People CentredPositiveCompassionExcellence Using The Safety Thermometer To Negotiate CQUIN & Approach a Whole System Improvement Tracy Burrell Assistant Director of Nursing &Quality

People CentredPositiveCompassionExcellence Objectives Trust information Background How we used Safety Thermometer Data Outcomes Improvements

People CentredPositiveCompassionExcellence The Trust Established 1st December gained teaching hospital status - Blackpool Teaching Hospitals NHS Foundation Trust April 2012 merged with community health services Serves a population of approximately 440,000 residents

People CentredPositiveCompassionExcellence Background March 2009 – 326 hospital acquired pressure ulcers >2 Cost of £2,000,000 March 2010 – 197 hospital acquired pressure ulcers (spot prevalence) March 2011 – 167 hospital acquired pressure ulcers (spot prevalence) March 2012 – 117 hospital acquired pressure ulcers (spot prevalence)

People CentredPositiveCompassionExcellence National CQUIN – 50% staged reduction on national median Prevalence not incidence Sufficient patients surveyed consistently to establish baseline median 6 data points Sept 12 – Feb /13 – National CQUIN Challenge!!

People CentredPositiveCompassionExcellence Using the Data

People CentredPositiveCompassionExcellence Using data to focus improvement

People CentredPositiveCompassionExcellence

People CentredPositiveCompassionExcellence

People CentredPositiveCompassionExcellence What did this allow? Supported dialogue with CCG’s Comprehensive report Negotiate CQUIN Identify non Trust acquired PU Triangulation of data – Board level reporting of Incidence Understanding outliers – rectify Replicated for Falls Identify Blackpool top 10 Nursing Homes Collaborative working – Trust and CCG’s Shared process with NW Safety Collaborative

People CentredPositiveCompassionExcellence Service Developments Care Home Team Blackpool CCG funded pilot -12 months commenced in April 2013 The Care home team- 1 matron and 3 case managers To target 15 homes :- Reduce ambulance call outs by 20% Reduce A/E attendance by 20% Reduce hospital admission by 20% 100% of residents involved in the planning of their care 95% of residents have a care plan in place Training for care home staff in falls, pressure ulcer prevention and urine infection Falls Prevention Transfer Best Practise Standards Multi Disciplinary approach 2014 – Replicated in North Lancashire

People CentredPositiveCompassionExcellence Improvements as a Result - PU March 2012 – 117 hospital acquired pressure ulcers March 2013 – 76 hospital acquired pressure ulcers March 2014 – 52 hospital acquired pressure ulcers (78 reported via Safeguard actual) April 2009 – March % reduction in prevalence April12-March 14: 32% reduction in patient incidence £1,400,000 Saving – Patient Impact Five year journey - still travelling

People CentredPositiveCompassionExcellence Improvements as a Result -Falls Care homes reporting falls more accurately 150 staff trained in falls prevention 21% reduction in ambulance call outs 20% less residents being transported with falls and redirected to other services 100% of residents involved in the planning of their care 95% of residents have a care plan in place Improvements in the way falls are managed in the home Increased amount of residents prescribed with Calcium/ Vitamin D supplements Greater collaboration with stakeholders Increased quality of care and resident experience

People CentredPositiveCompassionExcellencePeople CentredPositiveCompassionExcellence

People CentredPositiveCompassionExcellence Thank You Any Questions ?