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Implementing Energise for Excellence and responding to the
Call To Action on the ward
Lesley Marsh
Assistant Director of Nursing
Aims
energise for excellence: the ward managers ‘Call To Action’
supporting safe and effective care, and delivering positive patient and staff experiences
enabling ward managers to tell their quality story and commit to the ‘call to action’
the tools and toolkits which measure improvement, change practice and spread success
• Education both pre & post registration
• Values based recruitment
• Personal Development
• Evidence based staffing levels
• Evidence based, using innovation & best practice
• Improving outcomes
• Productive & efficient
• Delivered in the right place
• Clarity of measures & impact
• Safety thermometer
• Continuous improvement
• Transparent & open reporting
• Real time monitoring & improvement
• Friends and Family Test
• Informed & involved in decisions
• Personal responsibility for health & well being
• Rewarding & worthwhile jobs
• Professionally accountable
• Proud to be a nurse /midwife
• Treated fairly
• Engaged in decisions
Get Staffing
Right
Get Staffing
Right
Deliver Care
Deliver Care
Measure Impact
Measure Impact
Patient Experience
Patient Experience
Staff Experience
Staff Experience
Leadership at every level
We call you to commit to take FIVE actions.
1. Commit to take a specific action to make a specific change within a specific timescale
2. Use the most relevant tools
3. Measure it
4. Celebrate success
5. Tell your story to others
Values based recruitment
Education and training
Fallsafe train the trainer
Leadership programmes
Values based recruitment
Education and training
Fallsafe train the trainer
Leadership programmes
Fallsafe project Fallsafe project
Harm free care / safety
thermometer
Observations of care / peer review
Safe and productive care of
older people
Harm free care / safety
thermometer
Observations of care / peer review
Safe and productive care of
older people
Complaints
Patient feedback
Friends and family test
Complaints
Patient feedback
Friends and family test
Reporting falls
Learning
Feedback from study days
Reporting falls
Learning
Feedback from study days
Get Staffing Right
Get Staffing Right
Deliver CareDeliver Care Measure Impact
Measure Impact
Patient Experience
Patient Experience
Staff Experience
Staff Experience
Falls
Inte
rnal &
Extern
al
concern
Changes to care
Patient risk factors
Cardiovascular Balance Confusion Bone health Medication Vision Toileting
Environmental risk factors
Patient environment Equipment Special observation
THINK FALLS
F = Fatal
A = Assessment
L = List risk factors & act
L = Leave essentials within reach
S = Stop medication if you can
Falls – what did we achieve?
Fallsafe champion in every clinical area Falls assessment for every patient over 65 Falls pathway for every patient identified at
risk Post falls protocol Falls group Resource folder THINK falls
Falls – the numbers
0
50
100
150
200
250
2008 2009 2010 2011 2012
2008 229 180 177 177 157 181 211 173 187 184 179 166
2009 181 187 181 194 186 182 221 167 132 208 194 178
2010 194 181 219 203 199 211 167 195 201 198 196 194
2011 238 230 218 180 196 204 161 173 216 215 201 221
2012 234 194 203 190 173 196 176 151
Jan Feb March April May June July Aug Sept Oct Nov Dec
0102030405060708090
100
pe
rce
nta
ge
%
date
Audit of care for patients regarding falls assessment and management
Series1
National Outcomes The number of patients without a call bell in reach was
reduced by 78%. Twice as many requests for medication reviews were
made. The number of patients who did not have safe
footwear was reduced by 67%. Twice as many patients had their lying and standing
blood pressure checked manually. There was a 56% increase in patients being assessed
for signs of confusion. More than twice as many patients were asked if they
were worried that they might fall. There was a 41% decrease in the number of patients
given night sedation.
Trust outcomes The number of patients without a call bell in reach was
reduced by 80%. 55% increase in request for medication reviews The number of patients who did not have safe
footwear was reduced by 47%. There was a 64% increase in patients being assessed
for signs of confusion. 50% patients over 65 were asked if they were worried
that they might fall. There was a 30% decrease in the number of patients
given night sedation. Reduced length of stay for older people by 3 days
Next steps
Environmental audits Review pathway Night time medication Chair review Toileting Continue audit