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LCHS Draft Quality Priorities 2018/19

14th November 2017

Quality Accounts are annual reports to the public from NHS healthcare providers about the quality of services they deliver.

Continuing to provide high quality and safe services, Lincolnshire Community Health Service actively listen to everyone with an interest in their services to learn, improve and reflect on the services we provide. Each year the trust identifies a set of quality priorities and outlines how it intends to evidence and measure our progress in our Quality Account.

For the coming year Lincolnshire Community Health Service have identified three domains of quality:
• Safe (Patient safety)
• Effective (Clinical Effectiveness)
• Responsive (Patient Experience)
Against those Lincolnshire Community Health Service are considering 7 potential quality improvement priorities for 2018/19 developed in response to continuous work around the Sustainability and Transformation Partnership (STP), our CQC inspection and continuous learning from other areas of focus.

Lincolnshire Community Health Service are currently consulting on these priorities and welcome your input to help identify which of these they should take forward during 2018/19 .

Priority 1: Improving management of the deteriorating patient and reducing sepsis in community settings
Sepsis is a life threatening condition that arises when the body’s response to an infection injures its own tissues and organs. Sepsis can lead to shock, multiple organ failure and even death if not recognised early and treated promptly. Reducing the incidence of sepsis is a national and local priority and spans all our services. Pathways, guidance and training will be developed and implemented in practice to staff and evidence of success measured through a reduction in the number of incidents reported relating to lack of recognition of sepsis and deterioration.

Priority 2: Insulin administration – Right dose, right time
Insulin is a widely used drug across our services and the incidence of errors associated with administration can always be improved. It is important that we have well trained and conscientious staff who correctly administer the drug and well-educated patients who are able to self-administer. Focus on improving both of these will help to ensure that insulin is always administered in accordance with the prescription.

Priority 3: Deep vein thrombosis (DVT) – Improved DVT management
Venous thromboembolism (VTE) is a condition where a blood clot forms in a vein. This is most common in a leg vein where it is known as deep vein thrombosis (DVT). LCHS has investigated incidents through the quality governance framework where there have been possible missed opportunities to identify and treat DVT patients attending urgent care services. Our priority for 2018 – 2019 is a reduction in missed opportunities to assess,confirm and treat DVT. We aim to evidence that when DVT is suspected or confirmed the treatment is effective and as described on pathway.

Priority 4: Patient Reported Outcome Measures (PROMs) – to be developed for the diabetes care pathway and leg ulcers
Patient Reported Outcome Measures (PROMs) are a mechanism for ascertaining the impact of healthcare on a patients’ health. Rather than focussing on what is the wrong with the patient, best practice demonstrates that focusing on what is important to the patient and involving patients in their own goal setting, ensures the care will be focused on what patients want to achieve. Patient reported outcome measures will be developed for the diabetes care pathway and patients with leg ulcers. These will be linked to patient satisfaction and experience feedback for the service.

Priority 5: Leg ulcers – Improving our healing rates to improve outcomes for patients
Venous leg ulcers are estimated to affect around 1 in 500 people in the UK although they become much more common with age. It is estimated that around 1 in 50 people over the age of 80 has one. Management of leg ulcers represents a major component of the community nursing workload and has major impact on patient’s lifestyle both psychologically and socially. Over the next year, this will be achieved by improving the skills and knowledge of all staff to undertake a review of treatment plans and their effectiveness. Self-care will be promoted wherever possible through individual management plans and updated patient information and other literature. Progress on healing rates will be bench marked against other community trusts.

Priority 6: Complaints – Improve the response times for handling of complaints
Complaints and compliments are important indicators of patient satisfaction and experience of our care. They provide valuable learning helping address issues and inform continuous improvement both of which are important to the trust. LCHS plans to implement a improved complaints management process which will reduce the number of extensions to complaints and increase the number of early resolution to patient concerns.

Priority 7: Suicide Safe
This programme fits in with the national and local mental health priorities. As part of integrated neighbourhood working LCHS aims to improve collaboration with mental health services. The Suicide Safe programme includes staff priorities and aims to improve the culture of metal wellbeing and resilience for staff. LCHS will work to raise awareness of suicide, help staff to recognise the signs and triggers for those at risk, support vulnerable individuals and learn how to respond to someone who may be at risk. Over the next year th trust will develop a local suicide prevention plan detailing how the organisation will contribute to a culture of mental wellbeing and resilience.