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 improvement projects.


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.


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).


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.

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

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