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Innovative improvement initiatives underway
The Health Foundation recently selected twenty-two new projects to be part of the fifth round of its £1.5 million innovation programme, Innovating for Improvement. The programme aims to improve healthcare delivery and/or the way people manage their own healthcare by testing and developing innovative ideas and approaches, and putting them into practice.
Clinical teams will develop their innovative ideas and approaches, put them into practice and gather evidence about how their innovation improves quality. Each team has been awarded up to £75,000 of funding to support the implementation and measurement of their project. The innovative ideas are now being tested in healthcare settings around the around the UK.
Among the twenty-two projects is an initiative led by Salford Royal NHS Foundation Trust which aims to reduce the toll of bleeding on the brain on patients in Greater Manchester. Bleeding in the brain (intracerebral haemorrhage or ICH) causes 1 in 10 strokes but accounts for a far higher proportion of death and disability. For those that do survive, over half remain dependent on others for day-to-day care. A team of researchers, led by honorary consultant neurologist, Adrian Parry-Jones, will seek to reduce the percentage of patients dying or left severely disabled six months after they have been admitted to a hyper-acute stroke unit (HASU) with acute intracerebral haemorrhage. Dr Parry-Jones has already brought in a hyperacute ICH care bundle at Salford Royal, which has resulted in an 8.5% reduction in the number of patients dying
within 30 days of being admitted with bleeding on the brain. The package – Acute Bundle of Care for Intracerebral Haemorrhage (ABC-ICH) – includes:
A: anti-coagulation reversal – reversal of any blood thinning drugs in patients within 90 minutes.
B: blood pressure lowering within six hours of patients first showing symptoms. C: care pathway – a detailed analysis of local data to make sure patients get timely access to neurosurgery and neurocritical care at the Greater Manchester Neurosciences Centre, based at Salford Royal.
It will be supported by an app for healthcare professionals to use at the bedside, which will also allow them to input live data to ensure close monitoring. Dr Parry Jones said: “Intracerebral haemorrhage can be absolutely devastating but we know that specialist care, given as quickly as possible, can improve survival and recovery. We hope our project will mean a much better outlook for patients and their families.”
A wide variety of other projects have also received funding, including an innovation in perioperative care at Imperial College Healthcare NHS Trust. There is a growing body of evidence to suggest that pre-habilitation and enhanced recovery for cancer surgery patients can improve postoperative outcomes. The project will roll out the Perioperative RemOte Monitoring of PaTients (PROMPT) system, which enables a real-time interface between patients and clinicians, facilitating supported self-management and proactive health monitoring.
NEWS IN BRIEF
Quality improvement guide for emergency medicine
The Royal College of Emergency Medicine recently launched a quality improvement guide which provides practical advice for emergency physicians at any stage of training. Dr Taj Hassan, RCEM President said “Constant improvement in the quality of care we provide for our patients lies at the very heart of what we do in the emergency department. The Royal College has been at the forefront of many efforts to introduce Quality Improvement (QI) initiatives to improve the care we try to deliver in our complex and at times intense working environments.” The guide can be downloaded from
rcem.ac.uk/qualityresources
Extra ‘triple therapy’ drug for type 2 diabetes
NICE has published final guidance recommending dapagliflozin for treating type 2 diabetes in ‘triple therapy’. Dapagliflozin can be added as a third drug where two drugs for type 2 diabetes are not controlling a person’s blood sugar. Professor Carole Longson, director of the NICE centre for health technology evaluation, said: “Having a range of drug options makes it easier to tailor treatments for type 2 diabetes to each person’s individual needs. This new guidance recommends dapagliflozin in triple therapy – only in combination with metformin and a sulfonylurea – which will widen the choice available for people whose diabetes isn’t well controlled with two drugs.”
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NEWS
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