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East Midland’s AAAQIP Progress: Spreading and Sustaining Change.

East Midland’s AAAQIP Progress: Spreading and Sustaining Change. Roxanne Potgieter AAAQIP Project Manager. Last Phase of Implementation QIP ends July 2012. P. QI in action – examples from UK. Criteria Led Discharge – Reducing HDU Usage Norfolk EVAR Nursing Care Pathway. EVARS 13 Post-op

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East Midland’s AAAQIP Progress: Spreading and Sustaining Change.

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  1. East Midland’s AAAQIP Progress:Spreading and Sustaining Change. Roxanne Potgieter AAAQIP Project Manager

  2. Last Phase of ImplementationQIP ends July 2012 P

  3. QI in action – examples from UK

  4. Criteria Led Discharge – Reducing HDU Usage Norfolk EVAR Nursing Care Pathway • EVARS 13 • Post-op • Vascular ward 12 • Planned HDU 1 • Unplanned HDU 0 • No unplanned HDU admissions • All complications dealt with on the ward. (March-July 2011)

  5. Patient Feedback – AAA Recovery Leaflets Patient leaflets tested in all regions Consistently outperform other information leaflets Developed through patient groups Advice based on practical needs 86% response rate

  6. Post-Operative Communication 86% response rate

  7. Medway: Telephone Follow Up • Findings: • Dietary concerns and lack of appetite revealed • Caused extreme anxiety for wives • Provided patients as well as partners with reassurance • Despite being provided with contact numbers patients reported “we didn’t like to bother you” • Identified areas for improvement

  8. local NVD VGNW Ward Episode completed Coding Department File storage HES VGNW NVD CMUH: Data Validation Paper Trail Discrepancy between HES and NVD 1/10/10 to 31/3/11

  9. Revised paper trail • Rules for data submission • Consultant verification • Code operations on op note • Use of discharge summaries Local data NVD VGNW Monthly report to Consultant Ward Episode completed Coding Department File storage Confirm with Consultant Quarterly report to Consultant HES

  10. Regional Progress • EoE, Y&H and N.West • Now self sustaining AAAQIP Networks • C&S Network led (EoE, N.West), clinician led (Y&H) • Outputs: • Regional implementation of pre-operative care pathways • Regional adoption of AAAQIP patient leaflets • Setting minimum quality standards for each unit to meet • Where there is strong C&S network + commissioner support, they are now driving change

  11. East Midland’s AAAQIP Progress

  12. EM AAAQIP October Meeting Acknowledged variability in day to day practice Key areas for improvement Standards for anaesthetic and cardiology assessment Adequate pre-operative planning Refine discharge procedures Telephone follow up as a routine practice

  13. Implementing Change

  14. Act Plan Study Do Set criteria and develop protocols Spreading a change to other locations Make part of routine operations Implement care pathway throughout the EM Implementing a change Test under a variety of conditions Implement best practice from other units Testing a change Theory and Prediction Developing a change

  15. Key Learning for Change • Local leadership is vital • A mutually supportive network encourages participation • Success more likely if all stakeholders engage; • VSGBI, VASGBI, BSIR, C&S Networks & Commissioners • Regular meetings to share best practice and focus on QI

  16. Value in sharing best practice Another meeting, take turns to host? Reconfiguration The importance of refining referral pathways Protocols & standards to be adopted throughout region? Build in regular patient involvement and feedback Local-PROMS Regional-Patient Groups How can QI work be built into the EM CVD Network? Should there be a East Midland’s QI Network? Linked to local meetings Discussion: Next Steps for the East Midlands?

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