Continuous Quality Improvement

Sharing learning is vital if we are to maximise the benefits of our improvements and embed positive changes across all areas.
 
Our Yokoten sessions allow both clinical and non-clinical teams to showcase improvements in patient care with the aim that colleagues across the Trust have the opportunity to learn from excellence and can take away ideas to share with their teams to see how they might be adapted and or adopted to generate further positive transformations.
 
Some of the improvements/innovations we have featured to date:
  • Introducing and embedding the Continuous Quality Improvement in the Imaging and Paediatrics and Neo-natal teams, illustrating how the methodology can support effective and sustainable changes
  • Street pastors in the Emergency Department – highlighting how using volunteers can be used to support patients who may be anxious or need extra support (this also frees up nursing staff to focus on patient care)
  • How taking part in audits can shape and change national guidance after #TeamKGH helped assess the clinical value of CT scans to screen for changes consistent with Covid-19 before patients undergo chest surgery
  • Cultural change campaigns, such as Calling it out with Compassion which promotes a positive and kinder more civil working environment for staff
  • How Radiology changed the language they used – developing a series of informal questions to help staff across the team “start a conversation” about changes to working methods and improvements in care.

How QSIR helped me as we transformed outpatient appointments

Clare Clark Outpatient Administration Manager_04 Cancelling and rearranging hundreds of clinic appointments at the start of the first phase of the Covid pandemic really put Outpatient Administration Manager Clare Clark’s QSIR skills to the test.
 
I used PDSA (plan, do study act) – to break down such a huge task which needed to be done at real pace in order to keep our patients safe.
 
I needed to plan and prioritise:
  • Which clinics would be cancelled?
  • Which were the most urgent, where patients had to be contacted verbally?
  • Which clinics would be switched to telephone clinics?
  • What staff were available to support contacting all these patients?
  • Where were we rebooking patients to, what slots were available to us?
As our processes developed, we worked with the systems team to make them more effective in this new working environment – always asking can we do things differently, change them to deliver better care for our patients?
 
The QSIR programme gives me the tools to be able to look at a project, recognise and include the stakeholders, and work through processes with logic to overcome the hurdles in our way.

 

Greater depth and accuracy of coding boosts patient care

Keeping accurate and meaningful information about our patients and our activities is a cornerstone of delivering safe, effective and efficient care.
 
As part of our commitment to continuous improvement we have recently transformed our clinical coding, not only to directly help us provide better care to patients, but also so we can improve efficiency and ensure we are investing in the right services – now and in the future.
308 Clinical Coding Picture1.jpg
And the quality of our Clinical Coding Transformation Programme has been recognised by the HSJ’s (Health Service Journal) Value Awards where it was named overall winner in the Operations and Performance category.
 
Head of Digital Programme Natasha Chare, said: “Every patient interaction we have has a clinical code attached to it and it is important we record this accurately so we can understand the demands on our Trust – helping us to provide appropriate services for our patients both now and in the future.
 
“There has been a renewed focus on working with clinical colleagues to improve the accuracy of our coding and we have also looked at developing greater depth in coding – which involves ensuring all appropriate underlying health conditions have been captured.
 
“It has been an honour to work with this team over the past year and this award is a testament to all of their hard work.”

One-stop giving more urology patients tests, diagnoses and care plans in a single visit

We are treating patients more effectively and sooner thanks to our Urology Patient One Stop.
 
Created by the Urology Team and Transformation Team, we are now able to test, diagnose and give individual treatment plans all in the same hospital visit. Previously the number receiving a package of tests and care in one attendance was 4%, now it is 50%. The One-Stop Urology and Transformation Team L-R Healthcare Assistant Claire Chandler, Transformation Programme Manager, Cath Chisholm, Consultant Urologist, Mr David Payne, Oncology Urology Nurse Support, Maggie Smyth, and Urology Nurse Practitioner, Emma Russell.
 
This model is being tested at both KGH and Northampton General Hospital, with the two trusts working closely together through Northamptonshire Health and Care Partnership to ensure patients across the county have the same consistently high-quality care.
 
By providing tests, results and a consultation in a single hospital visit we can diagnose and treat conditions faster, resulting in better outcomes for our patients and helping us to manage increasing demand in a sustainable and co-ordinated way.
 
This exciting development is a finalist in the Health Service Journal Value Awards 2020
 
This is what our patients are saying:
 
Quotes from patients

QSIR is helping me build my case for better care

Naseby Ward’s Therapeutic Activities Coordinator Sophie Cunningham is working on plans to create a therapeutic activity team working across #TeamKGH. If successful, the team will focus on improving patients moods through mental stimulation and physical activity.
 
This will:
  • Give patients a more positive hospital experience
  • Increase activity and help prevent patients, particularly older patients, becoming more frail. In turn, this will reduce the risks of falls
  • Reduce length of stay – if someone is more active and feels positive they are likely to be well enough to be discharged sooner.
The team will also specialise in working with inpatients living with dementia, creating a friendly and engaging environment on the wards to reduce the amount of stress that they experience during their stay with us.
 
The KIITE team (KGH Improvement, Innovation, Transformation and Effectiveness) has helped Sophie draw up a detailed business plan to provide a strong evidence base for the team and is now arranging meetings with teams across the trust whose support will be vital for the project to succeed.
 
“The KIITE team used their QSIR skills to help me build a professional, evidence-based business case, told me who I needed to involve and who I needed to get on board to make it a success,” says Sophie.
 
“I’m really looking forward to the next phase.”