Tag: Belfast Trust

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.

 

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

What matters to you?

What matters to you?

During September the Belfast Trust had a month of safety and quality events throughout the Trust which was branded as SAFEtember.

As part of SAFEtember 2018 the BHSCT had a week dedicated to asking patients, service users and staff “What matters to you?” to try and improve the services we deliver.

Having this type of conversation helps to establish a relationship and helps you understand about the things that really matter to others in order to identify areas that could be improved.

At the end of September we had a Trust wide feedback event with each Directorate presenting their feedback and what actions they will take forward in response. Lots of great learning was shared.

Key feedback from service users:

  • More open visiting times
  • Having a TV in my room
  • Being seen on time
  • Being treated as an individual not as a number

Key feedback from staff:

  • Too many emails
  • Having time to reconnect with my team
  • Recognition for staff
  • Faster recruitment process

The Trust run a ‘what matters to you?’ initiative each year as part of SAFEtember and also participate in the worldwide ‘what matters to you?’ day on 6th June.