How was the scepticism addressed?
Naturally, the proposal for partnership working in the Trust was met with some initial hesitancy. Through effective leadership and collaborative working with key staff (Lead Haematology Consultant, Medical Director), sensitivities from clinicians in the organisations were addressed, and the risks and benefits discussed via a proposal paper in a well-attended open forum. These meetings agreed that this was a sensible way forward. Clinical staff were made aware and educated of the implications of the NICE guidance CG 92.
By understanding our specific needs, the pharmaceutical company was able to identify opportunities to develop tailored solutions to achieving the CQUIN goal.
Did the Trust initiated the contact with Sanofi to do this project or was it initiated by Sanofi Aventis?
In Kettering General Hospital, achievement of the CQUIN goal was regarded as a highly important objective, both from a patient safety perspective, with an acute appreciation that many lives could be saved, and from a financial viewpoint, with a significant figure attached. To help us accomplish the challenging task of documenting risk assessment of at least 90% of all inpatients KGH approached Sanofi, the suppliers of our existing low-molecular-weight heparin. Sanofi was able to provide dedicated time and resources that we could not, and some of their staff became closely integrated with our team.
Does the VTE guidelines or protocol include Sanofi Aventis products?
Yes. Sanofi Aventis products were the standard products used in this Trust since May 2004, well before the collaboration was mooted.
Did the collaborative working result in an increase of the Sanofi Aventis product?
Yes. From starting with risk assessment rates of just over 30% in June 2010, we became the first hospital in the East Midlands to achieve the CQUIN goal in November 2010, with 90.1% of patients undergoing a VTE risk assessment upon admission.Our progress outstripped the average for NHS East Midlands, and we had a higher rate than the national average of 68.4% published by the Department of Health in Q3 2010.
The nature of the national CQUIN raised the issue that not enough awareness or appropriate treatment was given to at-risk patients, as highlighted in NICE CG 92. As a result of improved awareness of this patient safety issue there was an increased in enoxaparin prescribing.