Annual Report and Accounts 2012/13 - Royal Devon & Exeter Hospital

2. Our Trust Royal Devon and Exeter NHS Foundation Trust 31
Annual Report and Accounts 2012/13
Quality of care
The Board’s principal purpose is to
ensure that the Trust is governed in
a way that leads to the best possible
patient care. Improving patient care
drives everything that the Board does,
and everything it does is viewed
through the impact decisions may have
on patients.
The Board receives regular Ward
to Board reports which monitor
performance at acute inpatient ward
and divisional level and provide a
risk-rated outcome indicator for each
area. The report has now become part
of the Integrated Performance Report
that is seen by the Board each month.
The report enables Board Members to
take a view on the quality and safety of
work taking place at ward level and to
monitor this over time. Where actions
are required, this is overseen by the
Deputy Chief Nurse who holds the lead
nurses accountable. The information
is provided alongside outcomes for
the Care Quality Assessment Tool
(CQAT) and, with information from
incidents and complaints, enables
the Board to triangulate information.
This innovation has been seen by the
Board as providing a useful insight
into ensuring that changes in certain
indicators can be tracked and that any
repercussions can also be monitored.
The Board also undertakes 'drill downs'
into specific issues as necessary arising
from the Ward to Board reports and
these are either taken as agenda items
in Board meetings or in seminars.
During the course of the year,
the Board approved a new vision
to guide the work of the 2,800
nurses, midwives and allied health
professionals [AHPs] providing
patient care at the Trust. The
programme sets out an ambitious
organisational commitment to ensure
that high standards of care are
applied consistently. The three-year
programme, which was developed by
the senior leaders, seeks to capture the
pride and dedication that our nurses,
midwives and AHPs demonstrate on
a daily basis. It also emphasises their
passion to constantly improve patient
care: good is not good enough – we
want to be the best we can possibly
be for our patients, their families and
carers. Representatives of nurses,
midwives and allied health professionals
at the RD&E were involved in the
development of the vision to reinforce
their commitment to:
• Providing safe, dignified and
compassionate care
• Being open and honest in their
communication and working in
partnership with patients and their
families
• Recognising specific needs
of individuals and providing
personalised care.
The programme of work which sits
beneath the Vision includes simple
innovations, such as ensuring good
practice in one area can be rolled out
and applied consistently and reliably
across the hospital, and making sure
that individuals are held accountable.
For example:
• We are rolling out Comfort Rounds
where we ensure that each ward
undertakes a nursing round every
hour. We believe it is not acceptable
for patients to rely on a call bell to
request assistance. Every patient
every hour will be asked by a
nurse or midwife whether they are
comfortable and if there is anything
they need. This regular check will
address essential aspects of patient
care including pain management,
nutrition and hydration. We also
expect this pro-active approach to
reduce the incidence of patient falls
and pressure ulcers
• We have always sought to improve
our services by listening to patient
feedback. Now, based on a
successful trial in our orthopaedic
wards, we are systematically
capturing patient feedback whilst
patients are still in hospital. This is
shared at daily team safety briefings
to promptly address any issues or
concerns that may arise
• Staff morale and satisfaction in
the workplace can mirror patient
satisfaction. So, we now have
anonymous staff feedback cards to
pick up on themes or issues which
need addressing.
Good is not good
enough – we want to
be the best we can
possibly be for our
patients, their families
and carers.