1. Implementing Interventions – Success from 1000 Lives Campaign
Tuesday 11 May 2010
Implementing Interventions – Success from 1000 Lives Campaign
Insert name of presentation on Master Slide

2. ‘Transforming Care’ by 2012
Reduced waste
Linking measures to
practice & team vision
Efficiency
Effectiveness
Energy
Direct Patient Care time
Average Sustainable
Increase = 16%
Multi-disciplinary
Team ownership
Patient / family
centred care
Transforming Care at the Bedside, Releasing Time to Care and now Transforming Care is being implemented by teams within medicine, surgery, adult rehabilitation, and mental health wards and community hospitals throughout Hywel Dda Health Board.
The overarching measurement that recognises the impact of changes to practice, environment, processes etc... is Activity Follow that identifies the time available for direct patient care, noting the effect of interruptions and waste. The measurement is recorded by each area as a baseline and repeated at regular intervals.
All implementation sites across the Health Board are demonstrating a sustainable 16% increase, even when faced with severe work load pressures and patient dependency.
As Transforming Care is owned and driven by the individual multi-disciplinary ward teams they are the first to recognise the impact of this increase with a heightened awareness of the implications of measures on practice, which has produced a reduction in many types of waste, i.e overstocking , re-work, motion, patient falls, pressure sores etc… which leads the teams to appreciate hoe the Lean principles of can improve efficiency, effectiveness and even increased energy! Which in turn results in increased Patient and family centred care and improved levels of patient and staff satisfaction.
So where next!! The Health Board has an ambitious national target to introduce Transforming Care into all patient areas by 2012! The implementation and development programme to achieve this for all acute in patient and community hospital areas is currently being finalised.
And finally our golden nugget to leave you with!! Transforming Care must not be seen as another initiative in addition to all the other targets and pressures that staff are currently required to comply with, rather a dynamic and creative tool kit that enables those requirements to be achieved and importantly understood and interpreted into practice, by the whole team from the Hotel Facilities staff through to the ward Sister, Consultant and management team.
Transforming Care’ a creative toolkit to support and work with local and national initiatives / modernisation agendas e.g. F.O.C audit/ EWS / Discharge planning / Environmental audits / Health Care Standards.
Not as well!!
Judith Bowen, Transforming Care, Hywel Dda Health Board

3. Rapid Response to Acute illness The Velindre Perspective
Improved reliability of Observations
Recognition and Management of Severe Sepsis – An example of good practice.
Ceri Stubbs Clinical Lead –Critical Care,Velindre Cancer Centre

4. Warfarin Care Bundle
Practice 1
Practice 2
Downloading INR results from ICE
Template to link INRs with warfarin dose
Repatriate patients from ACC
Downloading INR results from ICE
Ensure INR monitored at least every 12 weeks
Record INR results on GP records
GP to check recent INR result prior to signing prescription
Libby Underhill, Medicines Management-Primary Care, Betsi Cadwaladr University Health Board

5. Reduction in C difficile through prudent antibiotic prescribing
High rates of C difficile - antibiotic policies in their infancy needed urgent implementation
Newly appointed antibiotic pharmacist/consultant microbiologist/IPaCT/clinical audit
The introduction of an antibiotic ward round (1 day/1 ward/10 patients)
Reduction of MRSA and C. difficile
Culture change in antibiotic prescribing
Spread the driver to primary care
Key message - Feedback of data to individual clinicians
Liz Waters, Reducing Healthcare Associated Infections, Aneurin Bevan Health Board

6. Pressure Ulcer – Zero Tolerance
Realising the size of the problem
Skin bundle and Culture change
Measurement
Collaboration is the key to achievement and successful spread
Nigel Broad, Reducing Hospital Acquired Pressure Ulcers, Abertawe Bro Morgannwg University Health Board

7. Reducing Surgical Complications
% with peri-operative normothermia
% Surgery with appropriate hair removal
% continued on beta blockade
% diabetics with glucose control
% daily team briefings
% assessed for risk of DVT
% antibiotics administered 0-60min prior incision
WHO Checklist
Team Success
Inspire people
Build the guiding team
Get the vision right
Communicate
Empower action
Create short-term wins
Don't let up
Make change sustainable
Rosanne Lyles – PTHB Surgical / Endoscopy Manager

8. Preventing Hospital Acquired Thrombosis
Buy in from senior level and coal face
Recognising the tipping point
Clarifying the outcome measure
Education and communication
Lessons learned from England
Simon Noble, Reducing Hospital Acquired Thrombosis, Aneurin Bevan Health Board

9. Lynne Hughes, Stroke Coordinator, Betsi Cadwaladr University HB (east)
Improving compliance with
Acute stroke care bundles
Lynne Hughes, Stroke Coordinator, Betsi Cadwaladr University HB (east)

10. Lynne Hughes, Stroke Coordinator, Betsi Cadwaladr University HB (east)
Improving compliance with
Acute stroke care bundles
Lynne Hughes, Stroke Coordinator, Betsi Cadwaladr University HB (east)