A guide to commissioning cardiac surgical services - NHS ...

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A guide to commissioning cardiac surgical services Quality - the current context The document ‘High Quality Care For All’ next stage review published in 2008 set quality as the key organising principle of the NHS with ‘quality’ being defined under the three domains of patient safety, clinical effectiveness and patient experience. Since 2008, these domains have begun to help define the way the NHS drives forward quality improvement and now feature as underpinning principles within all current NHS strategy including The Operating Framework 2010/11 (and quality framework see below), World Class Commissioning and the NHS Performance Framework (2009). Measuring quality using these domains is emerging with the development of the Improving Quality Indicators (IQIs) by the NHS Information Centre. Additionally many of the emergent Commissioning for Quality and Innovation schemes (CQUINN) are using these domains to define, manage and reward quality improvement within healthcare contracts. Bringing clarity to quality Measuring quality Publishing on quality Rewarding quality Raising standards Safeguarding quality Staying ahead The Quality Framework Quality is our organising principle - the full national enabling framework will be in place from 2010/11 Source: Operating Framework 2010\11 First four NICE quality standards by April 2010 on stroke care,VTE prevention, dementia and neonatal care Over 200 quality indicators now available on the Information Centre website First Quality Accounts to be published in 2010 National CQUIN goals on VTE, patient-reported outcome measures and patients’ experience National Quality Board review of system alignment Full CQC registration against essential levels of safety and quality in place from April 2010 Connecting innovation to our core purpose - the quality and productivity challenge Complementing this approach is the ‘Quality and Productivity Challenge’ which builds on the above domains by extending the quality focus to include innovation, productivity and prevention. Also described by the acronym ‘QIPP’ the intention is to provide a mechanism through which better care and better value can be achieved through the reduction of waste and in the prioritisation of effective treatments. With the above in mind it is useful to summarise the learning from the surgical project sites aligned to these principles. (Note: The author has omitted ‘prevention’ as this wasn’t considered a primary focus of the initiative). 42 www.improvement.nhs.uk/heart
A guide to commissioning cardiac surgical services Initiative: Pre-operative assessment Safety Effectiveness Patient Experience Innovation Productivity Page No. Same day outpatient clinic and pre-assessment 20 Standardisation of network wide pre operative investigations 22 Dedicated lead pre-assessment nurse 20 Pre assessment processes / protocols 9, 18 Anaesthetic assessment at pre assessment. 15 Implementation of cardiac advanced nurse practitioner 15 Revised pre – assessment algorithm’s (CABG , Valve , ACS) 32 Nurse led pre – assessment clinics 9 Patient information sheets 9 www.improvement.nhs.uk/heart 43
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