Learning from Excellence - call for abstracts 2017
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Innovations (All States)

Overview of Innovation:
Submitted on behalf of Dr Tamsin Holland-Brown

Greatix (reporting and learning from staff excellence) was introduced to CCS Paediatric department (8 South Cambridge based paediatricians, 5 North Cambridge Paediatricians, 2 psychologists and 5 secretaries) for a period of 12 months. Appreciated Inquiry (AI) was fitted into the agenda of the paediatric Business/ education meetings, monthly. 

Over the 12 month period 12 Datix and 19 Greatix were reported.
Greatix reports: admin initiatives (several); New course set up for parents; therapist who made up new therapeutic and fun games; a better type of work diary used; valuable education session; listing the plug sockets; filling cleared; weekend support; a meeting chaired well and sensitively, etc.

Audit after 12 months: Audit of 20 people in Block 13 Ida Darwin Hospital Cambridge (Community paediatricians, speech & language therpists, occupational therpists, admin/ support staff, community nurses) at the end of the 12 month period
12 people had heard of Greatix (8 people had not and had only ever used Datix)

Of those (12 people) that knew about Greatix 
5 people felt that they would use Greatix and Datix equally
5 people felt that they would be more likely to report a Greatix
2 people felt that they would be more likely to report a Datix
3 people felt that changes were made as a result of using Greatix (8 thought no changes were made and the rest were uncertain)
11 felt that it was possible to make service improvements with Greatix ( 1 didn’t think so)
9 felt that Greatix highlighted good role models 
9 Felt that Greatix contributed towards a better working environment
11 Felt that Greatix raised staff morale
11 Felt that Greatix shared best practice
11 Felt that Greatix improved our service to children

Discussion and results: 
  • Staff like to use the Greatix system
  • Over 12 months trial period, Greatix was a more popular reporting tool than Datix.
  • Most staff think that Greatix would improve the service, highlight good role models, create a better working environment, raise staff morale, share best practice.
  • Are we missing a way of reflecting and learning from practice across our NHS Trust by only incident reporting?
  •  Staff need to feel that changes could be made through the Greatix system.
Update (since the audit)
  • The speech and language therapists have asked to join Greatix reporting system.
  • Learning from Excellence first newsletter circulated
  • Managers now wanting to roll out Learning from Excellence Trust wide.
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Tammy Holmes 13/10/2017 - 13:48 Approved Login or Register to post comments
Overview of Innovation:
Discover

At Charles Gairdner Hospital in Perth, Western Australia it was noted that less than 7% of medical staff had ever reported a clinical incident. The second most common reason cited by doctors for not reporting was the negative connotations or consequences associated with reporting incidents. With the aim of redressing this balance it was decided to pilot a system of excellence reporting (ER).

The Medical Assessment Unit (MAU) was chosen as a pilot site and 3 methods of reporting were implemented, intially a paper form and e-mail automatic reply form in October 2016, followed by an online form via the hospital intranet. All staff groups are able to submit reports.

In September 2016, prior to commencing ER, we undertook a survey looking at staff morale and perceptions of learning. We received 74 reponses (74/149), a 50% response rate. 46% of respondants agreed or strongly agreed that there was more focus on failures than achievements on the MAU compared to 31% of respondants who disagreed or stongly disagreed with this statement.

51% of respondants perceived they learned best from reflecting on their own mistakes and incidents, 46% from studying good practice and only 3% felt they learned best from studying others mistakes or incidents.

From October 2016 to May 2017 27 excellence reports were submitted.

Dream/Design:

There have been several challenges associated with this project. The team initially leading the project were not MAU staff members so educating staff and keeping the reporting momentum going was difficult. Involving an MAU medical registrar and one of the nurses as ER champions and excellent communications support from the MAU ward clerk, has gone some way to addressing this.

Destiny:

Learning from excellence is currently being shared at the monthly ward meetings which have been renamed Morbidity, Mortality and Excellence meetings. The MAU nurse champion has created a communication board on the ward dedicated to ER which includes anonymised quotes from submitted reports.

We are currently repeating the staff survey a year after introduction of ER with the hope that staff appreciation via ER has led to an improvement in staff morale. We also plan to look at the rate of incident reporting by MAU staff in October 2017 compared to October 2016 to guage whether the measures implemented to redress the balance between reporting of errors and episodes of excellence has gone any way to decreasing the negative connotations around incident reporting. 
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Sarah Gibb 18/09/2017 - 01:05 Approved Login or Register to post comments
Overview of Innovation:
Discover
 
Staff morale at Southmead Hospital Obstetric unit has been under pressure due to staff shortages, budget constraints and a heavy focus on critical incident reporting. This is not unusual across the NHS.  We evaluated staff attitudes and morale to investigate and share key areas of concern, and act as a platform to launch Excellence Reporting.  We hope that introducing a system of peer-reporting excellent practice would provide a positive opportunity for learning, and improve team resilience, morale and patient safety.
 
An electronic survey was distributed to all staff on the Delivery Suite in March 2017. We received 125 responses from across all staff groups. The majority of staff actually enjoyed coming to work, mean score 3.9 on a 5 point Likert scale (1= strongly disagree, 5 = strongly agree), but with variation between groups. Staff perceive that learning from examples of excellent practice is as valuable as reflecting on their own mistakes (score 4.0 and 3.9 respectively), and both are more valuable than learning from other’s mistakes (score 3.2).
 
The free text responses described how morale is under pressure due to staff shortages and high workload. Staff frequently stated they would feel better appreciated  with more positive feedback, and better communication and understanding of their roles from other members of the multidisciplinary team.
 
Dream
There is clearly a demand for Excellence Reporting on Southmead CDS. Most staff enjoy coming to work, but we need to sustain and develop this attitude across all staff groups. We plan to launch excellence reporting as a means of improving staff morale, resilience and retention by focussing attention on the many examples of excellent care. By selecting some of the reports and studying them in depth using an appreciative inquiry technique, we hope to learn how to make things go right more often. There might be scope for rolling this project out across the whole hospital site.
 
Design and Destiny
We launched an electronic Excellence Reporting system in September 2017, easily accessible on the hospital intranet page. It is being advertised in staff meetings by champions and by posters on the wall. Reports will be collated by a core team, and individuals will receive a Certificate of Excellence for their portfolios. Key themes each month will be shared by the eBulletin newsletter and in staff meetings.
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Sophie Scutt 12/09/2017 - 01:20 Approved 2 comments
Overview of Innovation:
Discover: Safety in healthcare has focused on avoiding harm by learning from errors. Excellence in healthcare is highly prevalent but there is a lack of formal systems to capture it. Adrian Plunkett and colleagues at Birmingham Children’s Hospital recognised this and created a system of Excellence Reporting with the aims of identifying, appreciating, studying and learning from episodes of excellence (www.learningfromexcellence.com).
 
We introduced a similar system of Excellence Reporting at Sunderland Royal Hospital on the 14/2/17. This takes the form of an online reporting tool. The form captures: Who was excellent? What did they do? What does the reporter think we can learn from this? Those reported receive a verbatim copy of the episode of excellence personally signed by the hospital CEO. 
 
The system is designed to redress the balance between reporting of errors and recording episodes of excellence. It is hoped that we can create new opportunities for learning and and that by reflecting on positive events, improve staff resilience and morale.  To date we have had over 200 reported episodes of excellence at Sunderland Royal Hospital.

Dream:

Currently we feedback to the individuals reported as having demonstrated excellent practice but are keen to develop a system for wider organisational learning.
Following development of the Sunderland and South Tyneside Healthcare Alliance it is planned to introduce Excellence Reporting to South Tyneside General Hospital in the near future. This presents an opportunity to look at staff views on morale, appreciation and learning before and after the introduction of a system of capturing excellence.
Neighbouring Trusts have also been establishing similar systems which has given us the opportunity to begin to develop a regional collaborative. 

Design/Destiny:

Appreciative Inquiry is a tool for change management which focuses on strengths. The team at Birmingham Children’s Hospital has used this as a method to analyse some excellence reports in order to embed excellent practice into everyday working. We have arranged training in Appreciative Inquiry with our regional collaborators for November 2017.

We are currently undertaking a survey looking at staff views on excellence reporting, impact of reporting and perceptions on learning. Informal feedback has been very positive. We plan to start to share learning through a feedback bulletin, a lessons learned session and show case event with the Trust Innovations team.





 

 

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Sarah Gibb 12/09/2017 - 00:16 Approved 1 comment
Overview of Innovation:
Define:  
 
You’re Greatix - Implementing Excellence Reporting across a Major Trauma Network and a Teaching Hospital Trust

Discover:
 
In 2016 July Excellence Reporting (ER) was launched across the North Yorkshire & Humberside Major Trauma Network, covering 3 Acute Hospital Trusts & 2 Ambulance Services. Following successful multiagency reporting it was identified that the next step was to develop ER beyond Regional Major Trauma, to support centre specific learning from excellence. An online ‘Greatix’ form was introduced at the Hull & East Yorkshire NHS Trust in June 2017: https://www.hey.nhs.uk/greatix/. The Trust Employs over 8000 staff and sees approximately 1 million patients a year.

Initial test sites on the Major Trauma Ward, ICU & ED show promising engagement from staff. Using Quality Improvement Plan/Do Study/Act & ‘Just Do It’ methodology we matched with a local staff safety & engagement questionnaire, & plan to use this to compare results in test sites one year after introduction. Locally we are developing exciting smaller projects to trial & measure different uses of ER.  

Dream 
 
We aim to have an embedded system, shown by increasing report numbers - these feed into ongoing Lessons Learnt & monthly Quality Improvement Boards. Most importantly, we want the continued learning to feedback directly to staff in clinical, & nonclinical areas. Seeing implemented learning produce sustained positive outcomes.  We are developing an ‘induction pack’ to support different areas tailor Greatix to their needs, such as using Safety Huddles or poster boards. We aim to improve engagement & moral, by showing staff their ideas & observations are being valued. Also, it will feed into the next Trust annual ‘Golden Hearts’ Award voted for by staff, allowing the process to come full circle.

Design:  
 
Development has been variable, often quick thanks to engagement across the hospital, though we have struggled with delays in identifying the best ways to share information, & have found continuous staff feedback most helpful. We have developed formal & 5-minute Appreciative Inquiry, plus innovatively are directing a simple ‘Thank You’ into the established Trust ‘Moments of Magic’, allowing immediate recognition & feedback.
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Destiny:  
 
Shared learning from Greatix is a multi-disciplinary & multi-level approach.  We are keen to share our successes & learning points, all whilst celebrating fantastic staff. Our thanks go to the LfE Community for supporting us in this journey. 
 
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Anna Greenwood 11/09/2017 - 22:32 Approved Login or Register to post comments
Overview of Innovation:
To improve healthcare and patient safety we use incident reporting systems and mortality reviews to analyze cases where something possibly went wrong. It is known that headlining errors have a negative impact on the affected healthcare professional. On the other hand, drawing attention to positive performances results in increased healthcare professional’s confidence and thus may have a positive effect on patient safety as well. Therefore we started the PIMing (Positive Incident Reporting) project in the emergency and pediatric departments of our hospital.
Colleagues were asked to answer three questions (on paper or by email) when they were involved in an excellent care case.
These three questions concern:
1.       What made the care in the given case exceptional?
2.       What can we learn from this case?
3.       Which healthcare professionals were involved?
Feedback was given once a month to all persons involved in the reported cases. The most remarkable outcome was that the majority of the PIMs were about individual performance and patient-specific care. Procedures and organizations were less frequently reported.
Four months after starting the PIM project we sent a survey to the colleagues who had received or sent a PIM to analyze the effect. Colleagues who received a PIM felt appreciated, grateful and delighted. Colleagues who sent a PIM reported complimenting a colleague felt good. PIMing also has a positive effect on the working atmosphere.
The most important reasons mentioned to PIM were: good teamwork, cooperation between departments, individual performance and patient-specific care. This also applied to the majority of the 28 collected PIMs. Suggestion for improvement contains weekly noticing PIMing and department/hospital wide feedback.
During the project colleagues from other departments who never heard about PIMing before received PIMs as well. They were pleasantly surprised and asked if it was possible to introduce PIM in their own department.
After a column about PIMing in Medisch Contact (a Dutch medical journal) by Paul Brand, one of our pediatricians, other hospitals became enthusiastic and contacted us for more information. Currently emergency departments across the Netherlands have started similar projects.
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Monique 11/09/2017 - 21:43 Approved Login or Register to post comments
Overview of Innovation:
The North West and North Wales Paediatric Transport Service (NWTS) has used Excellence Reporting as a method of providing personal feedback and learning from good practice for over 18 months. We frequently encounter excellent practice amongst our colleagues in the region's district general hospitals and although able to provide feedback to individuals and teams we lacked a forum to share learning points with a wider audience.

As part of our education programme, NWTS offer annual outreach sessions to each of our 29 referring DGHs. These sessions are open to paediatric, ED, anaesthetic and ICU medical, nursing and ODP teams. This year, an excellence safari was included in these sessions, discussing individualised learning points for each department, recurring or significant themes relevant to all DGH practitioners and case summaries of particularly outstanding practice. 

As well as widening the scope of our Learning from Excellence initiative, this enabled the individuals and teams involved in many of the cases covered to discuss their experiences amongst their colleagues and the NWTS education team.

Excellent practice, innovation and teams and individuals going above and beyond their role often occurs in challenging situations (including in those where not everything went to plan, or where the outcome was poor) - allowing a forum to discuss these events whilst focusing on the positive created a safe environment for debreif and feedback. 

The Excellence Safari has been well received in this year's outreach provision and as such will remain part of the programme for next year. Feedback given by participants in the outreach sessions will be taken into account when developing future methods of sharing and learning from excellent practice. 

 
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Lisa Pritchard 11/09/2017 - 19:52 Approved Login or Register to post comments
Overview of Innovation:
Posted on behalf of Edel Roddy, PhD Student at Institute for Care and Practice Improvement

The Why 
Effective collaboration between regulatory staff and those they inspect has been recognised as a key component in furthering the improvement agenda within nursing homes. In a context where there is a recognised power imbalance between the regulator and the regulatee, literature focuses predominantly on exploring the role of the regulator/inspector in the success or otherwise of this relationship. This poster will present a study which used appreciative inquiry to bring together all those who participate in nursing home inspection (inspectors, inspection volunteers, care home managers and staff, residents and relatives),  where the focus was on the shared capacity of all involved to enhance the experience of inspection.  Drawing on relationship-centred care as the theoretical framework this study explored the relational processes at play in inspection with particular attention to those which help to build collaboration. Knowledge of these positive relational practices was used by the research participants to inform experimentation with new initiatives to develop these relationships further.
 
The How
The study took place over 17 months, during which time data was generated through group discussions, interviews and researchers observations of inspection visits in nursing homes.  The methods used in this study were chosen for their ability to recognise and value the place of extended ‘ways of knowing’ e.g. experiential, practical and presentational ways of knowing in the co-construction of insights and knowledge. The choice of methods in this study had been informed by conventional approaches to data generation within qualitative research studies, whilst also being cognisant of the particular creative impetus inherent within an appreciative inquiry approach.  Therefore, within the methods listed above creative techniques such as Visual Inquiry, collage work, and poetry were used to access tacit knowledge and stimulate generative and expansive thinking. 
 
What Emerged
Mapping the findings of the study to the principles of relationship-centred care suggested that the incorporation of the following ‘appreciations’ can help to bring about a R.I.C.H. (Relationship Inspection in Care Home) Ways.
We are all human- Human Face of Inspection
We value being together in ways which build trust and collaboration
Our Agenda is our Shared Purpose- We are connected by a shared purpose
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Manish Patel 11/09/2017 - 15:09 Approved Login or Register to post comments
Overview of Innovation:
Define: Sharing Outstanding Excellence (SOX) at Salisbury NHS Foundation Trust.
 
Discover: Having been inspired by ‘Learning from Excellence’ we conducted a staff questionnaire at Salisbury Spinal Unit, to ascertain their feelings about learning from incidents prior to launching a pilot project to introduce positive event reporting. This involved paper-based reporting with a central post box. Nominations fed-back to the nominee, their line manager and the person that nominated them. Results are shared on a noticeboard for team members and patients to read. 
Nominations are themed and shared Trust-wide via the Patient Safety Steering Group.
 
A follow-up survey determined staff thoughts about the initiative. More than 50% of staff said that they had used their nomination in an appraisal, with another 24% saying that they planned to do so. 93% reported that it improved staff morale, with 96% stating that it can increase quality of care. When asked if they had made a nomination those that hadn’t reported that it was because they did not know how and needed more publicity and promotion about the initiative. Those that had been nominated report feeling ‘appreciated’, ‘boosting confidence’ & ‘fantastic’.
 
Dream: There is trust wide SOX reporting, throughout all departments, where positive events are acknowledged and learnt from. With nominations displayed on each ward information board and recognition is given to staff whom are outstanding. Whilst sharing this excellence with all staff from cleaners to consultants, sharing of excellence is the norm with an electronic reporting system in place.
 
Design: The innovation has buy-in from the Chief Executive who feels that it fits in well with the organisation’s values and vision. Plus the Director of Nursing who chairs the Safety Steering Group and will form part of the steering group for Wessex Patient Safety Collaborative Scale Up 4 Safety. We aim to work together to create scale up units, each with their own champions and leadership to spread the initiative across the hospital. We aim to engage any sceptics by listening to their ideas and acting upon them to create momentum and promote SOX.
 
Destiny: This will involve presentation at clinical governance and promotion via hot boards & newsletters, with a branding logo.
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Anna Woodman 11/09/2017 - 15:08 Approved 1 comment
Overview of Innovation:
Define:  
Excellence Reporting in ChelWest…and Beyond

Discover:  
Following a difficult few months in London, with four major incidents in a short space of time, we felt that our staff needed some morale-boosting. This project seemed like the perfect solution. It provided a platform for formal positive feedback, rather than our previous system that encouraged only ubiquitous negative feedback through error-identifying incident reporting.
 
We created a simple system, allowing colleagues to submit Excellence Reports via online or paper forms. We used a short explainer video (see https://vimeo.com/209937486) and posters to tell people about the project. And then we got started.
 
And this project worked. In the first month we received 30 excellence reports, and in the second month we received 40. We distributed the reports, as well as sharing themes and anonymous quotes with the department as a whole.

Dream
In a year’s time, our Excellence Reporting project will be rolled out across the hospital and the Trust. Chelsea and Westminster ED will have demonstrated increased staff morale and overall well-being due to this project. We will have published our initial results In a peer-reviewed journal.
 
Excellence Reporting will be part of the governance structure of the hospital. We will encourage every clinical governance half day to have Excellence Reports presented. Additionally we will run appreciative inquiry workshops
 

Design:  
We have an Excellence Reporting team in the Emergency Department and the project has already expanded to the Medical Team, with the Executive Unit of the Trust interested in broadening this project further. Our Emergency Department team is a champion of Excellence Reporting and will lead the development throughout the hospital.
 
Our initial challenges were in implementing the project and encouraging staff to submit reports. We led by example, and the Excellence Reporting team submitted reports ourselves initially to help spread the word; other people started to follow.
 
We are focusing on developing the analytics and automating the online process to generate excellence reports and data analysis. Currently this is done manually by the Excellence Reporting team.

Destiny: 
We have presented this project at internal department, hospital, and trust-wide meetings. This project has also been presented abroad (in Australia) and widely across social media. Other hospitals have asked to use our resources, such as the explainer video for their own departments.
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Tessa Davis 11/09/2017 - 13:23 Approved Login or Register to post comments
Overview of Innovation:
Discover
Walsall Healthcare NHS Trust provides acute care and community services for people living in Walsall and the surrounding areas.

Dream
Our story began with a fortuitous meeting between three individuals who have become the core team for LfE -a consultant, senior nurse and senior manager- giving us a broad understanding of the organisation and credibility across professional groups. Sharing a Quality Improvement background, we committed to apply a rigorous QI methodology and a “ground-up” approach.

Design
Our first step was stakeholder engagement and selection of 3 pilot sites (paediatrics, general surgery and community). We obtained Appreciative Inquiry (AI) training for leaders in those areas, providing inspiration as to how they would implement LfE; accounting for local culture, personality and strengths. For example: paediatrics developed an app to facilitate reporting “on the go”. In surgery the trainee surgeons’ induction has been adapted to include AI principles and encouragement to notice excellence. In the community, AI principles have informed a facilitator guide to reframe conversations held in nursing homes.

There has been learning from individual nominations such as a successful MRI scan of an autistic boy has led to exploration and a SOP to get it this good, every time. There has also been much learning about the process, such as avoiding unhelpful resentment from those not nominated, by including them in the *giving* of the award.

An organisation-wide reporting tool used for Incident Reporting and oversight by the LfE project implementation group binds these 3 pilots. Use of the existing reporting tool brings familiarity to the organisation and ease of access. Its disadvantage was that it was not easily configured for excellence reporting and new pathways needed developing. The team have built on work in other organisations and used sequential improvement (PDSA) cycles to maximise learning and continuously refine the process. Moreover, we are vigilant for unintended consequences such as on intra-team dynamics.

Destiny
For sustainability we are keeping the process simple, maximising automation & linking to existing systems. Measures of success are qualitative and quantitative – including nominations received & inter-professional reporting. As an an measure of culture, we aim for a time where across the organisation the number of incidents is exceeded by the number of excellence nominations.
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Hesham Abdalla 10/09/2017 - 20:18 Approved Login or Register to post comments
Overview of Innovation:
Introduction and aims:  PRAISE is a QI project that seeks to identify excellence within the daily practice of all sectors of Great Ormond Street Hospital staff through peer reporting.
Method: Design of a simple intranet-based form followed by soft-launch (five emails and one MDT meeting presentation) within all members of theatre, anaesthetics, radiology and intensive care teams. All forms analysed against relevant Trust values and thematic analysis performed to derive master themes from peer feedback. All staff making or receiving a PRAISE received a written record of this and were invited to an Appreciative Inquiry event.
Results: 62 PRAISE forms were completed within the first 12 weeks of the programme. The flow of PRAISE is represented in Figure 1 (attached), with each arrow representing one PRAISE episode.
The majority of PRAISERS were medical (67%) whilst PRAISEES were split equally between medical and nursing/allied health professionals (38% and 32% respectively) with the remainder between non-clinical staff such as cleaners are 1.nd administrative staff. 12 (19%) directly PRAISED actions which impacted positively upon patient care,  and  29 (46%) PRAISED general brilliance. The GOSH values ‘Always Helpful’ and ‘Always One Team’ were the most frequently cited (63%) Trust values by PRAISERS. 28 (45%) PRAISE forms were from senior team members PRAISING more junior team members; 7 (11%) were from junior to senior team members.
Discussion: This pilot of PRAISE within a small number of departments within Great Ormond Street has demonstrated a clear appetite for a system that allows peers to report excellence across all fields of the Trust’s reach.  There is rich learning to be gained from appreciative inquiry and thematic analysis of the practices and data that this programme showcases.
Authors: Miss Clare Rees, Dr David Porter, Simi Thankaraj, Dr Peter Sidgwick
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Peter Sidgwick 10/09/2017 - 18:00 Approved Login or Register to post comments
Overview of Innovation:
DEFINE
Many days in our theatre suite our lists go well, staff perform brilliantly and patients receive excellent outcomes.  In order to celebrate, learn from and build upon these successes, we introduced LfE in March 2017.  In doing so, we aimed to improve staff morale.

DISCOVER
An initial 'test of change' in our cardiac theatre was carried out.  Word quickly spread and LfE was soon in use throughout the theatre suite.  We initially used a reporting form set up by our PICU colleagues using the BCH template (http://www.picu.scot/contact-us/RHC-PICU-learning-from-excellence-form/learning-from-excellence-report-form/). 

We promoted the initiative using posters, emails, presentations and by word of mouth.  This increased report numbers May and June 2017 (see figure 1).


Figure 1: Monthly LfE reports in our theatre suite, 2017.

There are now three test sites in our hospital: PICU, ED and Theatres.  A computerised reporting system is being trialled (figure 2), which allows a searchable database of reports to be collated. 



Figure 2:  'Datix' style online reporting system.


The staff reported and the reporter both receive copies of the form. A regular newlstter (latest edition attached) is distributed to staff, and example reports displayed on our communication board. 

LfE is gathering momentum and support throughout the theatre suite.  Staff members indicate that morale has been positively influenced.  We have learned that staff appreciate receiving their reports in a timely manner.  Some common themes are coming through, which merit further discussion using an Appreciative Inquiry (AI) structure.

DREAM
We aim for LfE to become as engrained in our culture as critical incident reporting.  Ongoing timely feedback and further AI for relevant reports would be ideal. We aim for LfE to become hospital-wide.

DESIGN
We will continue encouraging staff to participate.  Some staff have become 'LfE champions' to help keep the momentum up.  We ask staff to consider LfE at each surgical brief and debrief.  Once we have reflected upon lessons learned from our 3 test sites, the whole hospital will be invited to participate.

DESTINY
Being able to securely complete LfE reports at any time on any electronic device would increase accessibility.  It would be interesting to include patients and parents in this programme.  We hope that LfE will help create a cultural change of positivity allowing staff to reflect upon all the excellent work they do and keep the patient at the centre of all.
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Alyson Walker 08/09/2017 - 17:40 Approved Login or Register to post comments
Overview of Innovation:
Since establishing Learning from Excellence at Derriford Hosptial in Plymouth 8 months ago, we have received over 300 nominations.  Quality improvment methodology (PDSA cycles) has been employed since inception and resulted in a number of seemingly small, yet impactful changes that have greatly enhanced uptake.  The details of these PDSA cycles will be described in further detail.
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Gemma Crossingham 07/09/2017 - 20:18 Approved 1 comment
Overview of Innovation:
Define
Learning from Excellence in Salford Royal Critical Care

Discover

Critical Care at Salford Royal is a 24-bedded unit admitting over 1000 patients/year.  It serves as one of the country’s busiest neurosciences units and is a centre for major trauma.
Inspired by the Learning from Excellence team, we decided to implement LfE for two main reasons;
• To improve care for patients by recognising, examining and amplifying good practice.
• To enhance staff morale and build a culture of rewarding excellence.

Our project utilised a simple paper based reporting tool, staff are encouraged to report any excellent practice. An electronic excellence report is then sent to the reporter and the person whose excellence is being appreciated. Reports are analysed for reporters, reportees and themes. Bimonthly summaries are distributed to all staff, allowing learning to be shared and excellence celebrated with the whole team.
Since the project launched in December 2016, 252 excellence reports have been received. Staff from all groups including nurses,consultants and other medical staff and admin staff have submitted excellence reports.  At present nursing staff are the most frequent reporters; Band five nurses, the largest professional group, are most frequently reported.  Common themes include teamwork, communication and excellent clinical practice.
A staff satisfaction survey demonstrated that a large majority of staff agreed or strongly agreed that LfE was useful for learning, had positive effects on staff morale and has potential to improve patient care.  It was commented that LfE allowed staff to ‘highlight other people’s strengths’ and ‘encourages positive culture’.

Dream
We intend to build on our experiences by carrying out in depth analysis of excellence reports using Appreciative Inquiry methodology.

Design
Having recently undertaken training in Appreciative Inquiry with Learning from Excellence for Quality Improvement, we are planning our first Appreciative Analysis of Excellence. We plan to present our work to the Greater Manchester Critical Care Network  and will continue to support the expansion of LfE within Salford Royal and the North West Region.  We will continue to actively engage all members of the multiprofessional team.

Destiny
We will continue to share our bimonthly reports locally and plan to present our learning to the Executive Team of our hospital at the Leaders Forum.  We look forward to sharing our learning and learning from others at the LfE Community Event.
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Louise Dean 06/09/2017 - 11:17 Approved Login or Register to post comments

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