Aim 1 RAMI in line with top performing UK organisations and eliminate seasonal and weekly variation by June 2013 Aim 2 Reduce adverse events per 1000 patient days to 10 by June 2013

Developing the driver diagrams New content areas Dementia care Falls ERAS PVC Develop actions links with AQF and operational performance

To achieve 95% compliance with the PVC maintenance bundle Check the PVC insitu is still required. Remove or replace after 72-96 hrs Replace administration set after 72 hrs Implementation of the PVC bundle elements Check dressing if remaining in situ Perform hand hygiene before and after PVC procedure Clean hubs prior to access Remove PVC if signs of inflammation, phlebitis or infiltration To achieve 95% compliance with the PVC maintenance bundle Ensure patient/carer fully understands the PVC maintenance care bundle Integrate patient into care Ensure patient/carer fully involved Involve patient/carer in goal planning Robust induction programme for staff. Build staff knowledge & competency in quality improvement work Report VIP score over 2 & take blood culture Develop an infrastructure that promotes a team safety culture & quality care Implement daily safety briefings Feedback compliance to ward

What did we learn? Harm Mortality Systematised care Improvement in GTT possible Room to push HAI Value of walkabouts Mortality Value of death audits to create dialogue Importance of coding Systematised care Effectiveness of stroke intervention Potential in integrated care

What happened?

Strategy for next year Further step change in mortality Impact of C. diff improvement Understand potential for 7 day working Condition specific work – coding Views/sepsis recognition Sustain and spread mini-collaborative work Alignment with OD and service improvement Develop business case for quality - ERAS Improve use of coms/patient stories Develop primary care/community work Link with unscheduled care Reliable chronic disease care