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

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

3. People CentredPositiveCompassionExcellence The Trust Established 1st December 2007. 2010 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

4. 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)

5. 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 2012/13 – National CQUIN Challenge!!

6. People CentredPositiveCompassionExcellence Using the Data

7. People CentredPositiveCompassionExcellence Using data to focus improvement

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10. 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

11. 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

12. 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 2014 - 84% reduction in prevalence April12-March 14: 32% reduction in patient incidence £1,400,000 Saving – Patient Impact Five year journey - still travelling

13. 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

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15. People CentredPositiveCompassionExcellence Thank You Any Questions ?