Lindsey Webb, Director of Nursing and Governance

Our vision: To be the first choice for orthopaedic services for patients, carers and commissioners

The Fortunes of Leading Brands

National drivers Quality, Innovation, Productivity and Prevention (QIPP) Commissioning for Quality and Innovation (CQUINs) National contract Quality Accounts High Impact Interventions Essence of Care Safety Thermometer Energise for Excellence

Local drivers Organisational strategy and ambition Needs of the population Feedback from patients, carers and the public Patient safety issues Clinical outcomes Risks

External challenges

Internal challenges

Leadership Team Culture Evidence Assurance Triangulation Developing a quality service

Don’t just rely on the numbers Be mindful of hitting the target and missing the point! How does it look/feel? What story is it telling you? Consider the ‘so what’ factor Share and communicate Engage with staff – formally/informally Celebrate success Challenge complacency Remember - it can always be better Lessons learnt

Catheter associated urinary tract infections

On average every incidence of HA-UTI incurs an additional cost of £1, 563 per patient and blocks a bed for an extra 6 days Plowman et al % of patients are catheterised Cited in epic guidelines, % ROHFT Incidence CAUTI 7.3% hospitalised patients Plowman R et al % ROHFT CAUTI Problem…

Cost of additional nurse care£ Cost of microbiology£10.60 Cost of additional antimicrobials£4.71 Additional length of stay costs£ Additional consumables£82.45 Other additional costs (Plowman model) £ Cost of one CAUTI £1,563 each At a CAUTI rate of 32% total annual cost: £185,997

Strategy … Aseptic Non-Touch Technique Chain of Prevention Trial silver catheters

Bone Infection Unit

After….

If you think you’re too small to make a difference you’ve obviously never been in a room with a mosquito!!!