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2015-2016 quality priorities for improvement

We will be consulting on our quality priorities for 2016-2017 early in the new year. In the meantime, here are the Trust's current priorities. 

This information is taken from our quality report and outlines key areas for improvement in 2015-16.

These areas are called our 'quality priorities' and were identified in 2015. The priorities cover all three areas of quality as mandated by the Department of Health: patient safety, patient experience and effectiveness / patient outcomes. It incorporates the Trust’s commitment to "Sign Up To Safety" and the Safety Improvement Plan.

Quality priority one
Improving our organisational safety culture
What are the aims?
We aim to continuously improve the safety culture of the organisation. Through the implementation of the 'Sign Up To Safety' Safety Improvement Plan we will demonstrate clear leadership and further embed a safety culture throughout the organisation.  This places safety, effectiveness and continuous quality improvement at the heart what we do. We will build capacity and capability across the workforce and implement evidence-based safety and quality improvement projects. We will support it with a formal communications strategy.
How will we measure this?
Using a number of different methods we will measure the outcomes of the Staff Safety Climate Survey, a way of reporting incidents via the Datix system, executive patient safety walk rounds, training staff in quality improvement methodology, root cause analysis and being open, human factors and simulation training. The implementation of quality and safety projects, staff pledges and the outcomes of the Safety Improvement Plan, will also be used. 

Quality priority two
Improving the patient experience and co-ordination of admission and discharge
What are our aims?
We aim to improve the patient experience through improved admission to hospital, safe and effective pre-admission assessment, reduced procedural cancellations, effective and safe handover, and a revised discharge policy supporting effective discharge planning, thus reducing failed discharge rates.
How will we measure this?
We will measure this via a number of different sources of staff, carer and patient feedback. We will also examine patient flow, waiting times data, theatre utilisation data and data on number of hospital bed days, numbers of patients “lost to follow up”, attendance levels at post discharge appointments and levels of cancelled procedures and “failed discharge” through readmission to hospital after post discharge complications. We will continue to monitor mortality rates.

Quality priority three
Improving the identification and management of patients at risk of pressure ulcers and falls in hospital
What are the aims?
Both falls and pressure ulcers are significant patient safety issues that can significantly affect the quality of life and experience of patients from both a physical and psychological perspective. We aim to improve the care of patients at risk of falls and pressure ulcers and to fully implement the care bundles for these issues. We will ensure that risk assessment is carried out, using evidence-based prevention techniques, care planning and treatment and management plans.
How will we measure this?
We will use a number of metrics to establish our success against these areas including risk assessment completion levels of a minimum of 95%, case note review and weekly audits of practice and care plans against evidence-based care bundle standards and NICE Quality Standards, MUST screening tool completion, levels of staff awareness, education and training, risk summits / workshops for staff and further roll out of intentional rounding within clinical areas.

Quality priority four
Improving the management of patients with cancer
What are the aims?
We intend to continue the focus on improving overall waiting times for the 62 day cancer pathway. In addition, we want to ensure that cancer patients receive the best possible experience whilst in our care, having the appropriate interventions and getting the appropriate information at the right time.
How will we measure this?
We will use a number of indicators to establish our effectiveness against this priority including contracted performance measures and feedback on the patient and carer experience from  patients for whom we care.

Quality priority five
Improving the management of the deteriorating patient – reducing acute kidney injury, effective sepsis identification and management, appropriate escalation of NEWS and PEWS Scores
What are the aims?
We will improve compliance with NEWS and PEWS, SEPSIS 6 System to 95% and reduce the incidence of new onset AKI by 50% by 2018.


How will we measure this?
For AKI – incidence of RRT, readmission rates, incidence of KDIGO AKI1, AKI2, AKI3, % CCL risk assessments completed, % risk assessment pre CT scan, % appropriately monitored and adjusted aminoglycosides, glycopeptides. Audit of laboratory alerts leading to change in patient management.
For NEWS / PEWS - % level 1 patients with accurate score, % incidents of failure to detect and escalate, % appropriate care plans, number of cardiac arrests
For sepsis – staff training levels, care bundle compliance, documented review, number of sepsis cases, % cases tool correctly used within one hour. 

Quality priority six
Safer use of medicines and medical devices
What are the aims?
To improve the Trust’s medication and devices incident reporting levels, quality and feedback.
How will we measure this?
We will monitor the number of medication and device incidents and severity by division and clinical area, benchmark reporting rates, review the quality of information in reports (device name, category), number of staff champions, number of safety bulletins / alerts, levels of reporting and submission to NRLS within 30 days.

Share your thoughts

If you have any comments or suggestions on the above please email editorial@rbht.nhs.uk

Royal Brompton

Sydney Street,
London SW3 6NP
Tel: +44 (0)20 7352 8121