17 March 2017 St John's Hospital Clinical Change Forum

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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:

- Dynamic Discharge Planning
- Quality Improvement in Mental Health
- Quality Improvement in Death Certification

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. 

7th February 2017 East Lothian Clinical Change Forum

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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.

8th & 16th December 2016 RIE and WGH

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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.