North West Quality Improvement Group (NWQuIG)
Trainees are, by virtue of their frequent rotation between hospitals, uniquely placed in the NHS to drive quality improvement by exporting examples of good practice from one Trust into another. NWQuIG is a new initiative designed to facilitate this process.
Where you have been working to successfully implement a quality improvement project in one trust, we would like to post details of it on this page so that trainees in other hospitals can follow what you did and do the same. If you are looking for a project, we hope the NQuIG webpage will be a source of inspiration! When you undertake a quality improvement project from this site, we ask that you let us know and also acknowledge the original trainee so that both of your CVs can benefit.
The site provides a brief overview of the projects. If you would like further details/ resources to get you on your way please email us at: [email protected]
Where you have been working to successfully implement a quality improvement project in one trust, we would like to post details of it on this page so that trainees in other hospitals can follow what you did and do the same. If you are looking for a project, we hope the NQuIG webpage will be a source of inspiration! When you undertake a quality improvement project from this site, we ask that you let us know and also acknowledge the original trainee so that both of your CVs can benefit.
The site provides a brief overview of the projects. If you would like further details/ resources to get you on your way please email us at: [email protected]
Example project 1: Rescue analgesia guideline for use in theatre recovery areas
Trainee: Julian Scott-Warren
Hospitals / Trusts already using: Pennine Acute, UHSM
Introduction: Acute post-operative pain is usually straightforward to deal with, but every so often we come across patients in whom the usual simple measures don't seem to work. This guideline gives clear instructions on how to give less-commonly used analgesic agents and provides an overview of the clinical approach to difficult post-operative pain.
Hospitals / Trusts already using: Pennine Acute, UHSM
Introduction: Acute post-operative pain is usually straightforward to deal with, but every so often we come across patients in whom the usual simple measures don't seem to work. This guideline gives clear instructions on how to give less-commonly used analgesic agents and provides an overview of the clinical approach to difficult post-operative pain.
How did we implement it?
1 Audit of rescue analgesia usage in recovery areas. We did this in one hour by recording data from CD books, specifically looking into how many patients were receiving high doses of rescue opioid in recovery (numerator). We then found out how many patients were passing through recovery via theatre diaries (denominator). This gave us a simple but effective indication of the extent of the problem.
2 Presented audit together with guideline and evidence base. Received local feedback and adjusted guideline slightly to account for departmental preferences.
3 Presented audit and guideline at Trust Clinical Governance Committee for approval
4 Presented audit and guideline at Medicines Management Committee for approval.
5 Ensured guideline available and easily accessible in recovery areas and that staff were aware of it.
1 Audit of rescue analgesia usage in recovery areas. We did this in one hour by recording data from CD books, specifically looking into how many patients were receiving high doses of rescue opioid in recovery (numerator). We then found out how many patients were passing through recovery via theatre diaries (denominator). This gave us a simple but effective indication of the extent of the problem.
2 Presented audit together with guideline and evidence base. Received local feedback and adjusted guideline slightly to account for departmental preferences.
3 Presented audit and guideline at Trust Clinical Governance Committee for approval
4 Presented audit and guideline at Medicines Management Committee for approval.
5 Ensured guideline available and easily accessible in recovery areas and that staff were aware of it.
Example project 2: Pre-procedure pregnancy testing in under 18's
Trainee: Leanne Darwin
Hospitals/Trusts already using: CMFT
Introduction: Significant numbers of children and young people undergo surgical, radiological, anaesthetic and medical procedures in the United Kingdom each year. If the patient is pregnant there is a small but recognised risk to the patient and her pregnancy/foetus and potentially a need to modify technique or delay the procedure. Whilst the conception rate in under 18s is now decreasing, Manchester remains one of the ten areas in England and Wales with the highest conception rates for under 18's.
This guideline suggests which patients should undergo pre-procedure pregnancy testing and provides a flowchart to follow and includes advice on consent, documentation, managing test results and safeguarding implications.
How did we implement it?
Hospitals/Trusts already using: CMFT
Introduction: Significant numbers of children and young people undergo surgical, radiological, anaesthetic and medical procedures in the United Kingdom each year. If the patient is pregnant there is a small but recognised risk to the patient and her pregnancy/foetus and potentially a need to modify technique or delay the procedure. Whilst the conception rate in under 18s is now decreasing, Manchester remains one of the ten areas in England and Wales with the highest conception rates for under 18's.
This guideline suggests which patients should undergo pre-procedure pregnancy testing and provides a flowchart to follow and includes advice on consent, documentation, managing test results and safeguarding implications.
How did we implement it?
- Audit of baseline practice (pre-procedure pregnancy enquiry, testing and documentation at RMCH) against Royal College of Paediatrics and Child Health standards
- Presented audit results to paediatric surgeons and anaesthetists
- Developed a working group on pre-procedure pregnancy testing and consulted them during development of the guideline and patient information leaflet
- Further consulted representatives from all relevant departments and the hospital Youth Forum during development of the guideline and patient information leaflet
- Engaged the point-of-care testing team, who supported purchase of point of care pregnancy testing and advised on their cost, use and maintenance
- Underwent approval and ratification from the divisional clinical effectiveness committee
