Posted on: 10 June 2022
June 2022
@CNWLImprovement
In this edition, we have a lot of great improvement news to share with you including:
- An update on International #WMTY2022 Day @ CNWL
- Our improvement story this month is from Yogita Dawda, Clinical Lead for Mental Health Pharmacy and Nina Ezewuzie, Associate Chief Pharmacist for Jameson
- This month’s Exec QI conversation with our Bi-Borough School Health Service and Maria O’Brien, Chief Nurse
- Jameson Improvement Celebration Event
In addition, we also have exciting news from the Improvement Academy including links to great opportunities that are coming up.
- CNWL Improvement Practicum 2022 – Applications are now open!
- Improvement Academy Honorary Faculty membership - Applications are now open!
- Level 2: Silver QI Training - Project Team Leader- Applications are now open!
- Improvement Academy gains CPDUK membership and training accreditation
Each month we will be sharing great examples from across CNWL where individuals and teams are improving systems and processes to ensure that we deliver the best evidence-based service user and carer experience where ever teams are delivering care across the trust.
International What matters to you? Day
Thursday 9 June 2022
International #WMTY2022 Day was last Thursday. Thank you to all those who expressed an interest and made inquiries as to how to get involved or run a WMTY event in your local area. The Improvement Academy is very happy to support you and your teams with any WMTY activities and conversations with our CNWL service users, carers and staff. We look forward to sharing updates of WMTY events held across CNWL in future IA newsletters. You can join us on twitter using our twitter QR code at the top of this newsletter by opening your camera on your smartphone and scanning this image. You will then be taken straight to our CNWL Improvement Academy twitter page. You can follow us and see what we have been up and also what teams are doing both locally and internationally by searching Twitter for the hashtag #WMTY22.
Image Source : https://wmty.world/
You can also access many resources, gain inspiration and ideas at:
If the idea of holding a WMTY event in your local area and would like to explore this further with a member or our team please do not hesitate to get in touch with Geetika Singh, our Head of Quality Improvement at geetika.singh@nhs.net and we will be more than happy to help you.
Additional ways of gaining support are at our QI Clinic by contacting us at cnw-tr.improvementsupport@nhs.net and other educational opportunities here.
Improvement Stories: CNWL Pharmacy team
Reducing unplanned medicines-related readmissions to mental health wards and Crisis Resolution Home Treatment Teams
Congratulations to the CNWL Pharmacy Team who have been accepted to share their improvement work at the IHI/BMJ International Forum on Quality and Safety in Healthcare. The forum will be held in Gothenburg, Sweden in June this year.
Improvement Advisor, Bridget Browne caught up with Yogita Dawda, Clinical Lead for Mental Health Pharmacy and Niina Ezewuzie, Associate Chief Pharmacist for Jameson about their project to reduce unplanned medicines-related readmissions to mental health wards and Crisis Resolution Home Treatment teams (CRHTTs).
Can you give us a bit of background about your project?
Hospital readmission is common in mental health. Unplanned readmission within 30 days is considered a poor indicator of quality.
We investigated the potential role of medication related factors in unplanned readmissions to mental health wards and CRHTTs and looked at whether a collaborative multidisciplinary Quality Improvement approach could help to reduce medicines-related readmissions.
What did you do to understand the problem and start to develop change ideas?
Notes for patients admitted to 16 wards and 6 CRHTTs over a 2-week period were checked to identify a previous admission.
For the 213 cases identified, notes were reviewed and GP practices and patients interviewed to assess if medication contributed to readmission either ‘significantly’, ‘partly’ or ‘not’.
Where readmission was identified as medicines-related, we identified whether:
- the patient had received discharge medication at the previous discharge and left with their medication
- a discharge notification was sent and received by patients’ GP
- post discharge follow-up was completed (either at 3 or 7 days)
Once we understood the factors that contributed to medicines related re-admissions we used a multidisciplinary QI approach to test the impact of systemwide changes on medicines-related readmissions.
What has been the outcome of your work?
Using a QI approach, medicines-related readmissions reduced from 58% to 2-5% in 6 months.
What is the benefit of this work for patients?
- Readmission is distressing for patients and their families – reducing readmission reduces this distress.
- Reducing readmission has positive benefits for patient safety, outcomes and continuity of care.
What is the benefit to staff?
- Improved knowledge of the role of medication in readmission
- Improved sharing of information between primary and secondary care (discharge notifications)
- A collaborative and consistent approach to discharge planning and post-discharge follow-up
What is the benefit to the system?
- Supports the wider health economy by reducing unnecessary admissions
- Reduction of readmission supports increased bed capacity
- Systems and processes embedded to reduce medicines-related readmissions
- Better communication across interfaces with the aim to avoid unplanned medicines-related readmissions
What have you learnt as a result of this work?
- Readmission is used as a gauge for quality of care and has negative health economic effects.
- Medicines are the most common healthcare intervention and medication changes during admission are common.
- Timely communication to GP post-discharge is essential to avoid discrepancies.
- The importance of ensuring patients are not discharged without an adequate supply of their medicines.
- QI methodology can significantly reduce medicines-related readmissions by multidisciplinary approach to discharge planning and continuity of care.
What would you say are the key factors for successful change?
- Good engagement with key stakeholders
- Coproduction – involving patients and carers is key
- Clearly defined goal and aims
- Clearly defined measures
- Good planning
- Start small to test your ideas
- Continuous monitoring
- Be flexible and open to changes
- Share your work to influence wider change across the healthcare system
This project was also shared here in the Pharmaceutical Journal.
Executive QI Conversations with Maria O'Brien, Chief Nurse and Bi-Borough School Health Service
The latest in the regular series of improvement conversations with members of CNWL executive took place in May with Maria O'Brien, Chief Nurse, hearing about a major development project in the Bi-Borough Health School Health Service.
Marta Thlon, Clinical Service Lead for Kensington Chelsea Westminster School Health, and Isabella Broughton, presented the work of a co-produced project with staff partnerships very much at the heart of the work. Over the past year, six workstreams (Communication, Wellbeing and Support, Workforce, Leadership, Recognition of KCW service, Estates and Equipment) have used a whole range of techniques to engage and develop staff, including: steering groups, open all-staff meetings, appointing champions and freedom to speak up events.
The data shows that the results of the project are truly impressive, inlcuding a complete ‘turn around’ of vacancy rates and a massive increase in engagement of staff and managers in supervision.
Huge congratulations for Marta, Isabella and the Bi-Borough School Health team!
Jameson Improvement Celebration Event – “We are good; we can be excellent”
On Friday 20 May 2022, Jameson (CNWL’s central London mental health division) played host to a virtual celebration of Quality Improvement projects from staff across the division over the past few years. This was an excellent event showcasing improvement stories from across the division and was a brilliant opportunity for sharing and learning across the division. If you would like to read more about this event please click here.
CNWL Improvement Practicum 2022
Applications for the next CNWL Improvement Practicum are now open.
The Practicum is a 6-month taught programme that is designed to support teams to plan, deliver and sustain improvements on trust strategic priorities. This programme combines formal teaching, workshops and wrap-around support and will be delivered in a hybrid of virtual and face to face formats. This collaborative learning environment will enable teams to share and learn from each other in a safe space that supports improvement. You will also receive support in how to write up your projects and share your learning with others. This programme is a great opportunity to connect individuals from across the trust and development networks.
This is the most intensive support that we offer teams to help you deal with your messy problems or challenges that you are currently grappling with.
In line with current CNWL strategic objectives there will be two themes for this year’s practicum:
- Focus on excellent care
- Simple effective processes
The 2022 Practicum starts in October 2022 and will run until April 2023. Teams on the course will receive a high level of training input from our own Improvement Academy Faculty and benefit from:
- 2 x Full day virtual training days & 4 half day workshops, teaching you the QI skills, tools and methodology in a supportive collaborative learning environment
- A QI coach will be assigned to your team to work with you throughout the practicum
- Sponsorship at a local level and governance via a Programme structure
- Access to Expert by Experience Improvement forum to gain coaching and support from a service user & carer perspective
- Access to a dedicated Improvement Advisor if you would like additional support
- Access to QI clinic sessions for additional 1:1 support if required
If you would like to know more about how to get involved, please read the application guidance here.
If sharing, learning and improving together in a team is something that excites you then please head to our IA training page to download an application form here.
Applications close at 5pm on 4 July 2022
Improvement Academy Honoury Faculty Membership
Applications are now open!
The success of the Improvement Academy (IA) is largely dependent on the community. We are therefore looking for staff, service users and carers who would like to become Honorary Faculty Members. There are many different ways to get involved. There is no minimum time commitment, but as a general rule, the more you put in to the IA, the more you will get from it. Some Honorary Faculty Members (HFMs) will take a more active role in the community and we expect individual involvement to vary over time.
When we refer to community we include, staff, service users and carers and our partners.
Guidance and more information on Honorary Faculty Membership is found here.
Please submit your application to cnw-tr.improvementsupport@nhs.net using the application form found here.
Please do complete all sections of the application form, incomplete application forms will be returned.
If you have any queries or would like to give us any feedback about the application process, please contact us: cnw-tr.improvementsupport@nhs.net
Level 2: Silver QI Training – QI Project Team Leader
Applications are now open for our second cohort of Level 2 QI Project Team Leader training, starting July 2022. This training is aimed at CNWL staff who wish to use improvement methodologies in their role and need to develop skills as a QI project leader. The course is a workshop-based programme, delivered over 4 months with 2.5 days training and also forms part of 21CLP.
To book your place go to LDZ and search/look for Level 2 QI Project Lead under the Improvement Academy (Quality Improvement) block.
Closing date for applications is 5pm Wednesday 22 June 2022
Improvement Academy gains CPDUK membership and training accreditation
The Continuing Professional Development (CPD) Service is the largest and leading CPD training accreditation service in the UK, with over 25 years’ experience supporting accredited CPD providers from across all industry sectors. We are pleased to announce that the Improvement Academy is now a CPD member and we are looking forward to providing CPD accredited courses from 2022 and beyond. Updates to follow in future newsletters and look out for this logo.
The QI Clinic is here to support your improvement ideas
Book time with us today to discuss
We are excited to announce that we have listened to your feedback and have increased our QI Clinic time slots from 20 to 30 minutes. So take the opportunity today to book a QI Clinic slot while they are still available!
To book, send a request stating your preferred date and time to: cnw-tr.improvementsupport@nhs.net and we shall confirm back to you with a diary invite and link to your QI clinic slot. We look forward to speaking with you!
Useful Links
Contact information for Improvement Advisors:
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Diggory Division |
Peter Toohey |
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Goodall Division and Corporate |
Peter Smith |
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Jameson Division |
Bridget Browne |
CNWL Improvement Academy Microsite:https://www.cnwl.nhs.uk/ia
Life QI: www.lifeqisystem.com/
If you want to get in touch please contact us here: