1. Lindsey Webb, Director of Nursing and Governance

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

3. The Fortunes of Leading Brands

5. 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

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

8. External challenges

9. Internal challenges

10. Leadership Team Culture Evidence Assurance Triangulation Developing a quality service

11. 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

13. Catheter associated urinary tract infections

14. 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 1999 12.6% of patients are catheterised Cited in epic guidelines, 2001 21 % ROHFT Incidence CAUTI 7.3% hospitalised patients Plowman R et al. 1999 32 % ROHFT CAUTI Problem…

15. Cost of additional nurse care£539.43 Cost of microbiology£10.60 Cost of additional antimicrobials£4.71 Additional length of stay costs£627.76 Additional consumables£82.45 Other additional costs (Plowman model) £298.05 Cost of one CAUTI £1,563 each At a CAUTI rate of 32% total annual cost: £185,997

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

17. Bone Infection Unit

19. After….

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