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The journey -

The aim of this project was to reduce hospital acquired pressure ulcers and falls, thereby having a significant impact on patient safety, patient experience and organisational productivity. It was undertaken as part of a Department of Health pilot, the Southampton University Hospitals NHS Trust chosen because of its previous success in rapid improvement projects.

Outcomes

Since the start of the project in 2010 there has been an overall reduction of 75 per cent in Grade 3 and 4 pressure ulcers.  The trust is currently on target to achieve a 62 per cent reduction in Grade 2 pressure ulcers during the current year. There has also been a reduction of 30 per cent in high harm falls since the start of the project, although this measurement has proved more complex, and has been amended to produce valid data. Productivity through length of stay since the project began equates to £900k for pressure ulcers and £300k for falls. Staff have also noted a reduction in call bells and greater patient satisfaction, and patients are experiencing less avoidable harm as a result of the project.  

Patient setting

In-patient     X Out-patient Community based
Mental health Chronic illness Cross-systems

Clinical area

Staying healthy Maternity and newborn Children and young people Acute care X
Planned care  X Mental health Long-term conditions End of life

Information, tools and techniques used

The project used Rapid Spread methodology, designed by the Department of Health to introduce evidence-based High Impact Actions (HIAs) in specific aspects of patient care.Rapid Spread is a ‘whole system’ approach and is launched Trust-wide as opposed to phased Plan Do Study Act (PDSA cycle) implementation. It consists of a systematic, week-by-week guide and workbook with supporting tools and coaching to equip staff without previous change expertise to bring about improvements.

Geography

The project took place within Southampton University Hospitals NHS Trust. It was implemented in 44 wards (only paediatrics, theatre wards and critical care were excluded because of either short stay or intensity of care).

Timescale

The project was started in June 2010 and initially covered a twelve week period. This included four weeks preparation, four weeks immersion and training and four weeks implementation.

Contact details and further information

Gail Byrne, Deputy Director of Nursing and Head of Patient Safety, Southampton University Hospitals NHS Trust. gail.byrne@uhs.nhs.uk [post_title] => The Turnaround Project [post_excerpt] => [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => the-turnaround-project [to_ping] => [pinged] => [post_modified] => 2015-03-24 13:27:32 [post_modified_gmt] => 2015-03-24 13:27:32 [post_content_filtered] => [post_parent] => 0 [guid] => http://clients.electricstudio.co.uk/tvhiec/wpcms/?post_type=improvement-science&p=3420 [menu_order] => 0 [post_type] => improvement-science [post_mime_type] => [comment_count] => 0 [filter] => raw ) [1] => WP_Post Object ( [ID] => 3415 [post_author] => 8 [post_date] => 2013-01-16 15:32:54 [post_date_gmt] => 2013-01-16 15:32:54 [post_content] =>

The journey -

Whilst ERP is a national programme, senior leaders of NHS trusts have also been instrumental in driving forward ERP. Programme objectives have been set differently in different trusts.  In the case of Royal Berkshire NHS Foundation Trust, ERP has focused on patients as well as NHS staff, in particular giving them information to help them prepare for surgery, give them the right expectations and support them throughout their hospital stay. Information packs and patient diaries have been central to this. The trust has also developed education packages for nurses and established education sessions for staff.  

Outcomes

In Royal Berkshire hospital, length of stay has reduced from ten to six days for colorectal surgery, from five to two days for hysterectomies, from four to two days for prostatectomies and from seven to under five days for hip and knee surgery; all with no significant change in readmission rates.  

Patient setting

In-patient   X Out-patient   X Community based   X
Mental health Chronic illness Cross-systems   X
 

Clinical area

Staying healthy Maternity and newborn Children and young people Acute care
Planned care   X Mental health Long-term conditions End of life
 

Information, tools and techniques used

Clinically led since its inception, the ERP programme at the Royal Berkshire NHS Foundation Trust uses Plan Do Study Act (PDSA) cycles to drive local implementation and improvements.  

Geography

This local ERP project took place in the Royal Berkshire NHS Foundation Trust.  

Timescale

An enhanced recovery programme started for colorectal surgery in 2005/06 but lapsed two years later. Following the national launch of ERP, the hospital’s own programme was re-launched in 2010.  The programme is still ongoing.  

Contact details and further information

Sarah Cherrill, Enhanced Recovery Nurse, Royal Berkshire Hospital.  sarah.cherrill@royalberkshire.nhs.uk [post_title] => Enhanced Recovery Programme, Royal Berkshire NHS Foundation Trust [post_excerpt] => [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => enhanced-recovery-programme-royal-berkshire-nhs-foundation-trust [to_ping] => [pinged] => [post_modified] => 2013-01-16 15:46:59 [post_modified_gmt] => 2013-01-16 15:46:59 [post_content_filtered] => [post_parent] => 0 [guid] => http://clients.electricstudio.co.uk/tvhiec/wpcms/?post_type=improvement-science&p=3415 [menu_order] => 0 [post_type] => improvement-science [post_mime_type] => [comment_count] => 0 [filter] => raw ) [2] => WP_Post Object ( [ID] => 3413 [post_author] => 8 [post_date] => 2013-01-16 15:25:05 [post_date_gmt] => 2013-01-16 15:25:05 [post_content] =>

The journey -

This year-long programme looked at caesarean rates across the NHS south central region in order to identify reasons for variation in practice.  The programme team worked directly with five maternity units whose caesarean section rates were below a benchmarked norm.  In each case they undertook an in-depth investigation into why they were performing particularly well.  These investigations were presented as case studies on best practice and shared with all participating trusts at networking events. Alongside the case study investigations, the team developed a regional normal birth pathway.  

Outcomes

All the units in the programme were able to work on areas of improvement in practice and by the end of the programme everyone was able to share examples of specific improvements.  The process of identifying and sharing best practice reduced variation and raised standards across the region.  A final report summarised the learning from the programme. As well as driving up clinical standards, the team also noted a maturing of attitudes and behaviours as a result of the programme.    

Patient setting

In-patient   X Out-patient Community based
Mental health Chronic illness Cross-systems
 

Clinical area

Staying healthy Maternity and newborn   X Children and young people Acute care
Planned care   X Mental health Long-term conditions End of life
 

Information, tools and techniques used

The programme used an appreciative inquiry approach, focussing on best practice.  It was led by a clinical director.  

Geography

The programme covered maternity units in the NHS South Central region.  

Timescale

This was a year-long programme which took place in 2010 – 2011.

Contact details and further information

Nicky Mason, Midwife Consultant: nicky.mason@institute.nhs.uk [post_title] => Sharing best practice in reducing caesarean rates [post_excerpt] => [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => sharing-best-practice-in-reducing-caesarean-rates [to_ping] => [pinged] => [post_modified] => 2013-01-16 15:25:05 [post_modified_gmt] => 2013-01-16 15:25:05 [post_content_filtered] => [post_parent] => 0 [guid] => http://clients.electricstudio.co.uk/tvhiec/wpcms/?post_type=improvement-science&p=3413 [menu_order] => 0 [post_type] => improvement-science [post_mime_type] => [comment_count] => 0 [filter] => raw ) [3] => WP_Post Object ( [ID] => 3410 [post_author] => 8 [post_date] => 2013-01-16 15:18:39 [post_date_gmt] => 2013-01-16 15:18:39 [post_content] =>

The journey -

Telehealthcare has been deployed in USA and Australasia for a number of years and after a number of pilots in the UK it is now beginning to be a mainstream option. The Wessex HIEC Partnership has recognised that not all healthcare services are convinced by telehealth/care delivery models.  The ‘Why adopt telehealth and telecare solutions in health and social care’ initiative aims to promote understanding and improve access to information about telehealth/care across the Wessex area.  The initiative will also provide support to organisations that choose to adopt and implement telehealth/care solutions as part of their wider service delivery to patients. The Wessex HIEC has implemented awareness raising activities of the potential of telehealth/care technologies that include: group training sessions and workshops with clinical and managerial staff, the provision of individual consultancy expertise and the production of video and DVDs.  

Outcomes

These results mean that telehealth now has an evidence base on which to grow. The Wessex HIEC programme has been shaping a local support network, links with local telehealth/care suppliers, workforce development materials and more recently, approaches to procurement to improve the local foundations for building telehealth/care solutions.  

Patient setting

In-patient Out-patient Community based
Mental health Chronic illness Cross-systems   X

Clinical area

Staying healthy Maternity and newborn Children and young people Acute care
Planned care Mental health Long-term conditions   X End of life
 

Information, tools and techniques used

This programme started in April 2011 and following a fact finding exercise on the extent of deployment of these technologies in Wessex staged a conference to get input from key local leaders on their issues around implementation of telehealth and telecare.  This conference gave the HIEC a mandate of work areas.  These were: training and education to staff; awareness raising to the public; input on specific areas such as business cases and funding streams; interoperability; and learning from other organisations in the UK and beyond. The HIEC has staged a number of events to address these issues; it has run training courses on specific issues such as how to write a business case on telehealth, where to find funding for adoption and produced a bi-weekly newsletter to share research, conferences, training courses, publications and news.  The Wessex HIEC was commissioned by the Strategic Health Authority to produce a range of training materials to support the roll out of telehealth in the region.  These courses are currently being trialled and will be available as a resource early in 2013. The HIEC has also offered individual consultancy to organisations and undertaken evaluations of services. The WIRES website is helping with the spread of innovation. www.wessexhiecpartnership.org.uk All resources that have been created in this work programme are available on the website. The areas where less progress has been made have been around supporting commercial companies to innovate in the health sector and around interoperability.  These are areas that are being targeted in the specification of the Academic Health Science Network.  

Geography

NHS (Portsmouth to Isle of Wight, down to Poole and up to Winchester), ambulance and university facilities (Portsmouth, Southampton and Bournemouth).  

Timescale

Started April 2011 and ends March 2013  

Contact details and further information

Further details of this and other change programmes managed by Wessex HIEC can be found at http://hiec.wessexhiecpartnership.org.uk

Contact: Katherine Barbour, Faculty of Health Sciences, University of Southampton, k.j.barbour@soton.ac.uk

[post_title] => Wessex HIEC Telehealthcare programme [post_excerpt] => [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => wessex-hiec-telehealthcare-programme [to_ping] => [pinged] => [post_modified] => 2013-01-16 15:18:39 [post_modified_gmt] => 2013-01-16 15:18:39 [post_content_filtered] => [post_parent] => 0 [guid] => http://clients.electricstudio.co.uk/tvhiec/wpcms/?post_type=improvement-science&p=3410 [menu_order] => 0 [post_type] => improvement-science [post_mime_type] => [comment_count] => 0 [filter] => raw ) [4] => WP_Post Object ( [ID] => 3408 [post_author] => 8 [post_date] => 2013-01-16 15:15:37 [post_date_gmt] => 2013-01-16 15:15:37 [post_content] =>

The journey -

The Small Business Research Initiative is an innovation challenge to industry. The object of this particular SBRI was to develop technology solutions to help reduce secondary care admissions and deliver new services and products to the NHS. The solution featured here is Message Dynamics’ ‘COPD Monitor’ which uses interactive voice technology to monitor patients’ wellbeing.  It is designed to improve patients’ quality of life, improve disease management, reduce admissions and reduce costs.  

Outcomes

The COPD monitor calls patients twice a week to record their state of health. Between September 2011 and February 2012, almost 1,500 calls were completed (a response rate of 91 per cent). Of these, 13 per cent generated an alert which starts an automatic escalation process. An initial follow up call by the unit’s nurses resolved 80 per cent of issues and the remaining 20 per cent required home visits. These home visits prevented nearly forty emergency admissions (representing a saving of at least £80,000). The investment in this project by the SHA has been £48,775. However, excluding the development cost the cost of the service to deliver this service is £375 – ie 25p per call. The return on investment ratio of this pilot is in excess of 200:1. An unanticipated benefit is that patients like talking to a computer; they do not feel they are wasting people’s time and patients report feeling less isolated. Clinicians are also noting that patients are becoming better equipped to understand and manage their own conditions.  

Patient setting

In-patient   X Out-patient   X Community based   X
Mental health Chronic illness   X Cross-systems   X
 

Clinical area

Staying healthy   X Maternity and newborn Children and young people Acute care   X
Planned care Mental health Long-term conditions    X End of life
 

Information, tools and techniques used

SBRIs start with a ‘problem space’ which can be defined quite closely to respond to a specific issue.  Prince project management underpins the thinking of the programme management team and helps provide a balance between process structure and outcome focus.  

Geography

The programme covers the South Central SHA area.  

Timescale

SBRI was launched in July 2010 and companies were given six weeks to bid. Sixty-nine companies from the UK and overseas responded in September 2010 and in November, Message Dynamics was one of four companies that received funding to take their proposal to a ‘proof of concept’ (POC) by February 2011. The product was adopted in September 2011 and is now offered to all patients referred to the specialist COPD service at Heatherwood and Wexham Park Hospital.  

Contact details and further information

Duncan Goodes, Head of Innovation Promotion: Duncan.Goodes@nesc.nhs.uk [post_title] => Small Business Research Initiative [post_excerpt] => [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => small-business-research-initiative [to_ping] => [pinged] => [post_modified] => 2013-01-16 15:15:37 [post_modified_gmt] => 2013-01-16 15:15:37 [post_content_filtered] => [post_parent] => 0 [guid] => http://clients.electricstudio.co.uk/tvhiec/wpcms/?post_type=improvement-science&p=3408 [menu_order] => 0 [post_type] => improvement-science [post_mime_type] => [comment_count] => 0 [filter] => raw ) ) [post_count] => 5 [current_post] => -1 [in_the_loop] => [post] => WP_Post Object ( [ID] => 3420 [post_author] => 8 [post_date] => 2013-01-16 15:57:01 [post_date_gmt] => 2013-01-16 15:57:01 [post_content] =>

The journey -

The aim of this project was to reduce hospital acquired pressure ulcers and falls, thereby having a significant impact on patient safety, patient experience and organisational productivity. It was undertaken as part of a Department of Health pilot, the Southampton University Hospitals NHS Trust chosen because of its previous success in rapid improvement projects.

Outcomes

Since the start of the project in 2010 there has been an overall reduction of 75 per cent in Grade 3 and 4 pressure ulcers.  The trust is currently on target to achieve a 62 per cent reduction in Grade 2 pressure ulcers during the current year. There has also been a reduction of 30 per cent in high harm falls since the start of the project, although this measurement has proved more complex, and has been amended to produce valid data. Productivity through length of stay since the project began equates to £900k for pressure ulcers and £300k for falls. Staff have also noted a reduction in call bells and greater patient satisfaction, and patients are experiencing less avoidable harm as a result of the project.  

Patient setting

In-patient     X Out-patient Community based
Mental health Chronic illness Cross-systems

Clinical area

Staying healthy Maternity and newborn Children and young people Acute care X
Planned care  X Mental health Long-term conditions End of life

Information, tools and techniques used

The project used Rapid Spread methodology, designed by the Department of Health to introduce evidence-based High Impact Actions (HIAs) in specific aspects of patient care.Rapid Spread is a ‘whole system’ approach and is launched Trust-wide as opposed to phased Plan Do Study Act (PDSA cycle) implementation. It consists of a systematic, week-by-week guide and workbook with supporting tools and coaching to equip staff without previous change expertise to bring about improvements.

Geography

The project took place within Southampton University Hospitals NHS Trust. It was implemented in 44 wards (only paediatrics, theatre wards and critical care were excluded because of either short stay or intensity of care).

Timescale

The project was started in June 2010 and initially covered a twelve week period. This included four weeks preparation, four weeks immersion and training and four weeks implementation.

Contact details and further information

Gail Byrne, Deputy Director of Nursing and Head of Patient Safety, Southampton University Hospitals NHS Trust. gail.byrne@uhs.nhs.uk [post_title] => The Turnaround Project [post_excerpt] => [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => the-turnaround-project [to_ping] => [pinged] => [post_modified] => 2015-03-24 13:27:32 [post_modified_gmt] => 2015-03-24 13:27:32 [post_content_filtered] => [post_parent] => 0 [guid] => http://clients.electricstudio.co.uk/tvhiec/wpcms/?post_type=improvement-science&p=3420 [menu_order] => 0 [post_type] => improvement-science [post_mime_type] => [comment_count] => 0 [filter] => raw ) [comment_count] => 0 [current_comment] => -1 [found_posts] => 9 [max_num_pages] => 2 [max_num_comment_pages] => 0 [is_single] => [is_preview] => [is_page] => [is_archive] => 1 [is_date] => [is_year] => [is_month] => [is_day] => [is_time] => [is_author] => [is_category] => [is_tag] => [is_tax] => 1 [is_search] => [is_feed] => [is_comment_feed] => [is_trackback] => [is_home] => [is_privacy_policy] => [is_404] => [is_embed] => [is_paged] => [is_admin] => [is_attachment] => [is_singular] => [is_robots] => [is_favicon] => [is_posts_page] => [is_post_type_archive] => [query_vars_hash:WP_Query:private] => 1dd34280d312b9df3e7f9aba841753a7 [query_vars_changed:WP_Query:private] => [thumbnails_cached] => [stopwords:WP_Query:private] => [compat_fields:WP_Query:private] => Array ( [0] => query_vars_hash [1] => query_vars_changed ) [compat_methods:WP_Query:private] => Array ( [0] => init_query_flags [1] => parse_tax_query ) ) [1] => derp )

Category: South Central

The Turnaround Project

The journey – The aim of this project was to reduce hospital acquired pressure ulcers and falls, thereby having a significant impact on patient safety, patient experience and organisational productivity. It was undertaken as part of a Department of Health pilot, the Southampton University Hospitals NHS Trust chosen because of its previous success in rapid […]

Posted on Jan 16th Cat: , , , Tags: , , Comments: Comments are off for this post

Enhanced Recovery Programme, Royal Berkshire NHS Foundation Trust

The journey – Whilst ERP is a national programme, senior leaders of NHS trusts have also been instrumental in driving forward ERP. Programme objectives have been set differently in different trusts.  In the case of Royal Berkshire NHS Foundation Trust, ERP has focused on patients as well as NHS staff, in particular giving them information […]

Posted on Jan 16th Cat: , , , , , Comments: Comments are off for this post

Sharing best practice in reducing caesarean rates

The journey – This year-long programme looked at caesarean rates across the NHS south central region in order to identify reasons for variation in practice.  The programme team worked directly with five maternity units whose caesarean section rates were below a benchmarked norm.  In each case they undertook an in-depth investigation into why they were […]

Posted on Jan 16th Cat: , , , Tags: Comments: Comments are off for this post

Wessex HIEC Telehealthcare programme

The journey – Telehealthcare has been deployed in USA and Australasia for a number of years and after a number of pilots in the UK it is now beginning to be a mainstream option. The Wessex HIEC Partnership has recognised that not all healthcare services are convinced by telehealth/care delivery models.  The ‘Why adopt telehealth […]

Posted on Jan 16th Cat: , , Comments: Comments are off for this post

Small Business Research Initiative

The journey – The Small Business Research Initiative is an innovation challenge to industry. The object of this particular SBRI was to develop technology solutions to help reduce secondary care admissions and deliver new services and products to the NHS. The solution featured here is Message Dynamics’ ‘COPD Monitor’ which uses interactive voice technology to […]

Posted on Jan 16th Cat: , , , , , , , , Tags: Comments: Comments are off for this post