Northumbria Healthcare’s HIP QIP .

Person centred care after hip fracture.

Why HIP QIP ?

• Common and serious. • Mortality is high at around 30%.

• 1 in 3 people will wait more than 2 days for surgery. • Prolonged hospital stay. • 33% need more care support • 1 in 5 people wont return home.

What we needed to do.

• Provide hip fracture care of the highest quality.

• Adopt a pathway approach to ensure consistency of care.

• Ensure recent evidence and national standards are systematically implemented.

• Provide exceptional patient experience – meeting physical, emotional and information needs.

Making it happen.

• HIP QIP Steering Group.

• Multidisciplinary membership :

– Key clinicians representing all parts of the patients’

pathway.

– Executive management team involvement.

– Voluntary sector – CEO : Age UK.

NORTHUMBRIA HEALTHCARE NHS FOUNDATION TRUST

Fractured Neck of Femur Quality Improvement Project.

How has it made a difference ?

Safe and effective care.

Deaths on NHFD since Oct 09.

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WGH NTGH Trust

Trustwide 30 day mortality has improved from 14.3 % to 9.8.%. This is a 31 % reduction.

Best in class - timely surgery.

• National average 61.5% (range 9% to 88%)

• Wansbeck best in NHS for 36 hours at 88%.

• North Tyneside best in NHS for 48 hours, operating on 99.6% of patients in this timeframe.

• Trust performance consistently maintained at 90% mark.

Providing safe and effective care.

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Apr-10 May-10 Jun-10 Jul-10 Aug-10 Sep-10 Oct-10 Nov-10 Dec-10 Jan-11 Feb-11 Mar-11 Arp 11 May-11 Jun-11

BPT NORTHUMBRIA

BPT NATIONAL

BEST PRACTICE TARIFF – BPT 2010/11

Co-ordination and integration.

• surgical care bundle

• rehab standards

• early mobilisation – 25%

• timely involvement of orthogeriatrician

• mutidisciplinary audit framework

Measuring outcomes. Weekly:

• Additional nutrition for patients • Best Practice Tariff • Surgical Care Bundle Compliance Fortnightly: • Patient experience Monthly: our Quality Account • Time to x ray • Mortality Rates • Pain blocks • Early Mobilisation • Infections and pressure sores • Home to Home rate

Physical comfort.

80% of patients receive a nerve block on admission

97% of patients interviewed believed we did everything we could to effectively control pain. (n= 384)

80% of patients now receive additional feeding each day, with the help of nutrition assistants and volunteers.

Improving information.

• Experience based design methodology.

• Information booklet designed by patients.

• Chosen as early CQUIN

target.

Quality in the round.

“The staff are marvellous, I cannot fault anyone of them, doctors, nurses, tea ladies and cleaners all special people.”

Infographics.

Key things we have learnt.

• The benefits of real time reporting at team level.

• Executive management team support is crucial.

• Ensure patients and families are part of your improvement team.

• Focusing on things that matter most has made sense.

• Investing in improvement has helped.

• Qualitative feedback appears particularly important .

• Transparency of reporting matters.