Annual Report and Accounts - The Great Western Hospital

Priority 7: Participation on the Regional Patient Safety Programme
Since March 2010 the acute services for Great Western Hospital NHS Foundation Trust, alongside
many of the acute Trusts in the South West region, has been actively involved in the Quality and
Patient Safety Improvement Programme. The programme, led by the South West Strategic Health
Authority (SHA) in collaboration with the Institute for Healthcare Improvement (IHI), aims to achieve a
30% reduction in adverse events and a 15% reduction in mortality by September 2014.
The acute programme consists of five work stream packages for the acute programme: leadership,
general ward, medicines management, peri-operative care and critical care. Each incorporating a
number of high risk topics, for example preventing venous thromboembolism, use of the Safer
Surgical checklist, and reducing complications from ventilators in intensive care units. Workstream
leads and teams have been established within the Trust to deliver improvement in each of these
areas, supported by our recently appointed Patient Safety Project Coordinator.
Following the merger of acute and community service in June 2011 between the Great Western
Hospital NHS Foundation Trust and Wiltshire Community Health, the acute and community
programmes now run in parallel.
The community programme consists of six measures and one work stream package for the
community programme: Average length of stay for inpatients, Patients with Observations complete,
patient falls, pressure ulcers, urinary catheters, venous thromboembolism and leadership. Each
measure and workstream has a Trust Lead.
Leadership - As part of the SW SHA Quality and Patient Safety Programme, GWH has been
conducting patient safety walk rounds within the acute services, visiting various areas to establish
first hand patient safety concerns from frontline staff. The walk rounds for the community are planned
to be rolled out during 2012/13. Non Executive Directors (NEDs) and Governors are now actively
involved in this process, the first NED joined the executive team walk round for the visit to the
mortuary in January 2011 helping to develop actions and solutions to concerns raised. A NED or
Governor now takes part in a patient safety walk round on a monthly basis. Since implementing
patient safety walk rounds within the Trust executive teams have visited 18 clinical areas, most
having had two visits; with up to a further 16 programmed for 2012/13.
During the walk round, actions are identified to resolve issues that are raised by staff, the Patient
Safety Coordinator within the Clinical Risk Team monitors completion of actions, of the 90 actions
raised to date 67 have now been completed and resolved. The most common themes that have been
identified are communication, treatment/care delivery problems and equipment related issues. In
continuing to develop the process, themes that are being identified are now being incorporated into
the Trusts aggregated analysis and improvement report which is produced on an annual basis
alongside incidents, claims and complaints data.
As a method of providing assurance that change is taking place, NEDs and Governors will be
undertaking bi- annual meetings to review progress, discuss common themes and resolution of
actions that have been identified. In addition the Chief Executive’s report will include the key themes
schedule which identifies key and common concerns raised on the walk rounds, this ensures that
patient safety concerns are raised directly to the Trust Board.
General Ward – During 2011/12 the general ward teams have successfully implemented and rolled
out the hydro bottles across the Trust in conjunction with the productive ward handover module. The
bottles aid with hydrating patients and help to provide more independence to those who are less able.
The Tissue Viability Nurse Specialist (TVNS) presented on Pressure Ulcers at the SW SHA learning
session in June 2011. The work undertaken to reduce the Trust’s pressure ulcers was so inspirational
that she was invited by the SHA and Improvement for Healthcare Improvement (IHI) to host a South
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