Delivering enhanced recovery: Helping patients to get better sooner after surgery
The DoH has just published this document on patient care after surgery. Enhanced recovery of patients undergoing surgery is an evidence-based approach involving a selected number of individual interventions which, when implemented as a group, demonstrate a greater impact on outcomes than when implemented as individual interventions. The aim is to reduce delays, length of stay and to improve the patient experience. The enhanced recovery pathway is outlined in the diagram below:
ProductivitySeven Ways to No Delays
This tool from the NHS Institute, written for clinicians and managers provides information on tried and tested improvement practice used in the NHS, to reduce delays to patient care:
01 Focus on the whole patient pathwayAlso see this 2010 update to the case studies of successful implementation of Seven Ways to No Delays.
02 Plan ahead along all stages of a patient’s pathway
03 Balance demand and capacity
04 Pool similar work together and share staff resources
05 Keep things moving - see and treat patients in order
06 Reduce things that do not add value to patients
07 Keep the flow - reduce unnecessary waits
No Delays Scotland has also identified seven areas of waste that can be removed from the patient journey, and thereby reduce delays. In addition, try out their RTT tool to help you meet your 18 week waits.
Prevention
Safer Care Trigger Tools
Trigger Tools are a metric for measuring the rate of harm in healthcare using case note review. They can also be used to track improvements in safety over time. The NHS Institute has developed one for paediatrics and one for acute care.
Data can be entered onto the trigger tool on the NHS Institute’s website. You will need to register to do this. A video guide to using the trigger tool is available.
You may also be interested in these other trigger tools from the Institute for Healthcare Improvement that use case note review:
Prevention
Safer Care Trigger Tools
Trigger Tools are a metric for measuring the rate of harm in healthcare using case note review. They can also be used to track improvements in safety over time. The NHS Institute has developed one for paediatrics and one for acute care.
Data can be entered onto the trigger tool on the NHS Institute’s website. You will need to register to do this. A video guide to using the trigger tool is available.
You may also be interested in these other trigger tools from the Institute for Healthcare Improvement that use case note review:
Global Trigger Tool – measures the overall level of harm in an organisation
Intensive Care Unit (ICU) Adverse Event Trigger Tool
Outpatient Adverse Event Trigger Tool
Pediatric Trigger Toolkit: Measuring Adverse Drug Events in the Children’s Hospital
Trigger Tool for Measuring Adverse Drug Events
Trigger Tool for Measuring Adverse Events in the Neonatal ICU
Surgical Trigger Tool for Measuring Peri-operative Adverse Events
Local Update
QIPP - what is it?
The NHS must demonstrate that it is making the most effective use it can of public money to deliver quality healthcare. Quality, innovation, productivity and prevention (QIPP) is the mechanism through which we can achieve this.
More information…
What is ULHT doing?
We have a QIPP Committee to lead our plan. In the plan we have included measures to improve the quality of care by focusing on our performance measured against other trusts. Our local analysis has shown that we could make significant quality and improvement gains if we had length of stay and outpatient performance that was nearer to the best performing trusts.
In addition the Trust was successful in two bids to the SHA innovation fund centred around the Productive Ward, and has developed a DRAFT Improvement Strategy.
More information…
This bulletin is brought to you by Library and Knowledge Services. It aims to keep you up-to-date with clinical governance issues. At the beginning of each month, a librarian will update the bulletin with relevant information published in the preceding month. If there are areas you think we also need to cover, please let us know.