Professor Jean White Chief Nursing Officer Together for Health Conference June 2012 Improving quality of care

Together for Health – 5 year strategy for NHS Wales The main commitments are: service modernisation, including more care provided closer to home and specialist ‘centres of excellence’ addressing health inequalities better IT systems and an information strategy ensuring improved care for patients improving quality of care workforce development instigating a ‘compact with the public’; and a changed financial regime.

Quality in care – big agenda Patient safety agenda – 1000 Lives plus programmes; Transforming Care; NEWS/MEWS early warning systems Improving patient experience – Free to Lead, Free to Care initiatives; Older People’s Commissioner action plans; dementia action plans; care metrics and Nursing Dashboard; Fundamentals of Care Audits Healthcare Standards ‘Doing Well, Doing Better’ – HIW reviews, cleanliness and dignity spot-checks NHS Redress ‘Getting it right’ – complaints CHC role and annual ‘Hospital Patient Experience’ review Listening to patients A LOT OF WORK GOING ON!

Patient Experience Survey  Revised Household Survey – first report in Sept – rolling programme of reports  Need to avoid duplication and stream line activity  LHB/Trust approaches – wide variation  Fundamentals of Care Audits  HIW inspections & spot checks  CHC review  Scoping exercise underway to determine what else should be put in place  Options paper due with the Minister before summer recess

Nursing care metrics & Dashboard The dashboard will enable nurses from “ward to board” to review the quality of care being delivered in their clinical area, organisation or across Wales. Data to populate the All Wales Nursing Dashboard are being captured through a new Care Metrics module, created by NWIS within the Fundamentals of Care Audit Tool. Definitions are agreed nationally. This will mean that nurses can be sure the data they are collecting are standardised across Wales – everyone is collecting the same thing in the same way - making the information more meaningful.

Dashboard Indicators In place and being tested by Nurse Directors: WHO 5 Moments (Hand Hygiene) Healthcare Acquired Pressure Ulcers Nutrition Score Completed and appropriate action taken

Dignity and respect

Dignity in Care Tier 1 Priority – part of performance monitoring Older People’s Commissioner review – progress on action plans Fundamentals of care national audit – made public for first time HIW dignity spot checks CHC Hospital Patient Experience Report now being used in performance meetings Piloting Safer Nursing Care Tool – in patient settings

Dementia care National Dementia Vision for Wales launched Feb 2011 Dedicated help-line and website to offer emotional support and advice Workshop held June 2011 to discuss national audit findings (HQIP) – action plans developed by all LHBs – plans will be used as basis for 2012/13 national audit WG funded dementia care training in LHBs Leslie Rudd, 1000 Lives Plus, dedicated officer facilitating service developments

1000 Lives Plus website:

Care Bundles 1000 Lives Plus uses specific methodology to engage staff to bring about improvement: PDSA cycles Also use care bundles to standardise improvements, Examples: Peripheral venous cannulae care bundle Skin bundle Stroke bundle Launched in May 2012 – oral care bundle – FoC national audit finding

Care Bundle: Patients with Learning Disabilities Result of Ombudsman’s case into failings in care for Paul Ridd in ABMU – family wish lasting legacy – care bundle dedicated to Paul Launched 21 June 2012 by Minister Will be rolled out through 1000 Lives Plus Also tendering at present for awareness raising programme

Transforming Care Part of 1000 Lives Plus. The aims are to: improve the patient experience and the outcome of care increase the safety and reliability of care improve team performance and staff wellbeing add value and improving efficiency 285 wards have been fully transformed and many more are in the process of being transformed. The process to fully embed the changes in practice takes time.

Tangible outcomes 50% reduction in handover, 28% reduction in wasted time looking for equipment, 68% reduction in admin time = More time spent on direct patient care Intentional rounding – reduction in falls and pressure ulcers More efficient use of resources Patients and staff show higher satisfaction levels