Clinical Effectiveness - Deteriorating Patients
We have identified the need to improve the treatment and care of our patients when they deteriorate on our wards, to ensure they receive safe, timely and effective treatment and care. We know from our incident reports and investigations that we still need to improve in this area and will, therefore, continue to include this as a priority for improvement.
The Deteriorating Patients Collaborative commenced in July 2014. Sixteen collaborative wards have been utilising the Model for Improvement as a framework for testing new interventions and making changes in their areas. Ward teams identified small tests of change that they believed would lead to improvement. Following a period of developing and testing interventions, and identifying those interventions having an impact on reducing harm, the “Deteriorating Patient Intervention Bundle” was launched in June 2015.
Our ambition for 2016/17 is to scale up the implementation of the intervention bundle across all wards.
Clinical Effectiveness - Patients with serious infection (sepsis)
The care of patients with serious infection called ‘sepsis’ has been identified as a priority in the national quality scheme (CQUIN). We know that this has an impact on harm and mortality, and we are committed to making improvements regarding this.
The aim of the scheme is to develop and implement protocols for screening for sepsis within the emergency department, and in the medical admission and surgical admission wards where patients are directly admitted. The overall aim is to reduce mortality through improving the identification and management of red flag sepsis in acute adult patients and to reduce the mortality rate from red flag septic shock.
This will be achieved through:
- Reliable sepsis screening using the BUFALO tool
- Reliable communication across teams of at risk and deteriorating patients
- Developing a program of education on sepsis identification, management and patient safety improvement
- Clinical leadership for the sepsis program
- Effective antimicrobial stewardship
Clinical Effectiveness - Patients with Acute Kidney Infection (AKI)
We know that the early detection of acute kidney injury (AKI) is important in reducing longer-term harm to patients and this has been identified as a priority for the Trust. We have been working to make improvements in this area and implement the national guidance, led by our AKI project group.
The overarching aim of the LTHT AKI project is to apply evidence based interventions to improve the prevention, detection, management, safe discharge, follow up and rehabilitation of patients with AKI.
LTHT is part of a Health Foundation ‘Scaling up Improvement Programme’ which aims to assess whether the introduction of the following interventions can result in an improvement in the quality of care and outcomes for patients with AKI:
a) Acute kidney injury (AKI) electronic alert notifying clinicians of patients with AKI (stage 1, 2 or 3)
b) AKI education package for staff, and
c) AKI management plan linked to a patient care pathway.
In light of the national AKI CQUIN, the AKI project within LTHT also includes a fourth intervention of;
d) Additional information on the Electronic discharge and Advise Notice (EDAN), to improve the safe discharge, follow up and rehabilitation of patients with AKI.