Click here to view and download the presentations from the Clinical Change Forum
Date: 30th January 2018 Time: 16:30 – 19:00 Venue: 4th Floor Lecture Theatre, Old Out Patients Building, Western General Hospital
There are 4 exciting change forum events coming up in October and November! These are:
- Wednesday 25th October 2017 - 5 - 6.30pm Royal Hospital for Sick Children, Lecture Theatre
- Tuesday 31st October 2017 - 12 -1pm Royal Infirmary of Edinburgh, Lecture Theatre B
- Thursday 9th November 2017 - 12 - 1pm St John's Hospital, Clinical Skills Lab, Education Centre, 1st Floor
- Thursday 16th November 2017 - 1.30 - 4.30pm Royal Edinburgh Hospital, Annie Altschul Room, 2nd Floor, MacKinnon House
Agendas have been confirmed for most of the events:
Wednesday 25th October 2017 - 5 - 6.30pm Royal Hospital for Sick Children, Lecture Theatre
Improvement work in the children’s spinal pathway - Chris Adams
Cerebral Palsy Integrated Pathway for Scotland (CPIPS) programme - Mark Gaston
Tuesday 31st October 2017 - 12 -1pm Royal Infirmary of Edinburgh, Lecture Theatre B
Thursday 9th November 2017 - 12 - 1pm St John's Hospital, Clinical Skills Lab, Education Centre, 1st Floor
Thursday 16th November 2017 - 1.30 - 4.30pm Royal Edinburgh Hospital, Annie Altschul Room, 2nd Floor, MacKinnon House
The Edinburgh City Clinical Change Forum event took place on 13th September 2017 at 5.30pm - 7pm at Edinburgh City Chambers.
Nathan Richardson-Reid and Dawn Owen described their Pharmacy projects in the Leith area. They described how they had conencted with local third sector agencies to increase awareness of the services available through pharmcy and to increase attendance at minor ailments clinics.
Professor Sheikh spoke about digitsed health and social care data offer numerous opportunities for enhancing population health and patient care. Drawing on examples from work Aziz and his colleagues have undertaken, he described how he has used health record derived data to understand the epidemiology of diseases, evaluate the impact of clinical and public health interventions and increase the efficiency of clinical trials. He then summarised the approaches he is currently pursuing and described an ambition to scale up efforts to create a learning health and care system in Lothain.
17.00 -17.10 Introduction / Welcome – Chris Stirling, Site Director
17.10 – 17.25Surgical Expedition: Base camp to summit and back. – Dr Mike Robson, Consultant Anaesthetist
17.25 – 17.40 End PJ Paralysis – Sam Stirling, Physiotherapist
17.40 – 17.55 Using Patient Opinion for quality improvement – Dr Claire Gordon, Consultant Physician
17.55 – 18.10Enhanced Recovery After Surgery (ERAS) Angie Balfour, Nurse Specialist/Research Nurse
18.10 - 18.25 Improving patient flow – Kris Robertson, Charge Nurse, Ward 57
18.25 – 18.30 Final comments/close
The clinical change forum took place at the REH on the 22nd June 2017. The audience heard about fantastic improvement work from four teams working in Mental Health, CAMHS and Psychological therapies.
Margaret and Gwyneth from the CAMHS team spoke about their project looking at the pathway for ADHD assessment, which aimed to improve efficency and patient experience. Through getting patient feedback and staff ideas for improvement, they have implemented four tests of change and are measuring the impact on the service.
Mike Reid described his work on facilitating the reduction of the number of acute mental health beds ahead of the move to the new REH site. He explained that through improving communication between health and social care, delays for people getting home from hospital had reduced. There had been excellent engagement from the team across the site and there were many ideas for improvement that are currently being tested. There is continuing involvement from the patients council, ensuring the patients have a voice in any of the changes occurring. The project is now working on improving integrated care planning, so that care plans can be viewed by NHS 24 and health and social care.
The Lothian Pain Management team told the audience how they had used patient experience data to inform improvements in the service. They phoned patients who did not turn up for appointments to ask why they had not attended. One of the most frequent responses was that people had forgotten, therefore, the team has started to phone people before pain management groups. They have also been testing the idea of using phone appointments for people who were not able to attend their face to face appointment - this is being tested, the team recognise that this option may not work for everyone.
The next clinical change forum events will take place at the time of the QI Network meeting, at lunchtime. Dates will be confirmed and communicated shortly!
The Works - an organisation which helps people with mental health conditions get into or back into work - also spoke about thier service. They described how they had employed a data officer to look at their data to understand how they could improve the service. The Works encouraged recruiting managers in NHS Lothian who are looking for people 16 hours per week or less to consider recruiting through them. The Works offer two to eight week placements. They are a NHS Lothian vocational rehabilitation service for people living in Edinburgh. They support people with mental health conditions return to work or gain work for the first time. To find out more about the service e-mail the team.
The Clinical Change Forum heard from a number of thought provoking speakers. Nikki Maran gives a reflective account of the presentations in this short video.
Presentations can be found below:
- Quality Improvement in the Emergency Department - Ed James and Kate Easterford
- Using App Technology to Allocate Organs for Transplant - Mark Dunn
- Applying for Small Grants from Lothian Health Foundation - Owen Siddalls
Ed James and Kate Easterford kicked off the event with a presentation of the development of Quality Improvement in the Emergency Department. This was followed by Mark Dunn, who told an exciting story of innovation for allocating organs for transplant. The event closed with a summary from Owen Siddalls about how to apply for small grants from the Lothian Health Foundation.
Nikki Maran also mentioned at the CCF that we have licences for BMJ Quality, which is a tool that you can use to publish QI projects in a peer reviewed journal – you can find more information on how to do this, here.
A reminder that ‘What matters to you?’ day is on the 6th June, you can get more information on their website - http://www.whatmatterstoyou.scot/ If you want to join in activities in NHS Lothian, please contact Julie-Ann Farrer.
For anyone wanting more information on Small Grants in NHS Lothian, please see the Edinburgh and Lothian’s Health Foundation website, here.
Discussions around innovation at the forum inspired interest in 'hackathons' and other innovation events. The next event is through Product Forge and the Cancer Innovation Challenge, who are running an open cancer "data dive" event at CodeBase in Edinburgh from Thursday 15th to Sunday 18th June 2017.
The Data Dive is a unique opportunity for clinicians to explore cancer data in collaboration with entrepreneurially minded data scientists, analysts and software engineers to improve cancer care in the NHS in Scotland.
Register at the Cancer Data Dive event page
The clinical change forum event at St John's Hospital featured presentations about three pieces of improvement work based in and around St John's.
You can find the presentations below:
The group heard from Megan Reid, Service Improvement Manager for Unscheduled Care at St John's. Megan gave a presentation on a discharge planning pilot she and colleagues across multi-disciplines such as physiotherapy, pharmacy and medicine carried out in Ward 9 a general medical ward. The pilot has been influenced by the six essential actions in the Scottish Government’s Unscheduled Care Plan.
The team met twice a day for around 10 minutes to discuss discharge planning for patients that would see patients discharged safely and in a timely manner, helping to free up beds for admissions. The pilot has been very successful and is now being rolled out to other wards at the hospital. Similar work is also being done at the Western General and Royal Infirmary in order to help standardise practice. A case study has also been written up and will be shared with interested colleagues.
The second presentation was delivered by Dr Hosakere Aditya and described quality improvement work currently being conducted in Psychiatry in West Lothian. Hosakere explained the process through which his department has increased consultant capacity, and discussed some of the challenges with the approach.
The group also heard from Dr James McCallum, GP and Associate Medical Director, who presented work undertaken by an FY2 doctor, Pauline McAleer. She carried out an audit looking at the record keeping of patients who had died as it needed to be improved. A form allowing medics to put the information on the TRAK system was developed leading to a marked improvement in record keeping from 20 percent to 90 percent. In addition, it has provided significant other benefits including helping GPs to be kept informed of the death of their patients in a more timely manner, helped inform relatives and is particularly helpful in providing information for reviews under the new death certification process.
James McCallum, GP and Associate Medical Director, is giving the above presentation, around work undertaken by an FY2 doctor, Pauline McAleer. She carried out an audit looking at the record keeping of patients who had died as it needed to be improved. A form allowing medics to put the information on the TRAK system was developed leading to a marked improvement in record keeping from 20 percent to 90 percent. In addition, it has provided significant other benefits including helping GPs to be kept informed of the death of their patients in a more timely manner, helped inform relatives and is particularly helpful in providing information for reviews under the new death certification process.
The latest Clinical Change Forum was held in East Lothian on Tuesday 7th February.
This was the first forum of the new calendar year and was very well attended by clinicians from both primary and secondary care. The audience of over 120 people were joined by Tim Davison, Chief Executive and Brian Houston, Chairman.
The Clinical Change Forums are designed to bring together clinicians from across NHS Lothian to discuss the issues and ensure clinical engagement and leadership.
The aims are to change practice, improve outcomes, to reduce waste and variation, by developing our approach to individual patient care and drive quality.
February’s forum was introduced by Dr Simon Watson alongside Dr Tracey Gillies, who was introduced as the new Executive Medical Director for NHS Lothian.
This was followed by a presentation on quality improvement in Primary Care in Lothian by Dr Lisa Carter, who has recently been appointed as the Quality Lead for Primary Care.
Dr Shelagh Stewart, Cluster Quality Lead, spoke about Quality Improvement specific to East Lothian Clusters.
Four local teams who are currently carrying out valuable quality improvement projects shared their work with the group. All the examples presented were very positively received by the group.
Further presentations on Data Dashboards, Health Literacy, and Health & Social Care concluded the afternoon.
More forums are planned for 2017, with the next one being held on Wednesday 15th March, 5pm -6:30pm at St John’s Hospital. To register your interest in attending, or if you have any questions, comments, suggestions for discussion please visit this page.
Download the presentations
- Welcome & Introduction to Quality in Lothian (Dr Simon Watson, Chief Quality Officer and Dr Tracey Gillies, Executive Medical Director)*
- QI in Primary Care in Lothian (Dr Lisa Carter, Associate Clinical Director, Lothian Unscheduled Care Service (LUCS) and Quality Lead for Primary Care in NHS Lothian)*
- East Lothian Clusters & QI (Dr Shelagh Stewart, Cluster Quality Lead)*
- Examples of local QI projects: "Birthday Reviews" (Dr Anna Beedel, Prestonpans Medical Practice)*
- Examples of local QI projects: "Capturing types of consultation" (Dr Nadeen Brown, Tyne Medical Practice)*
- Examples of local QI projects: "Lothian Interface Group" (Dr Amy Small, Prestonpans Medical Practice)*
- Examples of local QI projects: "QI Academy project" (Dr Jo Smail, Tranent Medical Practice)*
- Data dashboards (Hannah Waite, Principal Information Analyst, Lothian Analytical Sevices)
The December 2016 Clinical Change Fora showcased 5 different change ideas.
At the Royal Infirmary of Edinburgh, Professor Martin Dennis told the forum about his idea for an electronic diary for each patient, which could be adapted to different specialities. We heard from Dr Roger Smyth, who highlighted changes to the law following the Montgomery ruling. Finally, the forum heard from the Renal team at the RIE, who described their conservative care approach as an alternative to dialysis. At the Western General Hospital, we heard from Anne Haston and her team of stoma nurses, who described their approach to caring for stoma patients in NHS Lothian. Dr Stuart Richie followed with a description of some of the challenges in caring for patients with diabetes, and suggested some areas for improvement.
Download the presentations
- Innovation Challenge - keeping track of tasks in the digital age (Martin Dennis)
- Bedside point-of-care glucose testing as a driver for improving inpatient diabetes care (Stuart Richie)