A quality improvement project to continue increasing Learning from Excellence nominations at the Royal Devon and Exeter Hospital

N West, F Birch, E Crehan, T Varley, H Diment, R Randhawa, J Tremlett, M Dineen, R Jaroenchasri

Introduction

Aim 1:

To increase the number of nominations made by staff by 100%

Planned interventions:

Lanyards

Coffee cups

Posters and leaflets

Our actions and progress

Aim 2:

To create a platform for patients to make nominations

Planned interventions:

Joint patient/Staff form

Integration into Electronic notes system (MyCare)

Patient facing posters, leaflets

We identified that nominations have generally since the last set of interventions, as shown by graph 1

We therefore chose to hold a Regional meeting with Derriford Learning from Excellence (LfE) team to learn from their excellence

We championed integration of LfEbetween Royal Devon & Exeter (RD&E) and North Devon Hospitals, supporting the inclusion of patient nominations and creating new and improved nomination cards focusing on diversity and inclusion

We worked with the Quality Improvement Academy (QIA) at the RD&E to gain support, funding, and approval of our intervention

We collaborated with the national LfEteam, gaining resources and key insight into how to build a successful project

In the era of DATIX, it is easy to focus on suboptimal patient care, while numerous examples of excellent care go unnoticed (1). Our established Learning from Excellence (LfE) initiative has created a system to report excellence, boost staff morale, and improve patient safety which we were keen to progress and develop from the already excellent standings. more user be shorter and more

We built a nomination form for both patient and staff use

Following this, we invited staff to give feedback on the form, with quotes shown in diagram 1

We then made informed changes to the form to make it clearer, easier to use, and more accessible

Gained approval from the Chief Executive to move forward with putting this onto the Trust Website and the electronic clinician and patient notes system (MyCare)

We developed advertisement in multiple ways including lanyards, posters and coffee cups

Challenges and future progression

allowing patients to give thoughts be more more eye for wards and departments to make it quicker

One limitation is by having an online form, both on the Trust website and on the electronic notes system, we eliminate form whilst the patient is in hospital using mobile devices/tablets.

We believe that having patient nominations will allow for a feedback loop of nominations a patient nominates a member of staff , inspiring them to nominate someone else. This will therefore boost nominations more sustainably. Finally, our project so far has been focused on gaining more nominations and opening the platform up to patients, but not assessing the learning that can be extracted from this. In the future we aim to pull key themes and concepts from nominations to then feedback to managers and staff leaders to improve patient safety further.

Lessons learnt

Understanding how to overcome the changing culture and ingrained practice of learning from negative experience

Discussion with other hospitals in our region who have built the initiative within staff and patients proved very informative , and gave us the motivation and confidence to move forward with our own project

The sustainability of the process of writing personal nomination cards is a key limitation, both in the physical process of h aving one person writing them, and the environmental impact of paper copies. To overcome this we plan to create digital nomination certificates

This is an evolving project with new ideas being added all the time, and in order to get the optimum learning and therefore patient safety from it, we must continue developing and learning from our interventions

With many thanks to QIA at the RD&E for their ongoing support.