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Service

Improvement
Projects
Supporting social work and health practitioners to improve
services one setting and one service provider at a time.
The improvement of services, for the people we
serve, is at the heart of professional practice. This
is why we have designed a Masters degree to
include a focus on service improvement.

The Service Improvement journey at BU is


split into two Masters degree level units:
PSIP and SIP.

PSIP stands for Preparing for your Service

Improvement Project. Successful completion of


PSIP is a pre-requisite for moving on to the SIP
unit. It allows practitioners to develop a service
improvement proposal over a period of about 5
months and is primarily about THINKING.

SIP stands for Service Improvement Project

and is primarily about DOING or implementing


the proposal in practice. This poster is based on a
SIP completed in 2014.

The National Centre for


Post-Qualifying Social Work
(NCPQSW)
Professional education at the National Centre
for Post-Qualifying Social Work is centred
on a commitment, passion and dedication to
develop healthcare and social work practice.
We believe that by improving the quality of
services through partnering with practitioners
and employers across the health and social
care arena we make a vital contribution to
society in general and vulnerable people in
particular.
Over 10,000 practitioners have successfully
undertaken our programmes since the year
2000 and we have won a total of 9 prestigious
teaching awards during this time.
Visit us at: www.ncpqsw.com

I then devised a draft electronic proforma and


requested further constructive criticism from
the Outreach and multidisciplinary teams. I also
involved IT. From here, I conducted individual
coaching sessions with the team to ensure that
they were familiar with the changes prior to the
implementation. I also informed ward staff and
doctors. This ensured a smooth transition for the SIP.
A quantitative methodology, in the form of a 10item questionnaire administered to the Outreach
and Multidisciplinary Teams (n=104) one month
after implementation, has been used to evaluate the
success of the project.

Improving the outcome


of deteriorating patients
using electronic outreach
assessments

Service Improvement/changes:
The Outreach Team viewed the implementation of
the SIP as an overall success in terms of enhanced
communication, improved time management and
improved patient care/safety. Results from the
multidisciplinary team, whilst still positive, are
less so.

Critical Reflection and Future


Plans:

Julia Aston

It is recommended that the evaluation questionnaire


be repeated after a three-month period.
Future projects could include the connecting of
the Critical Care patient management system to
the new Outreach database and the provision of
individualised non-invasive care plans for patients
who require this level of ventilatory support.

Poole Hospital Foundation Trust

Context and rationale:

Aim:

I work as an Advanced Clinical


Practitioner/Outreach nurse.
Critical Care Outreach services have
been introduced (DoH 2000) to respond
rapidly to patients whose condition has
changed and/or deteriorated in the belief
that early intervention may avert further
deterioration or even death.
One of the major challenges associated
with the Outreach role is the
documentation used to assess patients,
particularly the amount of time that it can
take to complete it.
The introduction of an easily accessible
electronic Outreach Assessment Proforma
was likely to be more efficient than current
processes.

The aim of the SIP has been to improve


patient care/safety by devising,
implementing and evaluating a
standardised electronic Outreach
Assessment Proforma to meet the needs
of both the Outreach and Multidisciplinary
Teams.

Identified Problem:
The Outreach Team used to follow an
ABCDE free text approach to document in
the patients notes the patient assessment
and intervention information.
For audit purposes, it was then necessary
to complete our own assessment sheet.
This data also had to be manually entered
onto the computer system resulting in
triplicate duplication.
Research highlights that patient
assessments performed and documented
using free text have the potential to vary
significantly in terms of breadth and rigour
(Cheevakasemook et al. 2006).

Methods:

Cheevakasemook et al., 2006. The study of nursing


documentation complexities. International Journal of Nursing
Practice, 12, 366374.
Dimond, B., 2005. Exploring the legal status of healthcare
documentation in the UK. British Journal of Nursing, 14, 517-8.
DoH (Department of Health)., 2000. Comprehensive Critical
Care - A review of Adult Critical Care Services. London: DoH.

The challenge of this project has been to


design an electronic proforma that remains
patient focused yet also reaps the benefits
of standardisation in terms of more
accurate, up to date and easily accessible
information.
I started by asking my Outreach Team
for their suggestions/concerns regarding
changing to an electronic system.

Hakes, B., & Whittington, J., 2008. Assessing the impact


of electronic medical record on nurse documentation time.
Computer Informatics Nursing 26, 234-241.
Keenan, G., & Yakel, E., 2005. Promoting safe nursing
care by bringing visability to the disciplinary aspects of
interdisciplinary care. AMIA Annu Symp Proc, 385-389.
RC (Resuscitation Council)., 2010. Resuscitation Guidelines.
London: Resuscitation Council UK.

Does electronic
documentation improve
patient safety?

10
9
8
7

Strongly
agree
Agree

Undecided

5
4

Diagree

Strongly
Disagree

2
1
0
F1

For more information, please visit us at www.ncpqsw.com or phone 01202 964765

References

SHO

Registrar

Consultant

Outreach

Nurse

Other