On 4 July 2017, the Urgent and Emergency Care (UEC) Improvement Collaborative was launched as a catalyst for our continued collective effort across London to improve urgent and emergency care. A key part of any successful improvement collaborative is the use of detailed data and local knowledge to diagnose and drive improvement.
With renewed focus nationally on supporting patients to return home as quickly as possible, day of care surveys were conducted across 17 acute sites in London over three days on all inpatient beds except: paediatrics; obstetrics; intensive care and mental health. Since the development of the survey tool it has been used in England, Scotland and Australia with a total of 10,000 patients/beds audited over recent years; in London across just three days approximately 7500 patients/beds were surveyed. A feat made possible by the fantastic engagement from acute sites. We are grateful to everyone who participated.
The day of care survey is a peer reviewed tool which provides a snapshot in time of the patients in a hospital, next steps in their journey and any potential delays to them moving appropriately through the hospital to home using a simple, easy to understand approach. The surveys, led by Dr Simon Watkin, Consultant Physician, NHS Borders, provide access to local data that can be used to identify opportunities to improve people’s experience of being in hospital; identifying where there are delays to inform system wide improvement efforts.
In line with the principle of the collaborative to build capacity and capability for improvement, train the trainer sessions took place with site co-ordinators from across London’s trusts led by Dr Watkin. Following the surveys individual site reports were developed and sent to sites on the day of the survey and data is now being triangulated with the patient flow baseline and non-admitted and admitted patient data flow reports undertaken recently by the collaborative; together the data will inform site based recommendations to drive local improvements. This data allows individual sites to establish, down to ward level, reasons for delays and where to target improvements whilst also identifying where wider system blocks exist and need to be addressed.
The collaborative will be facilitating workshops with local systems to further support improvement and action planning; support will then be provided to local systems to take forward actions, with expert on-site support and facilitation where needed and routine check ins to ensure barriers are unblocked. In addition, to support local areas to build a systematic approach to quality improvement an e-learning resource has been commissioned, QI4U. It is targeted, but not limited to, frontline clinicians, professionals, service managers, patients and service users. To access the online learning resource please follow this link: http://hlp.qi4u.org/login
The next collaborative event on 7 December 2017 is also an opportunity to hear the themes from the Day of Care surveys across London, learn from good practice in London and take part in workshops to inform quality improvement cycles, such as data for improvement, stakeholder engagement, process mapping and PDSA (Plan Do Study Act).