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Delivered and presented by: Liz Tomlin – Head of Quality Improvement and Clinical Outcomes, Bradford Teaching Hospitals NHS Foundation Trust

Abstract

There are very few routine and reliable mechanisms for patients, carers and families to escalate past the primary team when concerned about standard care not meeting their needs. Failing to escalate in a timely manner timely can have adverse effects to patient outcomes. It has been recognised that having reliable patient and family escalation systems is also a quality marker of patient centred care. NHS England’s Worry and Concern Task and Finish Group (a subgroup of the Acute Deterioration Board) have run a national improvement collaborative from April 2023 for 12 months. Bradford Teaching Hospitals NHS Foundation Trust has participated in this pilot to develop, test, implement and evaluate methods to incorporate patients’ views of their wellness/illness and worries and concerns in the assessment and recognition of acute illness and risk of deterioration.
Using a Quality Improvement approach, we adopted the Patient Wellness Questionnaire as a tool to measure patient reported wellness. We have conducted small tests of change across three different wards (surgical and medical). We have demonstrated that when used by qualified nursing staff, supported by strong leadership at a ward level, the PWQ is a reliable and useful tool to identify ‘soft signs’ of deterioration and supports nursing staff to escalate to the Critical Care Outreach Team for an independent review.

Biography

Liz is Head of Quality Improvement and Clinical Outcomes at Bradford Teaching Hospitals NHS Foundation Trust. Qualifying as a Registered Nurse in 1990 in adult nursing, Liz has worked in the acute clinical setting for over 16 years. In 2007, Liz joined the Trust and has spent over a decade working in patient safety research at the Bradford Institute of Health Research. Following an MSc in Health Sciences at the University of York, Liz successfully completed a PhD in 2018, funded by the Health Foundation, at the University of Leeds. Her thesis explored the mechanisms of change underpinning a specific quality improvement (QI) methodology: experienced based co-design. Liz has pursued her interests with Improvement Science and has experience in patient and public involvement and engagement in the healthcare setting. Liz is committed to delivering meaningful changes to improve the quality and safety of patient care and improving the work experience for staff.

Presentation

Delivered and presented by:  Professor Ian Leistikow

Role and organisation

• Adviser at the Dutch Health & Youth Care Inspectorate
• Professor at Erasmus School of Health Policy & Management, Erasmus University Rotterdam, the Netherlands

Abstract

Challenges that health & care faces, translate to challenges for the regulatory authorities. Classic regulatory strategies aimed at compliance increasingly fall short in contributing to quality of (health)care. In this webinar Ian will use the model of ‘value driven regulation’ to show how the Dutch Inspectorate strives to keep up with the dynamics of the sectors it regulates, by keeping its eye on creating societal value. Ian will also give an overview of the broad range of scientific research projects within the Inspectorate aimed at improving the positive impact of its regulation.

NB The Dutch Inspectorate regulates/oversees all Dutch professionals and providers of healthcare, (long-term) care, youth care, pharmaceutical products and medical technology.

Biography

Ian Leistikow is inspector/advisor at the Dutch Health & Youth Care Inspectorate and professor at Erasmus University Rotterdam where he conducts and supervises research into ‘governmental regulation of health and care quality’. He is a non-practicing physician. In 2011 Ian became member of the Program Advisory Committee of the International Forum on Quality and Safety in Healthcare (BMJ/IHI). Ian is board member of SINC, an international collaboration of European health and care regulators. Ian teaches and publishes about patient safety and the role of regulation. In 2017 CRC Press published his book “Prevention is better than cure”, on learning from adverse events in healthcare.

Webinar Link

Delivered and presented by: Dr Laura Sheard

Associate Professor, University of York
Honorary Principal Research Fellow, Bradford Institute for Health Research

Abstract

The quality and safety of healthcare in prisons in the UK has had relatively little attention paid to it, in contrast with the abundance of research on these topics in the hospital environment. Prison based medicine is often viewed as a Cinderella area of healthcare provision; largely hidden away from public scrutiny whilst being an underfunded, undervalued and an unattractive sector for healthcare professionals to work in with a high number of complex patients living in overcrowded conditions. Only a few studies have examined everyday primary care provision in prisons (for example, asthma, diabetes or high blood pressure). Yet, the prison setting represents a unique opportunity to intervene and improve the healthcare trajectories of some of the most marginalised people in society.

In this presentation, Laura spoke about the importance of prison healthcare, how it can be improved and she is passionate about this topic. Laura drew on her own experience of the four years she worked in HMP Leeds alongside findings from several mixed methods studies she led in particular “Qual-P” which focused on understanding and improving the quality of and access to everyday primary care in prisons in the North of England.

A large part of the presentation discussed the major factors which influence the quality of primary care. These are: chronic understaffing; high variability of quality between sites, little to no quality measurement; excessive Did Not Attend rate; community-prison interface incompatibility including IT systems and opioid prescribing; facilitative relationships between healthcare staff and patients.

Presentation