The third regional Emergency Department (ED) Collaborative event supported by the Oxford Patient Safety Collaborative took place on 6 September 2018 at the Academic Centre, Milton Keynes University Hospital. It was hosted by Milton Keynes University Hospital NHS Foundation Trust (MKUH) led by Dr Shindo Francis, ED Consultant, and Mandy Knight, ED Head of Nursing.
Sixty staff from Buckinghamshire, Milton Keynes, Royal Berkshire, Oxford University Hospitals (OUH) and Frimley NHS trusts came together to share excellence and innovation in practice and to learn from each other.
The day began with an inspirational address from Ian Reckless, Medical Director, MKUH. He spoke about his organisations improvement journey from 2013 to 2018.
The theme of the event was on a positive safety culture in the ED.
A diverse range of presentations illustrated the fantastic work going on throughout the region in our emergency departments. Some examples are summarised below:
Learning from excellence – the MKUH way
Appreciation improves motivation and can lead to culture changes. Staff are encouraged to record what went well using positive language through a system called GREATix. Dr Sally-Anne Shiels, Anaesthetics trainee, MKUH, acknowledged that while we need to understand what went wrong, this needs to be in the context of what is going right. Thematic analysis from the GREATix reports highlighted teamwork, exemplary professionalism, behaviour when dealing with an abusive patient and ‘going the extra mile’ as notable examples of excellence.
Point of care (POC) flu testing in Royal Berkshire ED
An Oxford AHSN-led and directed service evaluation of Roche COBAS LIAT flu PCR to assess its clinical impact on patient management and flow. Operated by the ED nursing staff with 20-minute turnaround to results during December 2017-February 2018. Overall positive feedback from clinical users with evidence of lower antibiotic use, reduced length of stay and earlier antiviral therapy. The study is awaiting a health economics report.
Mental health care for emergency department frequent attenders
A project shortlisted for funding from the Q Exchange addressed two difficult questions: the ability of EDs to deliver safe and consistent care and the need for a comprehensive service for patients with mental health problems. Dr Deon Louw, ED Consultant and Departmental Lead for Mental Health, OUH, outlined the opportunities for regional collaboration and shared learning to map health-seeking behaviour across the region in order to understand the causal patterns and develop collaborative strategies based on collective knowledge.
‘Hug in a bag’ quality improvement project
Winner of Nursing Times 2017 – Emergency and Critical Care Award.
The ED Safety Group, Dr Glyn Barrett, Frimley Health
National Early Warning System 2 (NEWS2), Laura Mathias, Clinical Governance Lead 999 North, South Central Ambulance Service
Feedback from attendees was overwhelmingly positive, describing the event as ‘stimulating’, ‘thought-provoking’ and ‘valuable’. The clinicians were deeply grateful for the opportunity to network with ED colleagues and learn from each other to improve safety and quality of patient care in their EDs.