From improving air quality to reducing dental anxiety and saving energy and paper through online pre-op assessments, the first joint Quality Improvement (QI) event for two Black Country NHS Trusts showcased innovation in healthcare at its best.
More than 200 staff from Walsall Healthcare NHS Trust and The Royal Wolverhampton NHS Trust (RWT) and attended the event at GTG Wolverhampton in Wednesfield, featuring more than 80 posters displaying staff initiatives, with an online poster gallery attracting more than 600 votes.
Dr Atul Garg, Consultant Anaesthetist at Walsall Healthcare and Clinical Lead for QI at Walsall, was master of ceremonies while Professor David Loughton CBE, Group Chief Executive, and Sir David Nicholson KCB CBE, Joint Group Chair, addressed delegates before the top 10 scoring poster teams gave verbal presentations.
Leading the way was the Neonatal Team at Walsall Healthcare, RWT’s Portering Team and RWT’s Respiratory Team, who all scooped two awards each.
Walsall Healthcare’s Neonatal Team’s poster ‘Let Thy Breastmilk Be Thy Medicine’ won the Applying QI Methodology Award and was voted best poster overall.
Led by Dr Marwa Alkotamy and Susan Cosgrove, the team set about educating families about the importance of early administration of maternal milk through education and a milk supply checklist.
Susan said: “Our initiative is to promote supporting mums to express breast milk for their babies to have this within 24 hours.
“It is seeing breast milk for what it is, which is more than just nutrition it should be seen as medicine within the start of the babies journey on the Neonatal Intensive Care Unit (NICU).
“Babies who have breast milk early on in their neonatal journey have better outcomes both short term and long term. To ensure expressing support is given from admission we utilized a breast milk check list ensuring all babies received support and advice during the babies admission to the unit.
“This also encouraged the first breast milk to be given within the first 24 hours. With one to one training and nursing leads the initiative has taken flight with 100 per cent compliance using the checklist.
“Both staff and parents feel more confident and able to provide this care. Parents also have felt more like partners in care seeing their breast milk and medicine promoting their babies to get better.
“Some mums who initially wished to bottle feed left the unit after a long journey fully breastfeeding which will go on to provide benefits for both mum and baby long after their journey with us.
“We are still early on in our project but so far the staff have been amazing and very open to the change in practice and we look forward to how far we can take this.”
The RWT Portering Team won the QI Champions award and the QI Team/Department Award for introducing a ‘huddle board’. This is a meeting at the end of each shift where colleagues are encouraged to find solutions for problems and share their ideas for improvement.
The latter honour recognises a team or department which has embraced QI tools and techniques to make changes, and whose staff have undertaken QI training and are working on QI projects.
Martyne Johnson, Portering Supervisor at RWT, said: “I’m overwhelmed and proud to win the two awards, but I’m so thankful to the Porters because their input has enabled their voice to be heard and for changes to take place.”
Winning RWT’s Applying QI Methodology Award and best oral presentation overall, Nicky Macduff and Dr Angela Holden showcased ‘safe air’.
This is a collaboration with West Midlands Fire Service to provide ‘safe and well checks’ to identify patient referrals based on the assessment of air quality and mould issues in homes to try to prevent healthcare issues or worsen them.
“The aim is to identify and address air quality concerns (such as damp and mould) before they can cause harm to health,” said Nicky.
Sir David said: “I’ve worked all over the world, and looking at all these presentations, I’ve never seen anything like it – it’s absolutely fantastic.
“It’s particularly relevant because it’s the 75th birthday of the NHS, and, having worked in 20 different countries, there’s not a week goes by where I don’t think it’s a wonderful set-up and a remarkable institution.
“When you walk into our hospitals in Walsall and Wolverhampton, all the pride and commitment comes out.
“What we need are the mechanisms to bring real change and that’s what we have here – how you can turn your ambition for patients into real outcomes.”
Prof. Loughton said: “It was great to see so many people involved in innovation. If I thought two years ago when I took over Walsall Healthcare that there would be so many examples of people working together across both organisations I probably wouldn’t have believed it.
“I’ve seen many partnerships over the years but working with our two Trusts has been one of the most satisfying things of my career.
“Looking at the posters and the whole range of examples across the organisations, I’m proud of what you have done because it’s not limited to one part of either organisation, it’s right across both Trusts.
“I could pay high-powered companies to come in and provide evaluations and recommend areas of improvement but I get far more value and satisfaction from seeing our staff use their own initiative to engineer and bring about improvement.”
Other winners:
QI Champion Award – Walsall Healthcare
Jo Adams and Deb Mason, Nursing Quality Team, developed a training package and a Fundamentals in Care study day for staff to drive improvements in falls, leading to a continued decrease in falls monthly.
QI Culture and Leadership Award – RWT
Dr Nina Johns, Clinical Director – Obstetrics has cultivated a culture of QI, where staff feel supported and encouraged to make improvements to maternity care and services.
QI Culture and Leadership Award – Walsall Healthcare
Mr Thomas Moores, Clinical Director – Trauma and Orthopaedics, has supported colleagues to make considerable changes in the way they work, from improving the fractured neck of femur pathway to increasing the number of procedures completed in a theatre session.
QI Team/Department Award – Walsall Healthcare
The community Podiatry Team has developed and delivered an action plan for improvement. The team has developed its QI skills by attending QSIR training and has applied QI methodology such as stakeholder analysis to improvement projects.
Clinical Audit Poster – Walsall Healthcare
Poster – S.O.R.T.ing out Sepsis in Walsall
Team – Amy Blakemore, Laura Hu, Helen Halsall, Louise King, Jeanette Roberts, Xana Marriott, Angela Dixon, Karen Rawlings, Dr Mohsen Khali and Miss Rushi Joshi.
Clinical Audit Poster – RWT
Poster – Improving sepsis door to needle time compliance consistently to 100 per cent over a 20-year period for Oncology/Haematology patients
Team – Kayleigh Morgan, Leanna Ellis, Nicola Sherward, Nicola Robottom, Emma Hall and Sarah McGuire from Durnall Ward.
Improving Services Together – Walsall Healthcare
Poster – Creating a Prolonged Jaundice Clinic
Team – Dr D Ferdinand, Dr U Kollurage, Dr A Bhaduri, Cora Billyard, Dr A Abdelhady
Improving Services Together – RWT
Poster – Introducing Conscious Sedation in the Oral and Maxillofacial Outpatient Department
Team – Dr J Mahmood, S Carter.
People’s choice best poster (most voted for) – RWT
Ophthalmology directorate ‘Going green – a sustainability initiative’ to reduce waste from cataract surgery.
Team – Pavitra Garala, Sohail Ahmed, Ian Bowen, Abigail Francis and Soupramanien Sandramouli.
People’s choice best poster (most voted for) – Walsall Healthcare
Acute Medicine Department ‘Deteriorating patient care bundle’ – the creation of an electronic data form to improve outcomes for those patients at risk of serious clinical decline.
Team – Sondos Eladawi, Sreelakshmi Rajan, Amreen Shakir, Abdul Samee, Claire Bustin, Pretty Nair, Shelley Raveendran.
Greener Services
Poster – The potential environmental impact of online pre-operative assessment
Team – Samir Nazir, Emma Sherry, Paul Forrester, Joan Dyer (Walsall Healthcare).
This idea sets the context of NHS environmental impact from one aspect of a surgery service, potentially saving 2.5 tonnes of CO2, which would provide a detached house 38 months of electricity.
Other winning posters were:
- Reducing patient dental anxiety through introduction of alternative options such as IV sedation
- Reduction anaesthetic emissions by removing Desflurane to help reach the goal of a net zero NHS by 2032
- Improving risk prediction for emergency laparotomy (surgical incision into the abdominal cavity)
- Environmental savings of online pre-op assessments
- Improving early diagnosis commonly-acquired pneumonia