Celebrating patient safety champions

It’s Patient Safety Awareness Week and to celebrate we’re giving a shout out to all the amazing patient safety champions across the West of England. Here are this year’s champions and the reasons for their nominations:

The Patient Safety Team for Children’s Services at University Hospitals Bristol NHS Foundation Trust for improvements they have made as part of the National Maternity and Neonatal Health Collaborative Improvement Programme. Specifically, for their work in achieving a 50% reduction in babies needing neonatal input for respiratory problems, active or passive cooling, and suspected hypoxic ischaemic encephalopathy.

Dr Karen Luyt from University Hospitals Bristol NHS Foundation Trust and Dr Sarah Bates from Great Western Hospitals NHS Foundation Trust for their work leading the PERIPrem project (in partnership with the other clinical leads) and have both continued to pioneer and innovate the the safety of preterm infants through reducing brain injury. Sarah and Charlotte have been the driving force in the shaping and development of the PERIPrem Bundle.

Charlotte Sampson from Royal United Hospitals Bath

Charlotte was part of wave 3 of the Bath Improvement System as part of the Medical Admissions Unit team. She developed a new improvement tool (a step by step guide of how to clean a commode), documenting and sharing best practice on standard work. Charlotte made it her mission to make sure every member of the staff understood the standard work, supported by some visual aids. She then observed staff carrying out the task and used coaching questions. The development of this piece of work will help to prevent unnecessary infections in hospital.

Gemma Rust from Avon and Wiltshire Mental Health Partnership (AWP)

Gemma has been the clinical lead for an improvement project focused on reducing the use of seclusion and restraint in on one of AWPs medium secure inpatient wards. Physical restraint poses significant patient safety risks such as physical injury and hypoxia. This intervention has been used widely in Mental Health Services for many years and has been highlighted by the CQC as one of the key patient safety issue for mental health service users. This project has been part of the national Mental Health Safety Improvement programme and has been running for 15 months. Gemma has provided clear clinical leadership to work collaboratively with staff and service users to implement changes to the environment, ward structure and increase the use of de-escalation. She has enabled staff and service users to be innovative and creative and take positive risks that result in an improvement. The national programme has seen some great successes and we are really proud that Bradley Brook ward have achieved an 85% reduction in the use of seclusion, restraint and rapid tranquilisation, which has significant impact on both patient safety and experience.

Michael Okocha from North Bristol NHS Foundation Trust for organising the South West Winter QI conference for junior doctors, creating a wonderful space to share learning, hear from fantastic speakers and showcase all the great QI work delivered by our trainees across the South West. Celebrating success during the middle of winter (January 2020) was very uplifting for all who attended.

The Parry Ward Team from Royal United Hospitals Bath

As part of the Bath Improvement System training, Parry ward, part of wave 4, chose “hospital acquired infections” as their driver measure. This is the performance measure they have chosen to actively work on improving. As part of their work, they used QI tools and lean principles to identify variation in processes and waste. Their main work focused on blood bourne infections, MSSA in particular. They identified that cannulation was a top contributor to this problem and therefore they developed standard work for the process of cannulation insertion following current best practice. They also identified that the store cupboard needed rearranging to give staff easy access to the required equipment. Since then (two months), they have not seen any cases of MSSA hospital acquired infections on their ward. It has raised staff awareness and the audit results related to cannulas have greatly improved.

Caroline Horrobin and Naomi Burns from University Hospitals Bristol NHS Foundation Trust for their continued work in improving the early recognition and response to patient deterioration and sepsis in adult services.

The Robin Smith Ward from Royal United Hospitals Bath

Robin Smith was one of the first teams to go through the Bath Improvement System training 18 months ago. They chose to actively work on improving the length and efficiency of drug rounds on their ward. They identified that drug rounds took an average of 60 minutes with 22 interruptions, leading to patient not receiving medication in a timely manner and possible increasing the risk of drug errors. Using QI methodology and lean principles, they reviewed and streamlined the contents of the drug trolleys and made sure the patient’s own drugs were stocked in bedside lockers; they also developed standard work of how to best carry out a drug round; they implemented wearing tabards to minimise unnecessary interruptions and got a second set of keys to avoid unnecessary motion. By implementing these changes, the length of their drug rounds have reduced to the point of saving 52 nursing hours per week. This has allowed the release time to care for patients.

Joanna Morris, Joanna Westlake and Richard Baker in the Patient Safety Team for Children’s Services from University Hospitals Bristol for their work in improving staff knowledge about understanding and assessing harm associated with patient safety incidents.

Becca Porteous, Quality Improvement Lead at Avon and Wiltshire Mental Health Partnership

The Daisy Unit based in Devizes is a small inpatient unit for people with Learning Disabilities and complex behavioural needs. In 2018 the CQC rated the unit as Inadequate and as part of the planning to addresses the concerns it was decided that a Quality Improvement approach would be taken to turnaround the services. Becca was employed as a fulltime QI facilitator as part of the MDT and developed a programme of improvement work with key underpinning improvement projects which she has worked with this clinical staff to lead this work. The unit have seen significant improvements in clinical outcomes which include an increase in service user participation in activities, increase in the amount of activity undertaken off the unit, decrease in the use of restraint. There has also been an improvement in staff experience which has resulted in a an increase in staff retention and a reduction in the use of agency staff. Becca has championed development of other staff and shared her expertise to enable staff to embed the use of Quality Improvement methodology through development of QI champions in the unit.

Carly West, Patient Safety Improvement Programme Manager at University Hospitals Bristol for her work in leading the World Patient Safety Day events at the hospital in September 2019.

The Medical Admissions Unit from Royal United Hospitals Bath.

As part of the Bath Improvement System, MAU concentrated on improving “vacancy rates”. At the time they had 23% vacancy rate overall over a six month period, impacting on patient safety and staff morale. Using QI methodology and lean principles, they identified that most vacancies were within the Band 5 nursing role, with a total of 13.2 WTE vacancy rate. Through a root cause analysis, they identified that their top contributor was limited platforms used to advertise vacancies. They carried out a staff survey to gain an insight on working on MAU and looked at development opportunities available to staff. They organised an open day and by showcasing how it is to work in their ward, they reduced the vacancy rate to 0.92 in just two months. This has led to safer staffing levels. They are also able to ensure staff development through regular study days.

Charlotte Bradbury, Consultant Haematologist at University Hospitals Bristol who is celebrated for her wonderful work in prevention of venous thromboembolism across the Trust.

Dr. Rachel Awan, Associate Specialist in Anaesthesia at Royal United Hospitals Bath

Rachel has worked with Lesley Jordan, Consultant Anaesthetist & Patient Safety Lead at RUH, over the last year on a pathway to improve identification and assessment of frail patients who require surgery for colorectal cancer. This has been a truly multidisciplinary work and Rachel has worked tirelessly, involving the many stakeholders, so that we now have a robust process of improved assessment, involvement of patients and family and improved shared decision-making for these high risk patients.

The ‘Greatix’ Team from University Hospitals Bristol NHS Foundation Trust for their work in instigating a system for learning from excellence across the Trust.