet with those involved from primary care, hospital, community care, service users, carers, third sector and local government.

 

Managing Frail Elderly Patients across Both Acute and Community Settings in the Southern Trust

With the catchment population for Southern Trust expanding, and disproportionately for frail older people, this visit emphasised the need to develop services to provide support for elderly citizens. At Craigavon Area Hospital the European delegates heard how the Trust has introduced improvements to help manage the care of frail elderly people.

  • Acute Care at Home – a consultant geriatrician led multi-disciplinary service that provides active treatment by healthcare professionals in the person’s home and prevents Emergency Department attendance/acute admission and/or facilitates prompt discharge from an acute hospital bed. Acute hospital care can be associated with adverse health outcomes, particularly for older people, confusion is made worse, confidence is lost and social networks are disrupted.  There is also growing evidence on deconditioning effects of hospital stays, particularly among older people.  In the first 7 months of 2019/2020 the service saved an estimated 5,535 bed days: this equates to a 26 bedded ward at 100% occupancy, or a 29 bedded ward at 89% occupancy.
  • Discharge to Assess – Discharge to Assess enables patients identified as fit to return to their own home to be assessed in a timely manner by multi-disciplinary professionals in a familiar environment. This streamlines the patient pathway involving the patient and carers in the discharge planning process and eliminates unnecessary delays.
  • Older Person’s Assessment Unit –The unit has an environment that is more suited to the older person, calmer than Emergency Departments, with a layout more suited to the needs of elderly patients. Evidence indicates that circa 80% of patients were re-directed from CAH acute admission through the OPAU.

 

Nurturing future talent, coaching for high performance: Ulster Rugby

Delegates visit Ulster Rugby

In addition, to the health care setting visits across the region some of the delegates visited Kingspan Stadium to explore how Ulster Rugby are nurturing future talent and coaching for high performance. Ulster Rugby Academy Manager, Kieran Campbell and Jo Hopkins, who is a consultant with the British Olympic programme, highlighted the work of the Ulster Rugby Academy to nurture talent, and the work Ulster Rugby do to manage high performance for their professional team.

The feedback from the conference delegates and the IHI was very positive with the site visits particularly being highlights of the two days. It was a great opportunity to put the excellent work in QI in region on the European map and new connections were made which will progress further collaboration on improvement.

 

IHI, HSCQI and South Eastern Trust

Massive thanks to all involved across the HSC in the planning and hosting of the conference.

The Power of Stories: Joint QI Conference in Dublin

The Power of Stories

HSE Schwartz Rounds generate a sense of community, improving teamwork and personal practice and Q community launched in Ireland

Speakers and facilitators

 

On Tuesday, 18 February members of the HSCQI travelled to Dublin to take part in the HSE’s second Schwartz Rounds and Quality Improvement (QI) conference in Dublin Castle, the HSE. The Conference marked four years since the introduction of Schwartz Rounds in Ireland. Since the process began, 25 organisations have signed a service level agreement with the Point of Care Foundation, helping to improve staff wellbeing and teamwork. 

Schwartz Rounds provide a forum for conversations about the emotional impact of work, open to all staff within an organisation. During the monthly, one-hour meetings staff can share their experiences that can improve relationships with colleagues and gain insight into how others care for patients.

The conference made the connection between Schwartz Rounds and Quality Improvement (QI) and provided great opportunities to communicate, connect, collaborate and network to further Schwartz Rounds and QI development and learning.

The conference, a collaboration between the HSE National QI Team and the HSCQI brought  people across the island together to share experiences.  Building on the concept of shared learning, the HSE announced country partnership with Q – an ambitious, long-term initiative that brings together people working to improve health and care. It is led by the Health Foundation and supported by partners across the UK and Ireland. HSCQI is already a Q Country Partner.

Q is not a taught programme, but a network for people with experience of delivering improvement. By creating opportunities for people to share ideas, enhance skills, and collaborate, Q supports members to use and develop the wealth of ideas and expertise.

Dr Mark Roberts, Clinical Director, Improvement Hub for HSCQI added: “This conference is part of HSCQI’s ongoing collaboration with the HSE’s National Quality Improvement team. This relationship is mutually beneficial and we are learning a lot from each other. It is great that colleagues from the HSCQI network shared their innovative QI work at the Dublin conference, which provided another opportunity for connecting people with common goals. We are all focused on providing safe and effective care for those who need our health and social care services and we all face similar challenges in doing so. It makes good sense for us to continue to build this relationship and develop our QI learning and expertise.”

Dr Philip Crowley, HSE National Director, National QI Team said: “The event is a further deepening of the National QI Team’s collaboration with the Health and Social Care QI team in Northern Ireland.  We share learning north and south and this represents the 5th joint event focusing on how we improve the quality of patient care across the Island. We are also celebrating four years of developing Schwartz Rounds in Ireland.  These have been evaluated very positively and help staff share their experiences of working in our health services.”

Penny Pereira, Q Initiative Director said “I’m delighted that we’re working with the HSE to launch Q in Ireland. Since Q began we have been working with Q members and partners to create a cross-sector, cross-profession, pan-country infrastructure for learning and collaboration. Launching in Ireland further demonstrates our commitment to growing the community and supporting members to connect across boundaries. The experience and expertise of improvers in Ireland will be a fantastic addition to the community.”

 

Schwartz Rounds

Schwartz Rounds provide a framework which helps to improve staff wellbeing, teamwork and support which ultimately has an impact on improved person centred care.  The National Quality Improvement Team in collaboration with the Point of Care Foundation (PoCF) will provide training in Ireland for up to 30 teams who want to establish Schwartz Rounds over the next two years.

 

Organisations introducing Schwartz Rounds

  1. Portiuncula University Hospital
  2. Mayo University Hospital, Ireland
  3. Midland Regional Hospital, Tullamore
  4. Connolly Hospital, Ireland
  5. The Royal Hospital, Donnybrook, Ireland
  6. Our Lady of Lourdes Hospital, Drogheda
  7. Temple Street Children’s Hospital
  8. The National Children’s Hospital, Tallaght
  9. Laura Lynn Ireland’s Children’s Hospice, Ireland
  10. Our Lady’s Hospice & Care Services, Harold’s Cross
  11. Our Lady’s Hospice & Care Services, Blackrock Hospice
  12. Beaumont Hospital
  13. UL Hospitals Group
  14. Cork University Hospital
  15. University Hospital Galway / Saolta University Health Care Group
  16. Cavan and Monaghan Hospital
  17. Adult Mental Health Service, HSE CHO 5  Carlow Kilkenny
  18. Adult Mental Health Service, HSE CHO 5  Waterford Wexford
  19. Adult Mental Health Services, HSE CHO 7
  20. National Ambulance Service (South Operational Area)
  21. Community HealthCare West -Roscommon CHO2
  22. The National Maternity Hospital, Holles Street
  23. The Mater Misericordiae University Hospital Dublin
  24. Resilience care
  25. St. Michael’s House

 

Q Community

Q is an ambitious, long-term initiative that brings together people working to improve health and care. It is led by the Health Foundation and supported by partners across the UK and Ireland. It is an exciting opportunity for improvers in Ireland to connect and collaborate with fellow improvers, use Q as a source of innovation and practical problem solving, and get involved with a range of activities and benefits that are on offer. By creating opportunities for people to share ideas, enhance skills, and collaborate, Q supports members to use and develop the wealth of ideas and expertise that currently exists in every part of the UK and Ireland.

For more information visit q.health.org.uk

 

 

 

GPs collaborating to improve urinary tract (UTI) infection antimicrobial stewardship in nursing homes

GPs collaborating to improve urinary tract (UTI) infection antimicrobial stewardship in nursing homes                          

Northern Ireland has the highest use of antimicrobials per person in United Kingdom. Major regional work is now underway to improve urinary tract (UTI) infection antimicrobial stewardship in nursing homes in the Northern Trust area. The work in this important sector of our healthcare system, is one of four Regional Scale and Spread areas of work underway in NI’s Health and Social Care Quality Improvement (HSCQI) network.

UTIs are one of the main sources of HCA gram negative infections. 45%* of all infections treated were UTIs. Staff in three care homes in the Northern Trust area are working alongside four Antrim GP practices with the aim of reducing the GP practices’ inappropriate antimicrobial prescribing by 10% for the care home residents. The use of a decision aid and checklist tools are helping to progress the improvements and the QI project is an excellent example of how all sectors can work together using quality improvement science methodology to make a real difference to a critically relevant issue.

Elizabeth Graham, Assistant Director of Person Centred Practice, Nursing Innovation and Development at Northern Trust and Dr Brian McCloskey, A Critical Care Consultant in the Belfast Trust are the joint project leads for this HSCQI work which is being facilitated by the Institute for Healthcare Improvement (IHI). Speaking at a recent project strategy meeting hosted in Massereene Manor Care Home, they spoke about the progress to date:

Elizabeth noted “This antimicrobial stewardship QI project with three of the Hutchison Group’s Care homes in the Antrim area is exemplary in providing a platform for multiple stakeholders working, from both the independent and public sectors, having the key aim of providing safe, effective care for our growing older population. We are currently working with Massereene Manor, Clonlee and Antrim Care Homes and four Antrim GPs Practices.  Nurses in the homes and their management have been amazing in embracing this work.

Brian added,” Alongside the care homes and the GP practices, we are collaborating with the Northern Trust, Public Health Agency (PHA), the Regulation and Quality Improvement Authority (RQIA) and Quality Improvement experts. Although based at present in the Northern Trust area, this work will in time benefit the long-term health of the NI population as HSCQI intend project spread across other NI care homes and GP Practices following outcomes based testing.

Dr Alan Lewis Vice Chair Antrim/ Ballymena GP federation and one of the participating GP Practices commented:

From my perspective I expect this project to streamline and standardise prescription requests for possible UTIs in nursing home patients giving GPs a more accurate clinical description of the patient to ensure appropriate prescribing in a timely manner.  I also expect that by giving nurses structure to their requests it will help them consider alternative diagnoses for the presenting symptoms and signs and may actually reduce requests for antibiotics for UTIs.  In the current antimicrobial crisis this would be an important step in the fight against antibiotic resistance.

Sharon Mc Cracken, the Manager of  Antrim Care Home who is taking part in the project commented:

“This is a fantastic opportunity for us in the private sector to work closely with the GP’s, PHA and Trust to reduce the use of antibiotic use to improve the quality of care for residents in Nursing Homes. “

The Project Team of Dr Jackie McCall, Clinical Lead for the HSCQI Improvement Hub;
Ursula Gray, Practice Education Facilitator for REaCH service NHSCT;
Angela McCabe, Lead Practice Based Pharmacist Antrim /Ballymena GP Federation;
Susan Hanna, Senior Director, the Institute for Healthcare Improvement (IHI);
Elizabeth Graham, Assistant Director of Person Centred Practice, Nursing Innovation and Development at Northern Trust and Dr Brian McCloskey, A Critical Care Consultant in the Belfast Trust, who are the joint project leads.

Dr Jackie McCall, Clinical Lead for the HSCQI Improvement Hub who is working on the project commented:

“Media campaigns such as the recent ‘Antibiotic Guardian’ campaign have been reminding us all that antibiotic resistance is one of the biggest threats facing us today. This project continues to work towards safeguarding our antibiotics for future use. We want to keep antibiotics working.”

Click on https://vimeo.com/373856239/c3c4d92c88 where you can hear Brian and Elizabeth discuss the importance of this regional work.  You can also follow @HSCQI on Twitter to follow the #ScaleUpNi progress or see www.qi.hscni.net

This work is one of a series of four HSCQI Regional Scale and Spread areas of work which comprises of Sepsis, Antimicrobial Stewardship in Care Homes, Towards Zero Suicide Safety Planning and Safeguarding for Children in a social care setting. These regionally important  HSCQI projects are being facilitated by the Institute for Healthcare Improvement (IHI) and are endorsed by NI Health and Social Care senior leaders and
the Department of Health.

*HALT (NI) Report

Elizabeth Graham, Assistant Director of Person Centred Practice, Nursing Innovation and Development at Northern Trust and Dr Brian McCloskey, A Critical Care Consultant in the Belfast Trust, who are the joint project leads with
Eddy Hutchinson, Hutchinson Care Homes; Pepsi Lata, Clonlee Nursing Home; Sharon Smyth, Antrim Care Home; Anne McCracken, Masserene Manor and James Laverty RQIA.

Southeastern Trust and Belfast Trust Sepsis Learning Event asks ‘Could it Sepsis?’

Southeastern Trust and Belfast Trust Sepsis Learning Event asks ‘Could it Sepsis?’ 

Sepsis is a term which describes the most severe form of infection and is potentially fully treatable in a number of cases. Major regional improvement work is now underway to identify sepsis earlier and more consistently and to administer appropriate antibiotics swiftly. Healthcare staff in acute hospitals, across the region are working with the Health and Social Care Quality Improvement Hub in Northern Ireland to test this approach in the adult non-neutropenic and non-maternity setting. This regional improvement project will be spread across the NI acute sector once the prototype has been fully tested.

Whilst many people may have heard about sepsis, fewer know what is really is or what the symptoms are. Sepis is organ malfunction due to infection which may be life threatening and can develop very quickly. In an adult sepsis it may feel like you have flu, gastroenteritis or a chest infection at first. Early symptoms include fever, chills and shivering, a fast heartbeat and quick breathing. Symptoms of sepsis or septic shock can include feeling dizzy or faint, confusion or disorientation, nausea and vomiting, diarrhoea and cold, clammy and pale or mottled skin,

Dr Mark Vignesha Roberts, Clinical Director, Improvement Hub for HSCQI who is working with teams on the sepsis regional improvement work commented:

‘We are working to help our clinicians use their clinical skills, alongside the patient’s symptoms and signs and history to make a faster diagnosis of sepsis and give the antibiotics quicker once the diagnosis is made. The message we need our healthcare staff to think about is ‘Could it be sepsis?’

Giving patients with evidence of sepsis antibiotics quickly is one of the measures that we know improves the outcome for the patient, but this is only the case if antibiotics are protected from overuse, otherwise they lose their effectiveness.  Hence inappropriately using antibiotics for single viral or other self-limiting infections create challenges and patients and families need to help clinical staff in their quest to use antibiotics responsibly and not overuse them.  Media campaigns such as the recent ‘Antibiotic Guardian’ campaign have been reminding us all that antibiotic resistance is one of the biggest threats facing us today.”

Seamus McGoran, Interim Chief Executive of South Eastern Trust, opened the event by thanking staff for the work they are engaged in:

“The work your teams are doing could not be more important. It is my hope that this collaborative event will develop a regional approach which will improve outcomes for sepsis.”

Speaking at the Sepsis Learning Event, Cathy Curran, Patient Safety and Improvement Lead, highlighted and congratulated frontline staff on the excellent work already going on to recognise Sepsis; “Healthcare staff have been working really hard under extreme pressures and high demand, and are recognising and preventing Sepsis, but we need to be able to measure and demonstrate that in a meaningful way.”

Staff from the sepsis test sites spoke about the ongoing work, the learning and the progress being made.  Presenting their work from South Eastern Trust were Dr Conor O’Toole, Consultant Emergency Medicine Ulster Hospital, Dr Melissa King, Specialty Doctor Emergency Medicine Lagan Valley Hospital, Cathy Curran, Patient Safety and Improvement, Safe and Effective Care, sharing the challenges teams have faced and how they have overcome them to move towards effective scale and spread.

From Belfast Trust, Dr Emma Greenwood Royal Victoria Hospital, Emergency Medicine, Dr Emma Murray, Belfast City Hospital, Intestinal failure Unit, Dr Matthew McGuckin, Mater Infirmorum Hospital, Emergency Medicine, presented their ongoing work and how it was progressing in BHSCT.

 

Cathy Curran, Resuscitation Officer Dr Conor O’Toole and Dr Melissa King who presented at HSCQI Sepsis Learning Event, with Dr Mark Roberts, Clinical Director HSCQI and Dr Kevin Rooney, IHI

A number of learning events for clinical staff are being held at several hospitals across NI over the next few weeks. More information on the sepsis regional improvement work can be found on www.qi.hscni.net  

Click on https://vimeo.com/376977469/e864fb27e8 where you can hear Dr Mark Roberts and Donna Gallagher, a nurse and family member of a surviving sepsis patient, discuss the importance of this regional work.

 

Dr Emma Greenwood, Dr Emma Murray and Dr Louise McKee who presented at HSCQI Sepsis Learning Event, with Dr Mark Roberts, Clinical Director HSCQI and Dr Kevin Rooney, IHI

Altnagelvin Sepsis Learning Event asks ‘Could it Sepsis?’

Altnagelvin Sepsis Learning Event asks ‘Could it Sepsis?’

Western Trust staff with Dr Mark Roberts Clinical Director, Improvement Hub for HSCQI  at the Sepsis Learning Event in Altnagelvin

Sepsis learning event
Western Trust staff share and learn at Sepsis event in Altnagelvin

’ 

Sepsis is a term which describes the most severe form of infection and is potentially fully treatable in a number of cases. Major regional improvement work is now underway to identify sepsis earlier and more consistently and to administer appropriate antibiotics swiftly. Healthcare staff in acute hospitals, across the region are working with the Health and Social Care Quality Improvement Hub in Northern Ireland to test this approach in the adult non-neutropenic and non-maternity setting. This regional improvement project will be spread across the NI acute sector once the prototype has been fully tested.

Whilst many people may have heard about sepsis, fewer know what is really is or what the symptoms are. Sepis is organ malfunction due to infection which may be life threatening and can develop very quickly. In an adult sepsis it may feel like you have flu, gastroenteritis or a chest infection at first. Early symptoms include fever, chills and shivering, a fast heartbeat and quick breathing. Symptoms of sepsis or septic shock can include feeling dizzy or faint, confusion or disorientation, nausea and vomiting, diarrhoea and cold, clammy and pale or mottled skin,

Dr Mark Vignesha Roberts, Clinical Director, Improvement Hub for HSCQI who is working with teams on the sepsis regional improvement work commented:

‘We are working to help our clinicians use their clinical skills, alongside the patient’s symptoms and signs and history to make a faster diagnosis of sepsis and give the antibiotics quicker once the diagnosis is made. The message we need our healthcare staff to think about is ‘Could it be sepsis?’

Giving patients with evidence of sepsis antibiotics quickly is one of the measures that we know improves the outcome for the patient, but this is only the case if antibiotics are protected from overuse, otherwise they lose their effectiveness.  Hence inappropriately using antibiotics for single viral or other self-limiting infections create challenges and patients and families need to help clinical staff in their quest to use antibiotics responsibly and not overuse them.  Media campaigns such as the recent ‘Antibiotic Guardian’ campaign have been reminding us all that antibiotic resistance is one of the biggest threats facing us today.”

Speaking at the Sepsis Learning Event, Daryl Connolly, Quality Improvement Lead for the Western Trust commented “Sharing good practice and learning from others means making progress.   I have no doubt that working together with other Health and Social Care Trusts on regional ‘scale up and spread’ improvement projects will increase effectiveness and will create more opportunities to improve patient care.

Daryl added: “We were delighted to host the first of this series of Sepsis Learning Events for the region at Altnagelvin Hospital and the South West Acute Hospital.  It gave us the opportunity to showcase and celebrate the good work and progress already taking place within the Western Trust.  It also allowed us to highlight the importance of this particular ‘scale up and spread’ initiative to Trust clinicians, management and staff.”

At the Learning Event staff from the sepsis test sites spoke about the ongoing work, the learning and the progress being made.  Lee Soal, Sister in the Critical Care Outreach Team; Mark Hegarty, Systems Manager, ED; Laura Kyle, Sister ED Altnagelvin and Julie Collins, Sister ED, SWAH were all part of the team that presented. Dr Anne Kilgallen, Chief Executive  and Dr Bob Brown, Executive Director of Nursing/Director of Primary care and Older People Services both joined the event from SWAH and thanked staff for the ongoing sepsis work that the Altnagelvin and SWAH teams were engaged in and reinforced the importance of the sepsis work.

A number of sepsis learning events are being held at several hospitals across NI over the next few weeks. More information on the sepsis regional improvement work can be found on www.qi.hscni.net  

Click on https://vimeo.com/376977469/e864fb27e8 where you can hear Dr Mark Roberts and Donna Gallagher, a nurse and family member of a surviving sepsis patient, discuss the importance of this regional work.

Regional Scale Up progress

Regional Scale Up Event highlights progress

Around 80 staff from across the HSC came together on Friday 22 November at the Regional HSCQI Scale Up event. The project leads for each of the four regional scale up work areas highlighted the significant progress made to date, Speaking at the event the Director of HSCQI, Dr Aideen Keaney acknowledged the hard work and commitment of the many staff, from across a variety of areas, who are working on these initiatives. Dr Keaney also welcomed the support of senior leaders from across the Health and Social Care System and the Institute for Healthcare Improvement (IHI) in progressing this important work into the future. The four regional scale up areas are Sepsis, Antimicrobial Stewardship in Care Homes, Towards Zero Suicide and Safeguarding.

Speakers present the scale up work

For details on selection of improvement protoypes please see.

IDENTIFICATION, ASSESSMENT AND SELECTION OF IMPROVEMENT PROTOTYPES – HSCQI DISCUSSION PAPER

Please contact the  ihub@hscni.net if you are working in one of the four proposed scale up areas and would like to get involved. 

Summary of agreed actions for each scale up area.

 

 

 

 

 

 

The next scale and spread regional event is scheduled for 25th March 2020 in Titanic Belfast

Register Now, People Make Change Happen @Dublin Castle 18 Feb

People Make Change

REGISTER NOW!

As it is expected that there will be significant interest in the conference, places will be allocated on a first come first served basis.  Please register your interest by clicking on the following link:

https://www.surveymonkey.com/r/AllIreConf2020HSCQI

We are delighted to open registration for the All Ireland Schwartz Rounds and QI Conference – People Make Change Happen.

This conference makes the connection between Schwartz Rounds and Quality Improvement (QI).  It will help you:

·to communicate, connect, collaborate and network, and

·showcase some of the most innovative QI work impacting on health services across Ireland. 

Conference speakers

We are looking forward to welcoming our esteemed speakers:

·Dr. Eanna Falvey, Consultant in Sports and Exercise Medicine and Team Doctor to the Irish Senior Rugby Team 2009 – 2015 British & Irish Lions Tours 2013 and 2017

·Ms. Laura Collins, Family Carer and HSCQI Alliance Expert Service User/Carer Representative

·Dr. Jocelyn Cornwell, Founder of The Point of Care Foundation

·Dr. Mark Roberts, Clinical Director, Improvement Hub for HSCQI (incorporating HSC Safety Forum)

·Dr. Philip Crowley, National Director National Quality Improvement Team. 

We also look forward to welcoming the leaders of the eight interactive workshops which include colleagues and advocates from across the health sector in Ireland.

For a full programme and to find details of the poster and photo display opportunities, please see our website www.staffengagement.ie.

Who is the conference designed for?

The conference has two strands and is designed to support those working in healthcare in particular:

·Members of the Schwartz Rounds Community – Schwartz Rounds clinical leads, facilitators, administrative staff and steering group members in existing sites 

·Healthcare staff interested in learning more about Schwartz Rounds

·Those with a passion or interest in quality improvement.

This event is a collaboration between the Health Service Executive (HSE) and the Health and Social Care in Northern Ireland (HSCQI).

To register

As it is expected that there will be significant interest in the conference, places will be allocated on a first come first served basis.  Please register your interest by clicking on the following link:

https://www.surveymonkey.com/r/AllIreConf2020HSCQI

 

Conference registration will close on the 24th January 2020. 

You will be notified of your place at the conference during the week of 27th January 202