Implementing Energise for Excellence and responding to the

Call To Action on the ward

Lesley Marsh

Assistant Director of Nursing

Aims

energise for excellence: the ward managers ‘Call To Action’

supporting safe and effective care, and delivering positive patient and staff experiences

enabling ward managers to tell their quality story and commit to the ‘call to action’

the tools and toolkits which measure improvement, change practice and spread success

• Education both pre & post registration

• Values based recruitment

• Personal Development

• Evidence based staffing levels

• Evidence based, using innovation & best practice

• Improving outcomes

• Productive & efficient

• Delivered in the right place

• Clarity of measures & impact

• Safety thermometer

• Continuous improvement

• Transparent & open reporting

• Real time monitoring & improvement

• Friends and Family Test

• Informed & involved in decisions

• Personal responsibility for health & well being

• Rewarding & worthwhile jobs

• Professionally accountable

• Proud to be a nurse /midwife

• Treated fairly

• Engaged in decisions

Get Staffing

Right

Get Staffing

Right

Deliver Care

Deliver Care

Measure Impact

Measure Impact

Patient Experience

Patient Experience

Staff Experience

Staff Experience

Leadership at every level

We call you to commit to take FIVE actions.

1. Commit to take a specific action to make a specific change within a specific timescale

2. Use the most relevant tools

3. Measure it

4. Celebrate success

5. Tell your story to others

Values based recruitment

Education and training

Fallsafe train the trainer

Leadership programmes

Values based recruitment

Education and training

Fallsafe train the trainer

Leadership programmes

Fallsafe project Fallsafe project

Harm free care / safety

thermometer

Observations of care / peer review

Safe and productive care of

older people

Harm free care / safety

thermometer

Observations of care / peer review

Safe and productive care of

older people

Complaints

Patient feedback

Friends and family test

Complaints

Patient feedback

Friends and family test

Reporting falls

Learning

Feedback from study days

Reporting falls

Learning

Feedback from study days

Get Staffing Right

Get Staffing Right

Deliver CareDeliver Care Measure Impact

Measure Impact

Patient Experience

Patient Experience

Staff Experience

Staff Experience

Falls

Inte

rnal &

Extern

al

concern

Changes to care

Patient risk factors

Cardiovascular Balance Confusion Bone health Medication Vision Toileting

Environmental risk factors

Patient environment Equipment Special observation

THINK FALLS

F = Fatal

A = Assessment

L = List risk factors & act

L = Leave essentials within reach

S = Stop medication if you can

Falls – what did we achieve?

Fallsafe champion in every clinical area Falls assessment for every patient over 65 Falls pathway for every patient identified at

risk Post falls protocol Falls group Resource folder THINK falls

Falls – the numbers

0

50

100

150

200

250

2008 2009 2010 2011 2012

2008 229 180 177 177 157 181 211 173 187 184 179 166

2009 181 187 181 194 186 182 221 167 132 208 194 178

2010 194 181 219 203 199 211 167 195 201 198 196 194

2011 238 230 218 180 196 204 161 173 216 215 201 221

2012 234 194 203 190 173 196 176 151

Jan Feb March April May June July Aug Sept Oct Nov Dec

0102030405060708090

100

pe

rce

nta

ge

%

date

Audit of care for patients regarding falls assessment and management

Series1

National Outcomes The number of patients without a call bell in reach was

reduced by 78%. Twice as many requests for medication reviews were

made. The number of patients who did not have safe

footwear was reduced by 67%. Twice as many patients had their lying and standing

blood pressure checked manually. There was a 56% increase in patients being assessed

for signs of confusion. More than twice as many patients were asked if they

were worried that they might fall. There was a 41% decrease in the number of patients

given night sedation.

Trust outcomes The number of patients without a call bell in reach was

reduced by 80%. 55% increase in request for medication reviews The number of patients who did not have safe

footwear was reduced by 47%. There was a 64% increase in patients being assessed

for signs of confusion. 50% patients over 65 were asked if they were worried

that they might fall. There was a 30% decrease in the number of patients

given night sedation. Reduced length of stay for older people by 3 days

Next steps

Environmental audits Review pathway Night time medication Chair review Toileting Continue audit