scholarly journals 988 A Quality Improvement Project; Improving the Quality and Safety of Handover During COVID-19

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
M Chawla ◽  
M Said Noor
Keyword(s):  
Quality Improvement ◽  
Patient Care ◽  
Continuity Of Care ◽  
Quality Improvement Project ◽  
World Health ◽  
Junior Doctors ◽  
Free Text ◽  
Post Intervention ◽  
Improvement Project ◽  
Handover Process

Abstract Aim The World Health Organisation (WHO) positions effective handover, in its top five patient safety solutions. During our District Hospital Trust’s COVID-19 response, an unprecedented reorganisation of all teams occurred. All surgical and medical speciality junior doctors were re-deployed and split into 4 zones to cover the hospital. In this quality improvement project (QIP), we sought to understand our trainees’ thoughts on this new multi-zonal handover process and aimed to identify risk-reduction measures to aid better patient care. Method The opinions of trainees on the new handover system were obtained using an online Likert scale survey. Following the responses, a new morning and night handover proforma was developed. This was used trust-wide and a post-intervention repeat survey was conducted to assess the new changes. Results The primary survey received 31 responses with feedback illustrating mixed effectiveness of the existing handover process. Free text comments highlighted issues surrounding “safety”, “poor organisation”, “poor continuity of care” with one serious incident reported. Post-intervention of a new handover proforma, a repeat online survey received 25 responses. Results were significantly more positive with >84% of responses being in the “strongly agree to agree” category, including for “continuity of care”, “organisation”, and “safety”. Conclusions This QIP illustrates a good example of a low-cost intervention to create a better handover system and aid hospitals during time of crises. For us, it managed to reform the handover process and ultimately improved our patient care. Forthcoming, we would like to create a national best practice guide for effective handover.

3 Peer-Produced Induction Material for Foundation Year One Doctors in Plastic Surgery – A Quality Improvement Project

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
L Dwyer-Hemmings ◽  
L Salfity
Keyword(s):  
Quality Improvement ◽  
Plastic Surgery ◽  
Quality Care ◽  
Smooth Transition ◽  
Junior Doctors ◽  
Free Text ◽  
Post Intervention ◽  
Improvement Project ◽  
One Year ◽  
Surgery Department

Abstract Introduction Induction programmes are recommended for all junior doctors starting new posts and are mandatory for foundation year one doctors (FY1s). Constraints on time and staff mean these guidelines are not always met. This project aimed to improve the efficiency, effectiveness, and timeliness of care by designing and distributing peer-produced induction material to FY1s starting placements in plastic surgery. Method A quality-improvement methodology was utilised. Online questionnaires assessed FY1 experiences in several domains using five-point Likert scales and free-text answers. This information was used to design induction material. Material was distributed to incoming FY1 cohorts, the questionnaire was repeated, and material updated and redistributed. Results Three quality improvement cycles were performed over a one-year period. Four FY1s were surveyed pre-intervention, and four post-intervention. Post-intervention, there was a statistically significant improvement in understanding of responsibilities (+2.2, p < 0.01) and departmental structure (+2.0, p = 0.018). FY1s felt confident in starting (4.75±0.5), prepared for on-calls (4.75±0.5), and satisfaction was high (4.75±0.5) Conclusions Peer-produced induction material for FY1s can improve understanding of responsibilities and structure within a plastic surgery department. This will increase confidence of new starters and facilitate smooth transition of staff, enabling the provision of high-quality care by enhancing its efficiency, effectiveness, and timeliness.

261 Using Technology to Improve Inpatient Surgical Lists

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
A Gowda ◽  
Z Chia ◽  
T Fonseka ◽  
K Smith ◽  
S Williams
Keyword(s):  
Quality Improvement ◽  
Patient Care ◽  
Junior Doctors ◽  
Research Projects ◽  
Point Scale ◽  
Improvement Project ◽  
Surgical Department ◽  
Team Meetings ◽  
And Training ◽  
Multi Disciplinary Team

Abstract Introduction Every day in our surgical department; prior to our quality improvement project, Junior Doctors spent on average 3.26 clinical hours maintaining 5 surgical inpatient lists of different specialities with accessibility of lists rated as “neutral” based on a 5-point scale from difficult to easy. Our hospital previously had lists stored locally on designated computers causing recurrent difficulties in accessing and editing these lists. Method We used surveys sent to clinicians to collect data. Cycle 1: Surgical Assessment Units list on Microsoft Teams Cycle 2: Addition of surgical specialities and wards lists onto Microsoft Teams. Cycle 3 (current): expand the use of Microsoft Teams to other specialities. Results Utilising technology led to a 25% reduction in time spent on maintaining inpatient lists, to 2.46 hours a day, and an improvement in the accessibility of lists to “easy”. Across a year, this saves over 220 hours clinician hours which can be used towards patient care and training. Furthermore, use of Microsoft Teams has improved communication and patient care, in the form of virtual regional Multi-Disciplinary Team meetings and research projects. Conclusions Microsoft Teams is currently free to all NHS organisations in England so there is potential for these efficiency savings to be replicated nationwide.

524 QUALITY IMPROVEMENT PROJECT: INCORPORATING COMPREHENSIVE GERIATRIC ASSESSMENT INTO COMMUNITY HOSPITAL CLERKING

2021 ◽  
Vol 50 (Supplement_2) ◽  
pp. ii8-ii13
Author(s):  
A Oates
Keyword(s):  
Quality Improvement ◽  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
Community Hospital ◽  
Quality Improvement Project ◽  
Junior Doctors ◽  
Medical Team ◽  
Improvement Project ◽  
Efficient Detection ◽  
User Friendly

Abstract Elderly patients transferred to community hospitals often have complex medical, social, psychological, functional and pharmacological backgrounds that require careful assessment in order to create and deliver a high quality, patient-centred care plan. Unfortunately, time pressures experienced by staff in acute hospitals can make Comprehensive Geriatric Assessment (CGA) unfeasible for every patient. Moreover, junior members of the medical team may be unsure as to which aspects of a patient’s background and presentation constitute important elements of a CGA. Failure to recognise and document pertinent issues can lead to prolonged admissions, disjointed care and failed discharges. Admission to a community hospital presents a convenient ‘checkpoint’ in the patient’s hospital journey at which to undertake a CGA. Recording the relevant information in an effective clerking proforma when the patient is admitted ensures that this information is displayed clearly and in a way that is accessible to all members of the multidisciplinary team. The pre-existing clerking proforma at Amersham Community Hospital omitted several important elements of CGA (such as examination of feet and gait, assessment of mood, FRAX-UK score, creation of a problem list etc.) The aim of this quality improvement project was to create a thorough, yet user-friendly and time-efficient clerking proforma which incorporated the important components of CGA. Using BGS guidance and NICE quality standards, alongside suggestions from the medical team, the existing clerking proforma was adapted and reformed. After one month, feedback from the team was used to further improve the clerking proforma, ensuring that it was user-friendly, whilst meeting the standards set out by NICE and BGS. This was repeated as part of a second PDSA cycle. The improved clerking proforma enables junior doctors to undertake a thorough and holistic assessment, promoting efficient detection of issues and the delivery of a higher quality of care.

scholarly journals Examining trainee awareness of dermatoses and dermatological assessments during acute admissions (A quality improvement project)

2018 ◽  
Vol 17 (3) ◽  
pp. 137-143
Author(s):  
Priya Patel ◽  
◽  
Natalie King ◽  
Keyword(s):  
Quality Improvement ◽  
Elderly Patients ◽  
Skin Care ◽  
Quality Improvement Project ◽  
Psychological Consequences ◽  
Post Intervention ◽  
Improvement Project ◽  
Care Bundles ◽  
Trust Hospital ◽  
Acute Admissions

Studies demonstrate 67% of elderly patients can have dermatoses, which could result in functional and psychological consequences. Elderly presentations are further complicated by comorbidities and polypharmacy. This combined with limited dermatology training at undergraduate and postgraduate levels creates diagnostic challenges. This project investigated dermatology assessments by trainees using the Trust’s acute medical admissions proforma. 100 proforma were reviewed for skin assessments alongside nursing skin care bundles. Subsequently, a skin survey was conducted amongst trainees evaluating knowledge and confidence when diagnosing and managing common dermatoses. Successively, a dermatology teaching series was delivered. Post-intervention the above were reassessed, demonstrating improvements in most areas. The dermatology teaching series will continue alongside a Trust hospital guideline to sustain improvements in dermatological care on admission.

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