Quality Improvement Zone

Appropriate choice of empiric antibiotic therapy, in line with local guidelines, improves outcome for children with infection, while reducing adverse drug effects, cost, and selection of antimicrobial resistance. Data from national point...

Oslo University Hospital, Ullevaal, is the largest hospital in Norway. In the Department of Internal Medicine, we have approximately 240 beds, 65 jr. doctors, 10 interns and 110 sr. doctors. During the past few years The Department of Internal...

The HSE is committed to putting in place a quality, patient safety enablement programme. This has led to the embrace of a wide range of improvement methods that require comparative date to understand performance. Pressure ulcer and falls...

Concussion, often describe as a mild – moderate traumatic brain injury, is often admitted to our emergency department (ED). Until recently our department had no guidelines or protocol concerning this group of patients, and their waiting time in ED...

The Need for Change: Over the next 10 years the proportion of over 75s in Scotland’s population will increase by over 25%. By 2033 the number of people over 75 is likely to have increased by almost 60% (Scottish Government 2012). In addition...

AMRU is a high risk clinical area with a large throughput of increasingly complex and often frail patients. There are basic patient care and acute medical care needs and constant bed-flow pressures. Clerking –in processes, investigations and...

Rehabilitation following Acquired Brain Injury in adults is shown to impact upon re-integration into family, work, educational and social life. Identification of goals is an important aspect of the rehabilitation process, however feedback from...

Aim: Develop a proactive system to detect sub-optimal care, near misses and harm in Emergency Medicine The main outcome measure used in EM is the achievement of the 4 hour target where 98% of patients should be admitted / discharged within 4 hours...

The plight of the Frail Elderly requiring hospital admission has been well documented in recent years in NHS literature and the media. Following local concerns about the volume of patients waiting at and being transferred from the Royal Victoria...

Effective strategies to reduce harm during in the perioperative period have included the use of checklists in order to increase the reliability of processes by increasing team communication and reducing the reliance on prospective memory. Our...

Aim – to improve the reliability of delivery of all elements of the sepsis 6 care bundle within 60 minutes to patients screening positive for sepsis. Where? – two Emergency Departments and two Wards on two acute hospital sites. By how much? –...

Managing a busy General Medical Ward in station 14 of University Hospital Ayr with clients with huge complex needs and challenges presents a massive test in delivering reliable, safe and high quality person centred care. As a unit we felt the ward...

The core long term goal of the project is to reduce maternal morbidity and mortality from post partum haemorrhage (pph). The checklist is the 1stkey step in the improvement journey. 5-10% of women experience pph and rates are rising. > 50% of...

Hazardous and harmful drinking are commonly encountered among hospital attendees; approximately 20% of patients admitted to hospital for illnesses unrelated to alcohol are drinking at potentially hazardous levels. An abrupt reduction in alcohol...

Aim: To enable a safe medicines management system for elderly patients in primary care identified as at risk by community nurses through medication safety reviews. How Much? Target is for 80% of new admissions to caseload. By When? June 2015.

Falls is a major cause of harm of elderly patients in hospitals, studies have reported falls rates between 3 and 5 falls per 1000 occupied bed days, with falls with injury resulting in increased cost associated with increased length of stay1. In...

Caesarean section is the most common major surgical procedure worldwide. In the UK it accounts for 20 to 25 % of all deliveries. Surgical site infection is responsible for significant additional cost to the NHS. A number of maternal factors will...

Synthetic Oxytocin (Synocinon ®) is a high risk medication that is used on a daily basis within labour wards to induce and augment labour. It is associated with adverse outcomes within the intrapartum period. A review of available clinical and...

Prescribing data for NHS Greater Glasgow and Clyde (GGC) indicates that there remains a high proportion of elderly patients who are prescribed oral NSAIDs along with other drugs that increase the risk of gastro-intestinal (GI) bleeds or acute...

Aim: To improve sepsis recognition, response and referral in the OOH period using the NHS NEWS app. Sepsis kills 37,000 people a year in the UK1. It can be difficult to recognise and early treatment has shown to improve survival. Sepsis 6 is a...

Mapping of different aspects relating to a model for improvement including: ideas, data, leadership, human factors, managing change and patient flow.

In the ICU patients are continuously monitored, and have a dedicated nurse. The ICU staff is very experienced in the complex multi morbidity patients. When the patients get better they are transferred to a general ward. Monitoring is reduced to a...

Medical wards are complex environments often operating with several clinical teams and within shift patterns that present challenges for high quality care. Systems of communication are not well developed and there are opportunities for improvement...

Frailty is a distinctive health state related to the ageing process in which multiple body systems gradually lose their in-built reserves. Around 10% of people aged over 65 years have frailty, rising to between a quarter and a half of those aged...

About 65 high-acuity patients are admitted every day to the 48-bedded Acute Medical Unit (AMU) in the Royal Infirmary of Edinburgh (RIE). Anecdotal reports suggested that poor handover and planning at the time of transfer was resulting in...

There are over one hundred community hospitals across Scotland, many providing care for elderly patients. They are often based in remote and rural settings, managed and staffed by GPs. They could be developed as a core resource in community-based...