A network of foundation trusts is focusing on four priority areas to maximise learning and spread improvements, writes Ailsa Brotherton
NHS QUEST is a network of 14 foundation trusts aspiring to levels of quality and safety beyond current expectation. The network is currently focusing on four key priority areas: leadership, measurement, building capability and improvement programmes.
Salford Royal Foundation Trust recently opened its doors to network members, the NHS Confederation, other trusts interested in joining the network, academic colleagues and visiting non-executive directors with the purpose of sharing learning.
The ambition in Salford is bold: it is aimimg to be the safest organisation in the NHS
Salford Royal chief executive David Dalton opened the day by describing Salford’s journey in quality improvement in patient safety.
The ambition in Salford is bold: the trust is aiming to be the safest organisation in the NHS and has invested heavily in its quality infrastructure − a team comprising four quality improvement leads, three project managers and a quality improvement fellow (who is a senior registrar) together with a dedicated intranet site, all executives trained in QI leadership, 12 divisional leaders trained in QI leadership and middle manager training (nurses and service managers) under way.
In addition, all inpatient nursing managers have participated in collaborative working, half of SRFT staff have been directly involved or influenced by QI, 350 people have participated in teamwork and culture training and internal in-depth quality training is provided for 30 per year (completed by 90 people to date). The approach is straightforward: success is celebrated and rewarded while poor performance is not tolerated.
Siobhan Moran, SRFT assistant director for quality improvement, presented the trust’s quality improvement strategy highlighting that Salford is a trust with an organisational memory as the lessons learned from 2008-11 were shared with delegates.
The SRFT QI strategy characteristics were discussed, including the setting of bold aims, delivering a suite of projects to achieve the aims, ensuring a strong focus on leadership and engagement with the right investment in staff. The latter included wide use of an improvement toolbox, creating the right culture and embedding measurement into all QI programmes of work.
Delegates were asked to share the characteristics of their own organisation’s quality strategies, for differences and similarities to be discussed, before the opportunity to ask the audience for advice and share the trust’s dashboard measures.
Salford Royal Foundation Trust
- Hospital standardised mortality ratio (HSMR)
- Unadjusted raw mortality percentage
- Readmissions (risk adjusted)
- Hospital readmission percentage
- Average length of stay
- Long length of stay (relative risk)
- Rate of adverse events (global trigger tool)
- Selected harms (NHS Safety Thermometer, pressure ulcers, CA-UTI, falls, VTE, MRSA, C difficile, VAP, cardiac arrests, SSI)
- Patient satisfaction with care score
- Staff assault/abuse
Colleagues visited wards within the hospital to see the quality improvement work and high-quality nursing care first hand. The day concluded with Mr Dalton summarising the key challenges facing the trust and a discussion to ensure the network maximises opportunities for sharing best practice.
NHS QUEST is taking a dynamic approach to knowledge transfer, an approach intended to engage organisations (senior executive leaders and clinical leaders) in a solution focused approach, to maximise learning and spread improvements at an unprecedented pace and scale.
We are turning our attention towards the need for investment in QI capability and recognising the immense importance of changing organisational culture.
NHS QUEST is consulting with network members to develop strategic plans for 2013-15 and new ways of working
Within the network, members are action focused and teams attending on the day are currently implementing key learning from the Salford visit into their organisations.
Plans include reviewing pressure ulcer improvement work, engaging with staff, sharing the SRFT performance framework with colleagues, raising thoughts about structure with corporate director colleagues, exploring with senior nurses about how to implement intentional rounding, appraising how clinical teams are supported in quality improvement and developing meaningful structural rewards for staff who succeed in quality improvements.
The NHS QUEST programme management office is currently consulting with network members to develop the strategic plans for 2013-15 and exciting new ways of working. These include new approaches built around clinical communities of practice to push the boundaries and collaborate with European and international leaders and innovative peer site visits, underpinned by effective knowledge management and transfer.
Find out more
NHS QUEST is continuing to recruit new members. More information can be found at www.quest.nhs.uk
Dr Ailsa Brotherton is director for clinical engagement and leadership at NHS QUEST