Sharon Deans
Ayr Hospital, Scotland
Posters & Accepted Abstracts: Gen Med (Los Angeles)
The Scottish Government 20/20 vision (2011) set out its strategic vision for achieving sustainable quality in the delivery of healthcare services across Scotland. Within NHS Ayrshire and Arran, a new Emergency Department (ED)/Combined Assessment Unit (CAU) opened transforming the delivery of unscheduled care and enabling the appropriate patients to be seen in the appropriate department, thus improving delivery of emergency care. Within the ED this transitional period was a suitable time to develop and introduce a framework for ongoing continuous clinical improvement. Using improvement methodology we devised a driver diagram defining our improvement plan. PDSA (plan, so, study, act) methodology was used to carry out small tests of change and identify further areas for improvement. We aimed to establish and maintain a continuous quality improvement (QI) programme. Identified priorities for improvement were: Standardized A-E approach to nursing assessment; improved care of deteriorating/septic patients and; improved imaging process for out-of-hours patients. To support staff to confidently and competently carry out a structured A-E assessment of deteriorating patients, a newly devised document was developed. To improve care of septic patients, we are developing a nurse-led framework to allow them to lead on a sepsis identification/treatment bundle. Additionally work to enable nurses to request images for minor injuries during out of hourâ??s period to expedite journey time. We have now begun to collect data to be able to demonstrate any improvements. Staff attitudes have changed with many embracing quality Improvement as part of our daily businesses. We plan to continue to support and develop a framework for Improvement which will be inclusive for all staff. By doing so we will be able to deliver the high quality healthcare that the people of Ayrshire and Arran expect and deserve.
