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