Quality Account: Update

David Emerton

Medical Director

Cath Siddle

Deputy Director of Nursing

The Patient

• Hospital and community and experience first

• Similar format• New guidance Dec 2010• Electronic and hard copy• Consultation• Third party narrative

Format

• Mortality– Infection– Falls– Medicine safety– Cardiac arrests – Dementia (new)

• Effectiveness– Discharge– Full EAU assessment within 2-hours– Communication/documentation

• Patient experience– Is care good (compassion/respect/dignity)– Recommendation– Compliments and complaints– Environment– Patient surveys– External reviews (LinKs, PEAT, peer, CQC,

commissioner)– Staff surveys

2011/12 feedback

3 priorities

National priorities

• Patient safety

• Effectiveness of care

• Patient experience

Our priorities

Priority Hospitals Community

1. Patient safety Reduce number of patients that die in our hospitals

Develop and introduce an early warning score for use in the community

2. Effectiveness of care

Improve clinical documentation and communication

Increase use of tough-books

3. Patient experience

Care with compassion Care with compassion

• Monday SUI panel• Monthly GTT reviews• Mortality reviews• Sepsis• Infections (MSSA)• Dementia• Deterioration; falls

Reduce mortality (hospital)

• Early warning score• Early intervention• Reduce deterioration• Avoid admission

Reduce mortality (community)

• Single contemporaneous record

• Reduce duplication• Improve communication

between and across teams• Maximise effectiveness of

care

Improve documentation and communication (hospital)

• Tough-books• Computerised

documentation• Speedy access to key

information and support• Release time to care

Improve documentation and communication (community)

Care with compassion

Hospital and community

• Quality review panel• Mystery shoppers• Patient voice (carers

diaries)

Timescales

• 18th April final draft* available for comment

• 2nd May deadline for response to draft

• 16th May to printers• 31st May published and

available on-line

* Data to end March included

Mortality was high

Impact

Clostridium difficile

0

5

10

15

20

25

Nov

-08

Dec

-08

Jan-

09

Feb

-09

Mar

-09

Apr

-09

May

-09

Jun-

09

Jul-0

9

Aug

-09

Sep

-09

Oct

-09

Nov

-09

Dec

-09

Jan-

10

Feb

-10

Mar

-10

Apr

-10

May

-10

Jun-

10

Jul-1

0

Aug

-10

Sep

-10

Oct

-10

Month/year

Nu

mb

er r

epo

rted

£387,000 cost reduction

MRSA bacteraemia

01234567

NovFeb

May Aug Nov

FebM

ay Aug NovFeb

May Aug Nov

Feb-1

0

May

-10

Aug

Month/year

nu

mb

er

Impact£47,300 cost reduction

(06/07 difference £120,400)

Influencing care pathwaysLOS over 21-days (2010 data)

0

100

200

300

400

500

600

Month 1 Month 2 Month 3 Month 4 Month 5 Month6 Month 7

Month (4-weekly data)

Nu

mb

er

of

bed

days

Summary

We know what we aim to do ; now we have to complete writing the quality account !!