welcome to elft qi - sikker psykiatri€¦ · qi launch event and roadshows . attended by over 1000...
TRANSCRIPT
1. Why are we focusing on Quality Improvement?
2. Examples of QI work focusing on Violence & Restraint
2
Mental health servicesNewham, Tower Hamlets, City & Hackney, Luton & Bedford
Forensic servicesAll above & Waltham Forest, Redbridge, Barking & Dagenham, Havering
Child & Adolescent services, including tier 4 inpatient service
Regional Mother & Baby unit
Community health services Newham
Urgent care centre Newham
IAPTNewham, Richmond and Luton
Speech & LanguageBarnet3
Challenges and
opportunities in East London
Cultural diversity
Social deprivation
Geographical diversity
Commissioningarrangements
Financial stability and
strong assurance systems
@ELFT_QI
4
The strategic case for change
Make quality our absolute priority
• Improving quality of care is our core purpose
• Of greatest importance to all our stakeholders
• Build on the excellent work already happening to improve quality
National drivers
• The need to focus on a more compassionate, caring service with patients first and foremost
• More structured and bottom-up approach to improvement
Enable our staff to lead change
• The desire to engage, free and support our staff to innovate and drive change
• Engaged and motivated staff leads to improved patient outcomes
The economic climate
• The need to do more with less
– improving quality whilst reducing cost
@ELFT_QI
5
The culture we want to nurture
A listening and learning organisation
Empowering staff to drive improvement
Increasing transparency and openness
Re-balancing quality control, assurance and
improvement
Patients, carers and families at the heart of all
we do
6
Our quality improvement programme
7
AIM:To provide the highest
quality mental
health and community
care in England by
2020
Build the will
Build improvement
capability
Alignment
QI Projects
1. Launch event & roadshows2. Microsite3. Using the power of narrative4. Celebrate successes5. Network of champions / ambassadors6. Learning events
1. Initial assessment of alignment & capability2. Recruiting central QI team3. Online training4. Face-to-face training5. Follow-up coaching on projects6. Develop in-house training for 2016 onwards
1. Align all projects with improvement aims2. Align team / service goals with improvement aims3. Align all corporate and support systems4. Patient and carer involvement in all improvement
work5. Embed improvement within management structures
Reducing Harm by 30% every year1. Reduce harm from inpatient violence2. Reduce harm from falls3. Reduce harm from pressure ulcers4. Reduce harm from medication errors5. Reduce harm from restraints
Right care, right place, right time1. Improving patient and carer experience2. Reliable delivery of evidence-based care3. Reducing delays and inefficiencies in the system4. Improving access to care at the right location 8
@ELFT_QI
Trust board bespoke learning sessions
Visiting other organisations that successfully implemented QI
Sentinel event
Focus groups
Building the will for change
Early small scale tests of QI methodology
9
AIM:To provide the highest
quality mental
health and community
care in England by
2020
Build the will
QI microsite the online hub for the programme has 60,000 page views to date qi.elft.nhs.uk
Staff and service user newsletter reaches 5000 people every month
10
AIM:To provide the highest
quality mental
health and community
care in England by
2020
Build the will
QI microsite the online hub for the programme has 65,000 page views to date qi.elft.nhs.uk
Staff and service user newsletter reaches 5000 people every month
QI launch event and roadshows attended by over 1000 staff, service users and carers
Bespoke QI learning events for staff, service users, commissioners, governors
11
AIM:To provide the highest
quality mental
health and community
care in England by
2020
Build the will
QI microsite the online hub for the programme has 60,000 page views to date qi.elft.nhs.uk
Staff and service user newsletter reaches 5000 people every month
QI launch event and roadshows attended by over 1000 staff, service users and carers
Bespoke QI learning events for staff, service users, commissioners, governors
Annual QI conference attended by over 270 staff, patients and external partners
ELFT experience day attended by over 70 international delegates
QI visibility wall to describe programme & update on progress
12
Building the Will: QI MicrositeThere have been over 60,000 views of the microsite with the number of weekly visits increasing over the year .
Staff report finding the microsite as a useful tool
4034,7
UCL
0
1000
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7000
8000
Jan-
14
Feb-
14
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-14
Apr
-14
May
-14
Jun-
14
Jul-1
4
Aug
-14
Sep
-14
Oct
-14
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-14
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-14
Jan-
15
Feb-
15
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-15
Apr
-15
May
-15
Jun-
15
Jul-1
5
Aug
-15
Mon
thly
Pag
e Vi
ews
Month
Monthly page views of the QI microsite - I Chart
13
AIM:To provide the highest
quality mental
health and community
care in England by
2020 Build improvement
capability
14
Experts
Front line staff
Managers and clinical leads
QI coaches
Board
Estimated number = 5000Requirement = introduction to quality improvement, identifying problems, change ideas, testing and measuring
changeTime-frame = train 10-20% in 2 years
Estimated number = 800Requirement = deeper understanding
of improvement methodology, measurement and using data, leading
teams in QITime-frame = train 30-50% in 2 years
Estimated number = 30Requirement = deeper understanding
of improvement methodology, understanding variation, coaching
teams and individualsTime-frame = train 100% in 2 years
Estimated number = 15Requirement = setting direction and
big goals, executive leadership, oversight of improvement, being a
champion, understanding variation to lead
Time-frame = train 100% in 2 years
Estimated number = 7Requirement = deep statistical process control, deep improvement methods, effective plans for implementation &
spreadTime-frame = train 100% in 2 years
Where are we?On track to train over 500
people through 5 six-month waves of ISIA between 2014-
16. New Pocket QI course commencing from October
2015
380 people have completed the ISA so far, with approx. 500 estimated to complete
within first 2 years
Developing QI coaches programme will train 30 QI
coaches in 2015
Most Executives will have undertaken the ISIA, and all
will have received Board sessions together with the
non-Executive Directors
Currently have 6 improvement advisors, with
4.3wte deployed to QI. To increase to 7 IA’s in 2016
(5.5 wte). 15
AIM:To provide the highest
quality mental
health and community
care in England by
2020 Build improvement
capability
Support for improvement work from the Trust’s QI
team
Partnership with IHI on delivery of QI training to
staff and Trust Board, and strategic guidance from IHI
executive team16
AIM:To provide the highest
quality mental
health and community
care in England by
2020 Build improvement
capability
Face to face improvement training -hundreds of staff, services users, Governors to be trained over the next few years
IHI Open School online training resource available to all. Providing essential skills to support people leading quality improvement.
Support for improvement work from the Trust’s QI
team
Partnership with IHI on delivery of QI training to
staff and Trust Board, and strategic guidance from IHI
executive team17
Prework Workshop9/29-10/1
Webex 110/14
Webex 211/2
Supports:• Listserve• Assignments
AP-1 AP-2Webex 3
11/30AP-3
ProjectPlanning Reliability Sustaining
Gains
Workshop
(3 days)
Webex #2Webex #1
• Faculty consults• Webex calls• Coaching calls
Webex #3 Learning Set 2 &
graduation
AP-5AP-4
The two learning sets will be focused on sharing the participants’ work on their projects and learning from each other. These sessions also will reinforce the
content from the Webex calls and the ISIA workshop.
Improvement Science in Action - 6 month learning path
Learning set 1
18
AIM:To provide the highest
quality mental
health and community
care in England by
2020 Build improvement
capability
Face to face improvement training -hundreds of staff, services users, Governors to be trained over the next few years
QI coaches- 30 staff to become coaches, spending 1 day/week
supporting local QI projects
IHI Open School online training resource available to all. Providing essential skills to support people leading quality improvement.
Support for improvement work from the Trust’s QI
team
Working upstream with external partners to build capability around continuous improvement
Partnership with IHI on delivery of QI training to
staff and Trust Board, and strategic guidance from IHI
executive team19
AIM:To provide the highest
quality mental
health and community
care in England by
2020
Alignment
20
Starting an Improvement Project
At ELFT
21
qi.elft.nhs.uk
22
23
24
25
To assist in this process we
have a Project Charter form that defines
what we want to accomplish.
26
Driver Diagrams
Support and resources available on microsite:http://qi.elft.nhs.uk/driver-diagrams/
27
Complete Your Charter and Driver Diagram!
• Email to QI team
• QI team or QI coach will get in contact in a few days
28
QI Resources
Project Sponsor
QI Forums
QI Coach
29
AIM:To provide the highest
quality mental
health and community
care in England by
2020
A process is in place forteams to submitproject ideas to the QIteam, who will helpwith planning,structure andmeasurement, andensure projects arealigned with our high-level aims.
Quality improvement programme-project support structures
Alignment
30
AIM:To provide the highest
quality mental
health and community
care in England by
2020
Alignment
31
AIM:To provide the highest
quality mental
health and community
care in England by
2020
QI projects
32
Our QI Projects
60
70
80
90
100
110
120
130
140
150
sep-14 okt-14 nov-14 dec-14 jan-15 feb-15 mar-15 apr-15 maj-15 jun-15 jul-15
No.
of n
ew p
roje
cts
No. of active projects per month
33
34
Trust project status over time
14 12 11 11 15 11
60
25 22
16 17 17 18 1515
15
3128
31 29 25 23 2522
21
35 4419 1920 20
2426
25 29 29
9 9 13 1317
16
15 15 14
97 10 10
12 17
17 19 19
2 6 7 7
9 9
10 8 7
3 3 2 2
4 3
3 4 4
1 1 2 2
5 7
7 10 84
16-Mar-15 30-Mar-15 13-Apr-15 27-Apr-15 19-May-15 28-May-15 15-Jun-15 7-Jul-15 13-Aug-15
35
August
36
Right Care, Right Place, Right Time
MHCOPLarch Lodge, Cedar Lodge, Sally Sherman Ward
CHNEPCS Teams (North East, North
West, Central, South)Multiple I/P Wards (Cazebon, Sally
Sherman and Fothergaile) City & HackneyAdult Psychiatry CMHT, All CMHT’s, Assertive Outreach, Rehab, Joshua, Conolly
NewhamCMHT’s, Newham Centre for Mental Health
CHN / MHCOPUrgent Care Centre
Children’sNewham CFCS, CDC West Ham
Lane, Community CAMHS TH, OT, Health Visiting
CHN / MHCOPNewham Memory Service
C&HSouth CMHT, AOS & CRRT, North
Team 1 Recovery/Primary Care
ForensicsClerkenwell, West Ferry Ward
REDUCE HARM BY 30% EVERY
YEAR
RIGHT CARE, RIGHT PLACE, RIGHT TIME
VIOLENCE REDUCTION
PHYSICAL HEALTH
ACCESS TO SERVICES
PRESSURE ULCERS
TH CollaborativeRoman, Globe, Bricklane, Lea, Millharbour, Rosebank
Children’sAll Community CAMHS, Adolescent MHT
ForensicsWoodberry, Victoria, Limehouse, Morrison
Psychological / LDCommunity Learning Disability Service
SmokingForensics, Millharbour
PsychologicalOlder People Richmond /
Newham, City and Hackney, Newham
CAMHSCoborn Unit
Tower Hamlets
37
• Reduced violence by 26% across all 6 wards. Reduced from 11.8 incidents of violence per 1000 Occupied Bed Day (OBD) every fortnight, to 8.8 incidents/1000 OBD.
Tower Hamlets Violence Collaborative
Tower Hamlets Collaborative
Roman ward, Globe ward, Brick Lane ward, Lea ward,
Millharbour ward, Rosebank ward
REDUCE HARM BY 30% EVERY
YEAR
VIOLENCE REDUCTION
38
UCL
LCL0
5
10
15
20
25
30
06-J
an-1
420
-Jan
-14
03-F
eb-1
417
-Feb
-14
03-M
ar-1
417
-Mar
-14
31-M
ar-1
414
-Apr
-14
28-A
pr-1
412
-May
-14
26-M
ay-1
409
-Jun
-14
23-J
un-1
407
-Jul
-14
21-J
ul-1
404
-Aug
-14
18-A
ug-1
401
-Sep
-14
15-S
ep-1
429
-Sep
-14
13-O
ct-1
427
-Oct
-14
10-N
ov-1
424
-Nov
-14
08-D
ec-1
422
-Dec
-14
05-J
an-1
519
-Jan
-15
02-F
eb-1
516
-Feb
-15
02-M
ar-1
516
-Mar
-15
30-M
ar-1
513
-Apr
-15
27-A
pr-1
511
-May
-15
25-M
ay-1
508
-Jun
-15
22-J
un-1
506
-Jul
-15
20-J
ul-1
503
-Aug
-15
17-A
ug-1
531
-Aug
-15
No.
of I
ncid
ents
per
100
0 O
BD
Incidents resulting in Physical Violenceper 1000 occupied bed days (OBD) - U Chart
Outcome measures - Acute Wards only
5.8 to 2.4 incidents/1000 OBD = 57% reduction
Note, there have been no reported incidents resulting in staff injury on the Acute Wards since 7th Sept (each dot shows when incidents were reported prior to that)
39
5,8
2,4
UCL
LCL0
2
4
6
8
10
12
14
16
06-J
an-1
420
-Jan
-14
03-F
eb-1
417
-Feb
-14
03-M
ar-1
417
-Mar
-14
31-M
ar-1
414
-Apr
-14
28-A
pr-1
412
-May
-14
26-M
ay-1
409
-Jun
-14
23-J
un-1
407
-Jul
-14
21-J
ul-1
404
-Aug
-14
18-A
ug-1
401
-Sep
-14
15-S
ep-1
429
-Sep
-14
13-O
ct-1
427
-Oct
-14
10-N
ov-1
424
-Nov
-14
08-D
ec-1
422
-Dec
-14
05-J
an-1
519
-Jan
-15
02-F
eb-1
516
-Feb
-15
02-M
ar-1
516
-Mar
-15
30-M
ar-1
513
-Apr
-15
27-A
pr-1
511
-May
-15
25-M
ay-1
508
-Jun
-15
22-J
un-1
506
-Jul
-15
20-J
ul-1
503
-Aug
-15
17-A
ug-1
531
-Aug
-15
No.
of I
ncid
ents
per
100
0 O
BD
Incidents of Physical Violence (Acute wards only)per 1000 occupied bed days (OBD) - U Chart
23
0
20
40
60
80
100
05-J
an-1
4
13-J
an-1
4
29-J
an-1
4
29-J
an-1
4
12-F
eb-1
4
07-M
ar-1
4
30-M
ar-1
4
05-A
pr-1
4
19-A
pr-1
4
19-A
pr-1
4
22-A
pr-1
4
30-A
pr-1
4
01-M
ay-1
4
02-J
un-1
4
20-J
un-1
4
21-J
un-1
4
26-J
un-1
4
02-J
ul-1
4
09-A
ug-1
4
21-N
ov-1
4
08-M
ar-1
5
20-A
pr-1
5
06-M
ay-1
5
16-M
ay-1
5
30-A
ug-1
5
07-S
ep-1
5
18-S
ep-1
5
Tim
e be
twee
n ev
ents
/ da
ys
Days between incidents resulting in staff injury (Acute wards only) - T Chart
OU
TCO
ME
MEA
SURE
S -A
CUTE
Outcome measures - PICUs only
No significant changes, with mean of 35 incidents/1000 OBD
40
UCL
LCL0
10
20
30
40
50
60
70
80
90
100
06-J
an-1
420
-Jan
-14
03-F
eb-1
417
-Feb
-14
03-M
ar-1
417
-Mar
-14
31-M
ar-1
414
-Apr
-14
28-A
pr-1
412
-May
-…26
-May
-…09
-Jun
-14
23-J
un-1
407
-Jul
-14
21-J
ul-1
404
-Aug
-14
18-A
ug-1
401
-Sep
-14
15-S
ep-1
429
-Sep
-14
13-O
ct-1
427
-Oct
-14
10-N
ov-1
424
-Nov
-14
08-D
ec-1
422
-Dec
-14
05-J
an-1
519
-Jan
-15
02-F
eb-1
516
-Feb
-15
02-M
ar-1
516
-Mar
-15
30-M
ar-1
513
-Apr
-15
27-A
pr-1
511
-May
-…25
-May
-…08
-Jun
-15
22-J
un-1
506
-Jul
-15
20-J
ul-1
503
-Aug
-15
17-A
ug-1
531
-Aug
-15N
o. o
f Inc
iden
ts p
er 1
000
OB
D
Incidents of Physical Violence (PICU's only)per 1000 occupied bed days (OBD) - U Chart
37
0
10
20
30
40
50
60
70
10-J
an-1
421
-Jan
-14
21-M
ar-1
424
-Mar
-14
27-M
ar-1
411
-Apr
-14
22-A
pr-1
426
-Jun
-14
26-J
un-1
403
-Jul
-14
20-J
ul-1
431
-Jul
-14
06-A
ug-1
421
-Aug
-14
25-A
ug-1
412
-Sep
-14
29-S
ep-1
401
-Oct
-14
30-O
ct-1
412
-Nov
-14
12-N
ov-1
418
-Nov
-14
20-N
ov-1
424
-Nov
-14
29-N
ov-1
407
-Dec
-14
20-D
ec-1
420
-Dec
-14
21-D
ec-1
431
-Dec
-14
07-J
an-1
509
-Jan
-15
11-J
an-1
511
-Jan
-15
13-J
an-1
526
-Jan
-15
03-F
eb-1
512
-Feb
-15
14-F
eb-1
515
-Feb
-15
23-F
eb-1
511
-Mar
-15
21-M
ar-1
522
-Mar
-15
23-M
ar-1
524
-Mar
-15
27-M
ar-1
522
-May
-15
17-J
un-1
528
-Jul
-15
29-J
ul-1
504
-Aug
-15
09-A
ug-1
516
-Aug
-15
17-A
ug-1
524
-Aug
-15
18-S
ep-1
5
Tim
e be
twee
n ev
ents
/ da
ys
Days between incidents resulting in staff injury (PICU's only) - T Chart
There have been no reported incidents resulting in staff injury since 24th Aug
OU
TCO
ME
MEA
SURE
S –
PICU
Outcome measures by individual acute wards
Because of the small number of incidents on each of the Acute Wards, these charts show “days between incidents” by fortnight, so we can still look at data over time.
41
65 days since last incident
0
10
20
30
40
50
60
7014
-Feb
-14
26-F
eb-1
410
-Mar
-14
16-M
ar-1
422
-Mar
-14
04-A
pr-1
424
-Apr
-14
24-A
pr-1
430
-Apr
-14
30-A
pr-1
405
-May
-14
16-M
ay-1
411
-Jun
-14
12-J
un-1
420
-Jun
-14
27-J
un-1
428
-Jun
-14
01-J
ul-1
427
-Jul
-14
04-A
ug-1
406
-Sep
-14
13-S
ep-1
418
-Sep
-14
29-S
ep-1
407
-Oct
-14
09-N
ov-1
411
-Nov
-14
14-N
ov-1
420
-Dec
-14
30-J
an-1
511
-Mar
-15
20-A
pr-1
520
-Apr
-15
14-M
ay-1
516
-May
-15
07-J
un-1
517
-Jun
-15
14-J
ul-1
515
-Jul
-15
15-J
ul-1
518
-Sep
-15
Tim
e be
twee
n ev
ents
/ da
ysDays between incidents of Physical Violence (Bricklane ward) - T Chart
71 days since last incident
0
20
40
60
80
100
120
140
10-J
an-1
4
11-J
an-1
4
11-J
an-1
4
11-J
an-1
4
11-J
an-1
4
11-J
an-1
4
26-F
eb-1
4
27-F
eb-1
4
05-A
pr-1
4
02-J
un-1
4
19-J
un-1
4
21-J
un-1
4
26-J
un-1
4
02-J
ul-1
4
04-A
ug-1
4
22-D
ec-1
4
22-D
ec-1
4
16-M
ar-1
5
20-M
ar-1
5
11-J
un-1
5
09-J
ul-1
5
18-S
ep-1
5
Tim
e be
twee
n ev
ents
/ da
ys
Days between incidents of Physical Violence (Globe ward) - T Chart
44 days since last incident
0
10
20
30
40
50
60
70
18-J
an-1
4
30-J
an-1
4
11-F
eb-1
4
17-F
eb-1
4
27-F
eb-1
4
05-M
ar-1
4
11-M
ar-1
4
29-M
ar-1
4
30-M
ar-1
4
17-A
pr-1
4
19-A
pr-1
4
26-A
pr-1
4
20-J
ul-1
4
02-A
ug-1
4
08-S
ep-1
4
19-O
ct-1
4
23-N
ov-1
4
17-J
an-1
5
03-F
eb-1
5
11-M
ar-1
5
09-J
un-1
5
02-J
ul-1
5
25-J
ul-1
5
Tim
e be
twee
n ev
ents
/ da
ys
Days between incidents of Physical Violence (Lea ward) - T Chart
19 days since last incident
0
20
40
60
80
100
120
09-J
an-1
4
16-J
an-1
4
29-J
an-1
4
10-F
eb-1
4
10-M
ar-1
4
29-M
ar-1
4
30-M
ar-1
4
10-A
pr-1
4
01-M
ay-1
4
20-M
ay-1
4
29-J
un-1
4
11-J
ul-1
4
31-J
ul-1
4
07-A
ug-1
4
15-S
ep-1
4
19-S
ep-1
4
27-S
ep-1
4
28-S
ep-1
4
10-O
ct-1
4
16-D
ec-1
4
23-J
an-1
5
31-M
ar-1
5
06-M
ay-1
5
30-A
ug-1
5
Tim
e be
twee
n ev
ents
/ da
ys
Incidents of Physical Violence (Roman ward) - T Chart
OU
TCO
ME
MEA
SURE
S –
ACU
TE
Outcome measures by individual PICU wards
42
19,6
3,8
29,9
UCL
LCL0
20
40
60
80
100
120
140
06-J
an-1
4
20-J
an-1
4
03-F
eb-1
4
17-F
eb-1
4
03-M
ar-1
4
17-M
ar-1
4
31-M
ar-1
4
14-A
pr-1
4
28-A
pr-1
4
12-M
ay-1
4
26-M
ay-1
4
09-J
un-1
4
23-J
un-1
4
07-J
ul-1
4
21-J
ul-1
4
04-A
ug-1
4
18-A
ug-1
4
01-S
ep-1
4
15-S
ep-1
4
29-S
ep-1
4
13-O
ct-1
4
27-O
ct-1
4
10-N
ov-1
4
24-N
ov-1
4
08-D
ec-1
4
22-D
ec-1
4
05-J
an-1
5
19-J
an-1
5
02-F
eb-1
5
16-F
eb-1
5
02-M
ar-1
5
16-M
ar-1
5
30-M
ar-1
5
13-A
pr-1
5
27-A
pr-1
5
11-M
ay-1
5
25-M
ay-1
5
08-J
un-1
5
22-J
un-1
5
06-J
ul-1
5
20-J
ul-1
5
03-A
ug-1
5
17-A
ug-1
5
31-A
ug-1
5
No.
of I
ncid
ents
per
100
0 O
BD
Incidents of Physical Violence (Millharbour ward)per 1000 occupied bed days (OBD) - U Chart
39,8
99,3
36,7
UCL
LCL0
50
100
150
200
06-J
an-1
4
20-J
an-1
4
03-F
eb-1
4
17-F
eb-1
4
03-M
ar-1
4
17-M
ar-1
4
31-M
ar-1
4
14-A
pr-1
4
28-A
pr-1
4
12-M
ay-1
4
26-M
ay-1
4
09-J
un-1
4
23-J
un-1
4
07-J
ul-1
4
21-J
ul-1
4
04-A
ug-1
4
18-A
ug-1
4
01-S
ep-1
4
15-S
ep-1
4
29-S
ep-1
4
13-O
ct-1
4
27-O
ct-1
4
10-N
ov-1
4
24-N
ov-1
4
08-D
ec-1
4
22-D
ec-1
4
05-J
an-1
5
19-J
an-1
5
02-F
eb-1
5
16-F
eb-1
5
02-M
ar-1
5
16-M
ar-1
5
30-M
ar-1
5
13-A
pr-1
5
27-A
pr-1
5
11-M
ay-1
5
25-M
ay-1
5
08-J
un-1
5
22-J
un-1
5
06-J
ul-1
5
20-J
ul-1
5
03-A
ug-1
5
17-A
ug-1
5
31-A
ug-1
5
No.
of I
ncid
ents
per
100
0 O
BD
Incidents of Physical Violence (Rosebank ward)per 1000 occupied bed days (OBD) - U Chart
OU
TCO
ME
MEA
SURE
S -P
ICU
What change ideas are making the difference?• 3 Safety Huddles per day, Safety Cross and Broset Violence Checklist.
Next steps• Wards currently working on ensuring Safety Huddles are focused on
outcomes• Wards also now working to integrate SafeWards evidence based
interventions (see www.safewards.net) • Next collaborative October 5th with IHI. Plan to co-design with ward teams
and include session with SUs at beginning of this meeting
43
BALA
NCI
NG
MEA
SURE
S
UCL
LCL0
5
10
15
20
25
06-J
an-1
420
-Jan
-14
03-F
eb-1
417
-Feb
-14
03-M
ar-1
417
-Mar
-14
31-M
ar-1
414
-Apr
-14
28-A
pr-1
412
-May
-14
26-M
ay-1
409
-Jun
-14
23-J
un-1
407
-Jul
-14
21-J
ul-1
404
-Aug
-14
18-A
ug-1
401
-Sep
-14
15-S
ep-1
429
-Sep
-14
13-O
ct-1
427
-Oct
-14
10-N
ov-1
424
-Nov
-14
08-D
ec-1
422
-Dec
-14
05-J
an-1
519
-Jan
-15
02-F
eb-1
516
-Feb
-15
02-M
ar-1
516
-Mar
-15
30-M
ar-1
513
-Apr
-15
27-A
pr-1
511
-May
-15
25-M
ay-1
508
-Jun
-15
22-J
un-1
506
-Jul
-15
20-J
ul-1
503
-Aug
-15
17-A
ug-1
531
-Aug
-15
No.
of I
ncid
ents
per
100
0 O
BD
Incidents resulting in Restraintper 1000 occupied bed days (OBD) - U Chart
UCL
LCL0123456789
10
06-J
an-1
420
-Jan
-14
03-F
eb-1
417
-Feb
-14
03-M
ar-1
417
-Mar
-14
31-M
ar-1
414
-Apr
-14
28-A
pr-1
412
-May
-14
26-M
ay-1
409
-Jun
-14
23-J
un-1
407
-Jul
-14
21-J
ul-1
404
-Aug
-14
18-A
ug-1
401
-Sep
-14
15-S
ep-1
429
-Sep
-14
13-O
ct-1
427
-Oct
-14
10-N
ov-1
424
-Nov
-14
08-D
ec-1
422
-Dec
-14
05-J
an-1
519
-Jan
-15
02-F
eb-1
516
-Feb
-15
02-M
ar-1
516
-Mar
-15
30-M
ar-1
513
-Apr
-15
27-A
pr-1
511
-May
-15
25-M
ay-1
508
-Jun
-15
22-J
un-1
506
-Jul
-15
20-J
ul-1
503
-Aug
-15
17-A
ug-1
531
-Aug
-15
No.
of I
ncid
ents
per
100
0 O
BD
Incidents resulting in Rapid Tranqper 1000 occupied bed days - U Chart
2,91,4
UCL
LCL0123456789
06-J
an-1
420
-Jan
-14
03-F
eb-1
417
-Feb
-14
03-M
ar-1
417
-Mar
-14
31-M
ar-1
414
-Apr
-14
28-A
pr-1
412
-May
-14
26-M
ay-1
409
-Jun
-14
23-J
un-1
407
-Jul
-14
21-J
ul-1
404
-Aug
-14
18-A
ug-1
401
-Sep
-14
15-S
ep-1
429
-Sep
-14
13-O
ct-1
427
-Oct
-14
10-N
ov-1
424
-Nov
-14
08-D
ec-1
422
-Dec
-14
05-J
an-1
519
-Jan
-15
02-F
eb-1
516
-Feb
-15
02-M
ar-1
516
-Mar
-15
30-M
ar-1
513
-Apr
-15
27-A
pr-1
511
-May
-15
25-M
ay-1
508
-Jun
-15
22-J
un-1
506
-Jul
-15
20-J
ul-1
503
-Aug
-15
17-A
ug-1
531
-Aug
-15
No.
of I
ncid
ents
per
100
0 O
BD
Incidents resulting in Seclusionper 1000 occupied occupied bed days (OBD) - U Chart
UCL
LCL0
2
4
6
8
10
12
06-J
an-1
420
-Jan
-14
03-F
eb-1
417
-Feb
-14
03-M
ar-1
417
-Mar
-14
31-M
ar-1
414
-Apr
-14
28-A
pr-1
412
-May
-…26
-May
-…09
-Jun
-14
23-J
un-1
407
-Jul
-14
21-J
ul-1
404
-Aug
-14
18-A
ug-1
401
-Sep
-14
15-S
ep-1
429
-Sep
-14
13-O
ct-1
427
-Oct
-14
10-N
ov-1
424
-Nov
-14
08-D
ec-1
422
-Dec
-14
05-J
an-1
519
-Jan
-15
02-F
eb-1
516
-Feb
-15
02-M
ar-1
516
-Mar
-15
30-M
ar-1
513
-Apr
-15
27-A
pr-1
511
-May
-…25
-May
-…08
-Jun
-15
22-J
un-1
506
-Jul
-15
20-J
ul-1
503
-Aug
-15
17-A
ug-1
531
-Aug
-15
No.
of I
ncid
ents
per
100
0 O
BD
Incidents resulting in Restraint (Acute wards only)per 1000 occupied bed days (OBD) - U Chart
UCL
LCL0
10
20
30
40
50
60
70
80
06-J
an-1
420
-Jan
-14
03-F
eb-1
417
-Feb
-14
03-M
ar-1
417
-Mar
-14
31-M
ar-1
414
-Apr
-14
28-A
pr-1
412
-May
-14
26-M
ay-1
409
-Jun
-14
23-J
un-1
407
-Jul
-14
21-J
ul-1
404
-Aug
-14
18-A
ug-1
401
-Sep
-14
15-S
ep-1
429
-Sep
-14
13-O
ct-1
427
-Oct
-14
10-N
ov-1
424
-Nov
-14
08-D
ec-1
422
-Dec
-14
05-J
an-1
519
-Jan
-15
02-F
eb-1
516
-Feb
-15
02-M
ar-1
516
-Mar
-15
30-M
ar-1
513
-Apr
-15
27-A
pr-1
511
-May
-15
25-M
ay-1
508
-Jun
-15
22-J
un-1
506
-Jul
-15
20-J
ul-1
503
-Aug
-15
17-A
ug-1
531
-Aug
-15
No.
of I
ncid
ents
per
100
0 O
BD
Incidents resulting in Restraint (PICU's only)per 1000 occupied bed days (OBD) - U Chart
UCL
LCL
30
35
40
45
50
55
60
65
70
75
80
Jan-
14
Feb-
14
Mar
-14
Apr-1
4
May
-14
Jun-
14
Jul-1
4
Aug-
14
Sep-
14
Oct
-14
Nov
-14
Dec
-14
Jan-
15
Feb-
15
Mar
-15
Apr-1
5
May
-15
Jun-
15
Jul-1
5
Aug-
15
Staf
f sic
knes
s (F
TE) p
er 1
000
OB
D
Staff Sickness (FTE) per 1000 occupied bed days (OBD) - U Chart
45
OTH
ER U
SEFU
L CH
ARTS
UCL
LCL
20
30
40
50
60
70
80
90
100
06-J
an-1
4
20-J
an-1
4
03-F
eb-1
4
17-F
eb-1
4
03-M
ar-1
4
17-M
ar-1
4
31-M
ar-1
4
14-A
pr-1
4
28-A
pr-1
4
12-M
ay-1
4
26-M
ay-1
4
09-J
un-1
4
23-J
un-1
4
07-J
ul-1
4
21-J
ul-1
4
04-A
ug-1
4
18-A
ug-1
4
01-S
ep-1
4
15-S
ep-1
4
29-S
ep-1
4
13-O
ct-1
4
27-O
ct-1
4
10-N
ov-1
4
24-N
ov-1
4
08-D
ec-1
4
22-D
ec-1
4
05-J
an-1
5
19-J
an-1
5
02-F
eb-1
5
16-F
eb-1
5
02-M
ar-1
5
16-M
ar-1
5
30-M
ar-1
5
13-A
pr-1
5
27-A
pr-1
5
11-M
ay-1
5
25-M
ay-1
5
08-J
un-1
5
22-J
un-1
5
06-J
ul-1
5
20-J
ul-1
5
No.
of I
ncid
ents
Incidents resulting in Physical Violence (Trust-Wide) - C Chart
UCL
LCL
3
4
5
6
7
8
9
10
11
12
06-J
an-1
4
20-J
an-1
4
03-F
eb-1
4
17-F
eb-1
4
03-M
ar-1
4
17-M
ar-1
4
31-M
ar-1
4
14-A
pr-1
4
28-A
pr-1
4
12-M
ay-1
4
26-M
ay-1
4
09-J
un-1
4
23-J
un-1
4
07-J
ul-1
4
21-J
ul-1
4
04-A
ug-1
4
18-A
ug-1
4
01-S
ep-1
4
15-S
ep-1
4
29-S
ep-1
4
13-O
ct-1
4
27-O
ct-1
4
10-N
ov-1
4
24-N
ov-1
4
08-D
ec-1
4
22-D
ec-1
4
05-J
an-1
5
19-J
an-1
5
02-F
eb-1
5
16-F
eb-1
5
02-M
ar-1
5
16-M
ar-1
5
30-M
ar-1
5
13-A
pr-1
5
27-A
pr-1
5
11-M
ay-1
5
25-M
ay-1
5
08-J
un-1
5
22-J
un-1
5
06-J
ul-1
5
No.
of I
ncid
ents
per
100
0 O
BD
Incidents resulting in Physical Violence (Trust-wide)per 1000 occupied bed days (OBD) - U Chart
46
0
5
10
15
20
25
30
35
jan-
13
feb-
13
mar
-13
apr-
13
maj
-13
jun-
13
jul-1
3
aug-
13
sep-
13
okt-
13
nov-
13
dec-
13
jan-
14
feb-
14
mar
-14
apr-
14
maj
-14
jun-
14
jul-1
4
aug-
14
sep-
14
okt-
14
nov-
14
dec-
14
jan-
15
feb-
15
mar
-15
apr-
15
maj
-15
jun-
15
No.
of I
ncid
ents
per
100
0 O
BD
Incidents of physical violence per 1000 occupied bed days (OBD)
Participating wards
Non-Participating wards
47