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Quality Improvement in Practice at Cwm Taf Morgannwg University Health Board

Over the next two days (25-26 November 2019), some of our quality Improvement (QI) leads at Cwm Taf Morgannwg University Health Board are participating in a national Improvement Conference hosted by Improvement Cymru – Re-thinking how we improve.

We will be highlighting examples of QI in practice and sharing our future vision for QI and transformation. Follow our conversation on Twitter @CwmTafMorgannwg /@CTMCymraeg

Come and visit our exhibition stand at the conference and ask us about these projects amongst others –

  • Transforming and Improving Safe and Effective Care Together: Mental Health

 

In early 2020, 14 members of staff will join our first QI cohort for mental health services. This cohort spans across eight different multi-disciplinary teams within our health board who will be developing QI skills and knowledge to apply QI in practice, and trained in using a data-informed approach for measuring improvement in their respective areas of work.

  • Falls reduction and prevention

 

Intentional rounding is a structured approach that has been introduced on one ward at Prince Charles Hospital in Merthyr Tydfil. Nurses on this ward conduct checks on patients at set times to assess and manage their fundamental care needs. It has demonstrated a reduction in patients’ falls and there are now plans to spread the model to four additional wards (two Wards at Prince Charles Hospital and two at Royal Glamorgan Hospital).

  • Electronic Whiteboards

 

Our health board has completed the first phase of an innovative project to develop a bespoke IT application that draws together patient information from hospital data systems and presenting this on a large TV screen in place of the traditional whiteboards – an e-whiteboard. These whiteboards have been further developed to allow effective communication between teams and provide visual prompts to multi-disciplinary teams regarding clinical care. These are effectively used for handover and quality improvement projects on acute wards and are being further developed in collaboration with Accelerate to expand functionality and clinical applicability across the Health Board.

  • Safer Intravenous Fluid administration

 

A Multi-disciplinary Quality Improvement Team are working on small tests of change within a large – scale improvement project to reduce clinical risk associated with intravenous fluids. This project involves a number of processes aimed to improve the consideration, prescription and the administration of intravenous fluids with appropriate substrates and compliance with NICE guidelines. The improvement project aims to reduce clinical complications including pulmonary oedema, electrolyte imbalance, surgical wound breakdown and acute kidney rates by promoting intravenous fluid use in the right patient, at the right time and the right rate.

  • Improving hydration of vulnerable people in our hospitals (this QI project has received Bevan Exemplar recognition)

 

In view of the plethora of evidence base that demonstrates the significant health benefits of good hydration and the serious risks of dehydration including Acute Kidney Injury, we are currently testing Droplet® on four of our hospital wards (Royal Glamorgan Hospital and Ysbyty Cwm Cynon) and in one residential home in Merthyr Tydfil. Droplet® is a talking aide memoire hydration aid- an intelligent, programmable base that will talk to the user if they are not drinking enough, and will alert the carer at the same time. With a simple twist it attaches to either the Droplet® Mug or Droplet® Tumbler. The Droplet® Flow Control Lid fits easily to the top of the mug or tumbler to help people who are coping with tremors or swallowing problems.

Highlighting the health board’s QI vision, Dr Helen Lane, Consultant Physician and Cwm Taf Morgannwg UHB Quality Improvement Lead said:

“Our vision is to implement a centralised improvement hub that will bring together all our staff who are currently involved in Quality improvement (QI) across our services, and provide them with the support and the QI system they need to feel empowered to make even further positive changes.

“Equally, we are focussed on expanding our QI capacity and capability, including looking at how we embed QI through a multi – disciplinary approach. In my experience, improvement projects are more successful and sustainable if done in multi-disciplinary groups, which breaks down barriers between disciplines, gathers knowledge and experience and creates a cohesive environment for change. Mutual respect across healthcare professionals and engagement at the time of project initiation also serves to change the culture in the working environment and improves the standards of care that we provide to patients.”

Rebecca Thomas, Senior Nurse at Cwm Taf Morgannwg, QI Training and Education Lead, plus Q (Cymru) member added:

“The conference provides us with an excellent opportunity to connect with our improvement peers across Wales, to learn from other improvement hubs and to be part of the rapidly growing all-Wales improvement network of individuals who are passionate about making things better for their patients through quality improvement tools and application.

“To truly achieve a community of continuous improvement in CTM UHB, we recognise that we need to build capacity and capability within our existing workforce that enables our staff to deliver change within their environments and demonstrate its impact. This is being turned into action through the delivery of classroom sessions and by providing more QI development opportunities for our staff – we are excited to be launching our first ever QI mental health cohort in early 2020.”

What is Q Cymru?

Q Cymru is a network of quality improvement enthusiasts in Wales. Through the Network, people with an interest or passion for improvement come together to enhance their improvement knowledge, to develop new knowledge that can be applied in the workplace, to share experienced and to Network. We have over 230 Q Cymru members in Wales,   Read more about the opportunities to get involved.

For more information on these projects, or to ask about other QI projects underway in Cwm Taf Morgannwg, please contact Rebecca Thomas who will connect you with the right staff member or team. Email:Rebecca.L.Thomas@wales.nhs.uk