RCH QI Conference 2022

Royal Cornwall Hospitals NHS Trust

About RCHT QI Conference 2022

Welcome to Royal Cornwall Hospital Trust’s (RCHT) first QI Conference where we are focusing on celebrating RCHT's journey, along with showcasing our developing QI capability and Improvement activity from across the Trust.

We are also aiming to inspire Quality Improvement (QI) locally, regionally & nationally. OUR THEME

Embedding a culture of learning & improvement”

Cornwall

“

Meet the Team

Ella Stracey, Interim Chief Strategy & Performance Officer

Ian Rowland, Head of QI & PMO

Heather Walker, QI Lead Sue Preston, QI Lead

Catherine Cade, QI Lead Tim Wing, QI Manager

Marie Thomas, QI Manager

Lisa Duckham, QI Manager

Sara Morgan, QI Project Support

Mandy Gorton, QI Manager

Jen McFarland, QI Project Support

Kenna Duston QI Manager

Michaela Johnson QI Manager

Serena Knight, QI Lead

Nic White & Beki Shields, QI Administrator

Your Facilitators

Lisa Mewton - QI Lead

“

There is something incredibly special in helping our staff to generate & implement their Brilliant ideas and to support change via our recognised methodology and approaches.”

Haydn Devereux-ChildsQI Communications & Engagement Support

“Nothing is more rewarding than being able to support our staff and share their improvements and celebrate them their hard work, energy and enthusiasm for change”

Sue Jenkin - QI Facilitator

“

QI methodology provides a structured way to help implement improvements and being able to help support staff to realise their change goals by using these QI methodologies and techniques is truly rewarding”

If you have any questions, make sure you pop them in the comments box & we will be sure to answer them. Also check out our FAQ section!

Conference Royal Cornwall Hospitals NHS Trust

Additional Agenda Details

Agenda Item Details

Brilliant Care Project “Preventable HA-VTE”

Patient Safety & Experience:  Maternity & Midwifery Improvements

PSIRF

Patient Experience

Drip Tags - Innovation

QI @ RCHT & our journey

Hear about the challenges and successes of tackling difficult improvements that are invaluable to Patient care.

Hear from a range of Staff from across Royal Cornwall Hospital about improvements that directly affect Patient Safety and Experiences.

Presentation Style

Presentation + Q&A

Presentation, Interactive Session, Q&A and Videos

Join us for a Q&A panel including Directors of the Trust and our guest speakers AHSN about our QI Journey to date and some of the things the future holds.

Q&A Panel

Showcasing Improvements Take a look at a wide range of improvements that have taken place across our Trust.

Join us to hear from Catherine Wood in a conversational style approach that highlights the benefits and advantages of a virtual student nurse.

Presentation

Digital Book & Video “Virtual Student Placement Project”

Brilliant People Project “Mandatory Nutrition & Hydration Training”

Hear about how you can take an idea from submission via our QIdeas platform, through QI Methodology to implementation.

Brilliant Rapid Improvements Rapid Style Improvements on:

Going Home Bags

Rosa Robot

Adopting Innovation Project

UKR Surgery

Presentation + Q&A

Videos

The QI Hub @ RCHT

The QI Hub was formed following staff feedback at RCHT in 2018/2019. Our aim is that we want everyone to have QI skills relevant to their role; to know how to access support and to ensure we place quality at the centre of everything we do.

So, What is QI?

Quality Improvement is simply about doing things better, safer, more effectively and efficiently. By placing QI at the heart of everything we do we want to instil a culture where everyone feels empowered to influence change

RCHT’s improvement triangle splits improvement into: Innovation, Research & Development, Quality Improvement.

QI at RCHT is embedded and supports our whole portfolio of the work we do.

Conference Royal Cornwall Hospitals NHS Trust

So, what does this mean? Where does Quality Improvement fit?

At RCHT, we use the IHI Model for Improvement which we based our own ‘6 Steps for QI’ on...

Preventable Hospital Acquired-Venous Thrombo-Embolisms

The Trust wants to reduce the number of preventable hospital acquired venous thrombo-embolisms (HA-VTE) experienced by patients.

HA-VTE have significant long-term and possibly serious outcomes for patients. By reducing HA-VTE a prolonged hospital stay, readmission,& poor patient experience can be avoided.

The overall aim of the project was that “the number of patients admitted to the Trust between 1st September 2021 and 31st August 2022 who develop a preventable hospital acquired venous thromboembolism (HA-VTE), during or within 90 days of admission, would be reduced by 50%”

of Scilly

Project Team Mission Statement

“

To connect together, as a transdisciplinary project team, and create an environment that enables innovation to improve care and reduce unwarranted variation in care of people who choose a plan outside of maternity guidelines.”

Creating an individualised, flexible, sustainable, co-produced pathway for people who choose birth outside of maternity guidelines in Cornwall & Isles

Patient Safety Incident Response Framework (PSIRF)

The framework represents a significant shift in the way the NHS responds to patient safety incidents and is a major step towards establishing a safety management system across the NHS. It is a key part of the NHS patient safety strategy.

The PSIRF supports the development and maintenance of an effective patient safety incident response system that integrates four key aims:

• Compassionate engagement and involvement of those affected by patient safety incidents

• Application of a range of system based approached to learning from patient safety incidents

• Considered and proportionate responses to patient safety incidents

• Supportive oversight focused on strengthening response system functioning and improvement

Here is a video on PSIRF which provides a lovely introduction: https://youtu.be/TyYekgo_IN0

Naomi Burden is proudly a Therapeutic Radiographer by trade but also boat rocking change agent for most of her career in various guises! Naomi returned to RCHT in August 2020 as the Trust Patient Safety Specialist and Lead for Safety Culture, a role that perfectly suits her drive for service improvement through safety and creating the conditions to be at our best. We are all here to do the best we can for those who need our services, Naomi is looking forward to learning more about QI projects from across the Trust and sharing her experience in developing the Patient Safety Incident Framework as a driver for improvement in NHS England.

Patient Experience

The Patient Experience Team are made up of the Complaints, Engagement & Feedback and Carers Lead teams. We listen to our patients through feedback received over the phone, by email, online, surveys, social media and patient stories. We then work collaboratively with patients to find out “what matters to them” and use their feedback to directly inform teams of potential changes which could be made to their service to improve patient experience.

We work with the clinical teams to discuss and support changes in process and facilitate resolutions to issues which helps to ensure that we close the loop to make sure our patients recognise that they have contributed to our improvements.

Patient Experience & Quality Improvement

The Patient voice is so important for everything we do, especially when it comes to improvements that we are making that effect Patient care, experiences and safety. You can use feedback already gathered for your measures, you can plan a QI project around the feedback you receive, and you can measure the impact of your improvements.

Innovation @ RCHT

What is Innovation?

Innovation is the development of truly new products or services – it is developing something which has not been done before but which has the potential to make a significant difference to how you work, how you care for your patients or how we work as an organisation.

What to do if you have an idea:

As a Trust, we are keen to support our innovative staff to make their ideas a reality. The Innovation Team is here to help from helping to refine your idea, developing a prototype and bringing a product to market all using our Innovation Pathway.

Please log your idea on QIdeas© in the first instance – we’ll make sure your idea gets to the right team to support you and we will get in touch with you to learn more.

Trust Innovation Leaders

Top tip: if you think your idea could be a commercial opportunity, it is best not to talk to other people about it before speaking to the Innovation Team. We can help you to protect your idea where it is possible to do so.

Innovation at RCHT is supported by two Trust Innovation Leaders: Frazer Underwood and Nathalie Purchase.

Please get in touch if you would like to learn more! We also have a generous Intellectual Property Policy which sets out the financial benefits you could have if your idea is successful.

Want to get involved?

Join us for Innovation Breakfast Club to learn more about innovation across the Trust, and to meet others keen to help make innovation a reality . Please contact Linda Matthews l.matthews5@nhs.net for an invite!

Blood Transfusion Take

Down Tags Innovation

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Abigail Parsons

Transfusion Practitioner

Abie has a Biomedical Scientist /Lab background but her primary role is a Transfusion Practitioner which means that she works Trustwide as the link between the Blood Transfusion Lab and the clinical area.

Patient Blood Management is at the heart of our service and Abie’s focus is on teaching all staff that are involved in Transfusions, how to ensure the right patient always gets the right and appropriate blood component along with ensuring compliance with the regulations.

Hemovigilance is fundamental to her role and she is always looking for quality improvements to make to the process in response to incident investigations and audits that are carried out.

Problem Identified:

“

Blood Transfusions are not being disconnected from the patient within 4 hours of removal from the cold chain, this increases the risk of bacterial infection. Legal requirement as per BSQR (Blood Safety & Quality Regulations) 2005 to ensure patient safety.”

Academic Health Science Network (AHSN)

We concentrate our efforts in the South West region, bringing together partners from the NHS, academia, local authorities, industry and community sectors to identify and spread innovation that improves population health and generates economic growth.

AHSN connects the NHS, academic organisations, local authorities, the third sector and industry they are catalysts that can help create change.

There are 15 Academic Health Science Networks (AHSNs) across England, established by NHS England in 2013 to spread innovation at pace and scale – improving health and generating economic growth. Each AHSN works across a distinct geography serving a different population in each region.

https://swahsn.com/ https://www.ahsnnetwork.com/

Conference Royal Cornwall Hospitals NHS Trust

Cornwall

Conference Royal Cornwall Hospitals NHS

Conference Royal Cornwall Hospitals NHS Trust

Conference Royal Cornwall Hospitals NHS Trust

© 2022 QI Conference Royal Cornwall Hospitals NHS Trust

QI Conference Royal Cornwall Hospitals NHS Trust

Royal Cornwall

Conference Royal Cornwall Hospitals NHS Trust

QI Conference Royal Cornwall Hospitals NHS Trust

Quality Improvement

"Building, supporting & delivering improvement using evidence-based methodologies, tools & techniques"

Role of a Virtual Nurse

What is the role of a Virtual Nurse?

To provide the patients of Cornwall with access to a specialist Hepatology Nursing service, offering outpatient clinical services on a virtual platform, with unlimited potential to enhance the patient experience, challenge traditional pathways of healthcare delivery and promote sustainable health care methods.

How does it work?

Full time role as a registered nurse

Working from home

Using an online video consultation platform and telemedicine as an alternative option

Full access to NHS systems

Requesting bloods, imaging and diagnostics

Virtual team meetings

Mandatory Nutrition & Hydration Training

Vicki Craig – Therapy Support Worker (Dietetics &SLT)

Vicki’s role is to assist the Dietetic, Speech and Language Therapy teams in the assessment and treatment of patients who are malnourished or at risk of becoming so, and to assess those with a dysphagia or at risk due to clinical condition. Vicki mainly works on the Admissions unit with the aim of preventing avoidable admissions, supporting patient flow and discharge through the hospital and contributing to reduction of re- admissions.

Vicki submitted her idea for Malnutrition and Hydration Training via our Trust’s QIdeas© engagement platform.

The original idea was that there should be a mandatory training module for clinical and support staff working with patients to complete. Vicki felt that this would help to decrease the risk of malnutrition and hydration risks with patients. Vicki felt awareness of these risks needed to be raised wider in the Trust and as such, this training package would help to achieve this.

Rapid Improvement Sprints

A series of short improvement videos following our ‘6 Steps to QI’ at Royal Cornwall Hospital Trust.

Rosa Robot Project

Part of Royal Cornwall Hospital Trust’s Clinical Strategy is to develop a robotic surgery programme and promote St Michael’s Hospital as a centre of orthopaedic excellence.

Implementation of the Rosa Robot assists surgeons with Total Knee Replacement (TKR) procedures and reduces surgical variance, resulting in better patient outcomes.

Going Home Bags

The “Going Home Bags” came around during the pandemic, when a Nutritionist highlighted that by providing a ‘Going Home Bag’ for our frail, elderly or vulnerable patients we could improve Patient care, help to reduce readmissions, provide reassurance to our Patients during the discharge process and help us to act in a timely manner to feedback and identify any problems sooner.

Day Case Surgery: UKR Surgery

(Uni-Compartmental Knee Replacement Surgery)

The British Association of Day Case Surgery (BADS) has set out model hospital targets stating we should achieve 40% of UKR as Day Cases. Doing UKR as Day Cases helps to reduce the length of stay in hospital and therefore help get patients back into their home environment improving Patient Care.

Adopting Innovation Project

What is Innovation?

Innovation is the development of truly new products or services it is developing something which has not been done before but which has the potential to make a significant difference to how you work, how you care for your patients or how we work as an organisation.

Make sure you tag us on Social Media @RCHTQIHub #RCHQIConference

TRAINING

A key principle of the RCHT approach to QI is that everyone should be able to make the changes that they want to see. It is therefore important that QI skills and expertise are not solely held in a central team.

To help support the spread of QI capability, we have created a network of QI Ambassadors across the Trust who are trained to a high level in QI methodology.

Contact us if you’d like to know more about any of our training or to be added to the mailing list for QI Ambassador training: rcht.qihub@nhs.net

QI Training @ RCHT

External Training

Opportunities

Improvement Fundamentals is a programme of online, self-directed mini-courses in quality improvement (QI) for those involved in heath or social

Develop the skills to make a difference and create change in your organisation on this course targeted at health and care staff.