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SEPTEMBER 2014
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Make quality your own responsibility New ways to improve and inspire quality will be everyone’s responsibility as the Trust continues to treat ever more patients over the coming months. UHB Chief Executive Dame Julie Moore says growth and demand on services in the face of efficiency savings and the changing health economy will put pressure on standards of care – but that all staff must play their part. “There is a huge demand on our services because they are so good,” says Dame Julie, “but we need to make sure we maintain that quality in the face of unprecedented demand. “It is a juggling act but we have to expect the best from every member of staff, whatever part they play. When the little things go wrong, bigger things follow. “My message to individuals is deliver the right care, at the right time to all our patients.” Over the next year the Trust’s priorities for improvement are: VTE (venous thromboembolism) prevention; patient experience and satisfaction; the electronic observation chart (completeness of observation sets); reducing medication errors (missed doses); further improveent in pressure ulcer care; infection prevention and control. Dame Julie says: “Medication is a good example of where things can improve. About forty per cent of care may be surgery but the remainder is drugs and care. “When I started as a nurse the drug rounds were arranged at the convenience of nurses and the ward routine. Yet timely drug prescribing and administration – the interval between drugs – is really important for patients. “Everyone must adhere to the
system to make sure we are making life better and easier for the people we treat.” She adds: “Every day we see headlines focussing on the NHS and the bad things that can happen. The majority of our staff do a great job and we are proud of the care we give. However, we have had recent incidents where staff have not done their best and we have had to take action.” The Trust is already recognised for its high levels of quality of care through the use of technology, information and benchmarking. Data quality and the timeliness of that data are fundamental aspects of the Trust’s management of quality. Dr Dave Rosser, Trust Medical Director, says: “We monitor quality in everything we do. There are priorities for improvement but the principles remain the same. “The Trust’s focused approach to quality, based on driving out errors and making small but significant improvements, is driven by innovative and bespoke information systems which allow us to capture and use real-time data in ways which few other UK trusts are able to do. “Data is available to clinical and managerial teams as close to real-time as possible through various means, such as our Clinical Dashboard. “We also have a monthly Clinical Quality Monitoring Group meeting where any blips are reported so we can pick up issues around quality at that group.” A key part of the Trust’s commitment to quality is being open and honest with staff, patients and the public, with published information not simply limited to good performance. The Quality web pages provide up to date information on the Trust’s performance in relation to
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Inspection team heading to Trust The Trust is due to receive a visit from a team of independent inspectors who will be checking that our hospitals are providing safe, effective, compassionate and highquality care for our patients. The Care Quality Commission regularly checks that all healthcare providers in England are meeting national standards. Their teams will inspect every NHS hospital by December 2015 and will publish their findings to give the public more choice about the care they receive. Dame Julie Moore, UHB Chief Executive said: “We constantly check the quality of what we do but an inspection gives us an added focus to make sure we are delivering the highest standards in every department, every day and to every patient. “The Trust’s vision and values apply to every member of staff. Everyone must realise that it’s important to focus on the little things that could make a real difference to whether or not our total care package is deemed to meet the required standard. “When the inspectors come they will be everywhere. There will be 60-plus in the team and they will be all over the hospital, not just in the Emergency Department. “If you work here, the chances are you will be spoken to and you may be asked questions. You need to have an answer – and if you don’t you need to know who to ask or where to look for it.” The CQC recently published a high-level overview of what they learned during inspections carried out at other hospitals from April to June. Areas for concern included: ■ Lack of suitably qualified, skilled and experienced staff, particularly at night and weekends ■ Wide variability in the standards of care relating to dementia, end of life and resuscitation
quality: http://www.uhb.nhs.uk/ quality.htm. In September last year the Trust launched a new website called mystay@QEHB in response to feedback about the type of information patients would like to receive before they come into hospital. Quality information is published monthly showing how each inpatient specialty
is performing for a range of indicators: infection rates, medication given, observations, clinical assessments and patient feedback. UHB plans to review and expand the information provided to patients and the public on the Quality web pages during the next year, in keeping with the national drive for greater transparency.
■ Policies and procedures not up to date and informed by evidence-based guidelines ■ Clinical audits not regularly undertaken, including mandatory audits such as those on the national programme and the World Health Organisation Surgical Safety Checklist ■ Significant variation in the discharge process ■ Medical and nursing handovers judged to be variable quality leading to inappropriate transfers, especially out of hours
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