QI Newsletter - January 2021

January 2021 – Happy New Year!                                                                      

101 QI projects showing improvement across CNWL

Happy New Year!

Welcome to the relaunch of the CNWL QI Newsletter.  We have had a break since the last edition in May, but we are back for the new year 2021! 

Firstly, we want to say a big say thank you to all CNWL staff who have participated in QI during 2020 and we celebrate the improvements that you have made across the Trust.

The year 2020 has been extraordinary for everybody, full of difficult challenges both at work and at home.  Yet as we enter the new year, we should reflect on all that you have achieved despite the limitations and changes brought about by the COVID-19 pandemic.  This month we look at our QI year with pride in that QI activity has successfully resumed following wave 1 and even flourished as services have used a quality improvement approach to the rapid changes that the response to the pandemic has brought about. 

In this issue we present our 2020 QI infographic and celebrate two significant milestones: the conclusion of the Violence Reduction and Falls Central QI Programmes and the huge contribution of staff working on QI projects to the CNWL Safety Conversation.

And as we look ahead to what 2021 will bring, we outline some of the exciting plans for the fourth year of Quality Improvement in CNWL. 

We welcome your feedback and if there is anything you would like to see in future editions of the newsletter, do please get in touch by e-mailing cnw-tr.improvementsupport@nhs.net. 

CNWL Quality Improvement Infographic 2020

The beginning of 2020 saw a new Improvement Advisor (Michele Dowling) joining the QI Team and a new Goodall Divisional QI Clinical Lead (Peter Smith).  Whilst the QI Programme was paused for three months during the Trust’s response to the Covid-19 pandemic, QI activity continued in many areas of the Trust.  Following the resumption of the programme, our training provision and coaching support became virtual and staff began attending monthly virtual QI medical trainee clinics.

In the latter half of the year, we concentrated on increasing the numbers of QI projects that were involving Service Users and Carers to answer the question ‘What matters to you?’ and continued the Improvement Science in Action Practicum training to support the two central QI programmes.  In October, the Violence Reduction and Falls QI programmes came to a close with a celebration of the considerable achievements in reducing violent incidents and improving the management a falls.

We ended the year with a highly satisfying contribution of 52 QI posters at the CNWL Safety Conversation event and a restructuring of the central QI Team, ready for the year ahead.

At the end of 2020 staff are working on 343 active QI projects registered on Life QI and 30% of staff in CNWL have been trained in QI and the science of improvement. 

Central QI Programmes – Violence Reduction and Falls

CNWL embarked on two central QI programmes in Autumn 2019, each supported by the delivery of an Improvement Science in Action Practicum training course.  This was CNWL’s first set of QI programmes and the subjects chosen, violence reduction and falls reduction, reflected two of the Trust’s key quality objectives.

The course was delivered in partnership with The Institute for Health Improvement (IHI), originally set to conclude in July 2020.  The course, like all other QI training, became virtual and was extended to October of the same year. 

Participants in the Practicum course have benefitted from ‘learning communities’ in each subject area and have achieved very high levels of service user and carer engagement; 90% of projects in violence reduction and 100% of projects in falls having meaningful service user involvement, either as Big I or Little i.

Violence Reduction QI Programme

Aggregate data shows that there has been a 46% reduction in violent incidents across the 10 wards taking part in the programme with some outstanding improvements in particular ward settings:

Nile Ward at St Charles Hospital reduced their rate of assault per 1000 OBDs by 41% between October 2019 to October 2020.

Shannon Ward at St Charles Hospital, reduced their rate of assault per 1000 OBDs by 52% between October 2019 to October 2020.

Falls QI Programme

Although we are only now seeing some data that suggests that the rates of falls across the 11 services taking part may be reducing, the programme learnt that using T-charts to plot the time between falls revealed some exciting data showing that all services were experiencing significant times that were falls-free.  The recorded number of days falls free ranged from 19 day up to 118 days.

The graphs below demonstrate how this has improved in two service settings.  Kenton Lodge, Brent Mental Health Rehabilitation Service, achieved over three months falls-free up to June 2020, whilst Ellington Ward, an inpatient mental health ward for older people has regularly seen periods of over a week when there have been no falls in the unit.

QI posters at the CNWL Safety Conversation

52 QI posters were submitted to the CNWL Safety Conversation, held on 12 November 2020.  This is an overwhelming response given all that has gone on this year, so we were particularly proud to be announcing the winners of the QI project poster prizes.  It was a difficult choice for the judges!

The shear breadth of the subjects covered by the QI posters was astounding; ranging from improving access, patient pathways and waiting times to reducing waste in prescribing.

Congratulations to the winners and runners up who won prizes, but every poster is worth a look and there is much to learn from the work of our colleagues.  In fact, every team that submitted a poster received a personal thank you and voucher from Dr Con Kelly, Chief Medical Officer and Maria O’Brien, Chief Nurse, provided by our Charitable Fund.

View the posters online on Trustnet at: https://staff.cnwl.nhs.uk/safety-conversation-poster-submissions

If you follow us on Twitter, you may have noticed that we have been celebrating the twelve days of Christmas by daily tweeting of links to a selection of your QI Posters?

Looking ahead

2021 is already looking like it will be another busy year for QI in CNWL.  We are well on the way to launching a refreshed QI website that is tailored to your QI journey and building on what we have learnt from staff and service user feedback.

The QI Team are forming within their new team structure and we shall have news of new roles and new full time Improvement Coaches who join the team early in the year.  Look out for our ‘get to know you’ features over the next months.

And with a huge sense of excitement, plans are beginning to take shape for training across the year.  Our monthly virtual Bitesize QI will continue of course (see details to book below), but we are also developing a CNWL Practicum to train more staff in the science of improvement as well as a partnership with other London NHS Trusts to deliver Improvement Advisor level expertise.

Further details will be in the February edition of the QI Newsletter.

Upcoming Bitesize QI Training Dates

Your virtual Bitesize QI training is bookable on LDZ at: https://cnwllearning.org/login/index.php

The full list of dates currently available are on LDZ

Useful links

Contact information for Improvement Advisors:

CNWL QI Microsite: www.cnwl.nhs.uk/qi

Life QI:  www.lifeqisystem.com/

IHI Open School:  www.cnwl.nhs.uk/qi-new/book-training

If you want to get in touch please contact us here: cnw-tr.improvementsupport@nhs.net