7 July 2020
Three major pieces of work, which improve safety for patients, have been shortlisted for the 2020 HSJ Patient Safety Awards - two of which have been co-led by Wessex AHSN, and one by the AHSN Network.
PINCER is a pharmacist-led intervention to reduce clinically important errors in medicines management, and has been rolled out across England by the AHSN Network and PRIMIS, based at the University of Nottingham.
Time to ACT has been developed by a multi-disciplinary team to improve the early recognition and treatment of deteriorating patients, and has been led by Portsmouth Hospitals NHS Trust, and supported by us at Wessex AHSN.
Both of the teams running these projects have been shortlisted for the Patient Safety Team of the Year Award.
RESTORE2 is a physical deterioration and escalation tool for care/nursing homes based on nationally recognised methodologies, and has been developed by West Hampshire CCG and the AHSN. This work has been shortlisted for the Deteriorating Patients and Rapid Response Systems Award.
RESTORE2 is a tool to support staff in care and nursing homes to proactively recognise and manage physical deterioration in order to improve resident experience and outcomes, reduce 999 calls and prevent admissions to hospital. RESTORE2 stands for Recognise Early Soft-Signs, Take Observations, Respond and Escalate and uses National Early Warning Scores as a common language across the healthcare system. The project was started by West Hampshire CCG in partnership with 66 care/nursing homes, local GPs, the ambulance service, secondary care clinicians and the Wessex AHSN. It has now been adopted by Care Homes across all Wessex CCGs and in 12 out of 15 AHSNs.
The British Geriatrics Society have also included RESTORE2 in their "COVID-19: Managing the COVID-19 pandemic in care homes" (BGS 25/3/2020) which states: "If taking vital signs, care homes should use the RESTORE2 tool to recognise deterioration in residents, measure vital signs and communicate concerns to healthcare professionals."
Facing tough competition from hundreds of applicants, these projects have been selected based on their ambition, visionary spirit and the demonstrable positive impact that their work has had on improving patient safety in primary care.
PINCER searches GPs' clinical systems using computerised prescribing safety indicators to identify patients at risk from their medications. Pharmacists, specifically trained in PINCER, review the outputs and work with practices on an ongoing basis to reduce both current and future patient risk, using a range of quality improvement tools.
PINCER was developed and tested by researchers at the University of Nottingham in collaboration with colleagues from the Universities of Manchester and Edinburgh. Findings from the PINCER trial, published in the Lancet, demonstrated that PINCER is an effective and cost-effective method for reducing a range of clinically important and commonly made medication errors in primary care. Having developed a replication model for the scale and spread of PINCER, PRIMIS has been working in collaboration with the Medicines Optimisation Leads from all 15 AHSNs in England to roll PINCER out to general practices in their locality. This has involved engaging with Clinical Commissioning Groups (CCGs), Primary Care Networks (PCNs), and general practices and providing training to pharmacists working in primary care to deliver the PINCER intervention. Over 1,138 pharmacists (of a total 1,622 individuals) have been trained to deliver the PINCER intervention through a combination of eLearning tools, online resources and face-to-face action learning set sessions.
Since commencing the national rollout in September 2018, 2,430 general practices in 130 CCGs have implemented PINCER showing that a minimum of 23.35 million patient records have been searched to identify instances of potentially hazardous prescribing. In total, 187,534 patients have been identified as being at risk of medication error in at least one prescribing safety indicator at baseline. Analysis of follow-up data from 1,060 practices shows a reduction of 13,387 patients (-14.4%) identified in at least one prescribing safety indicator. Greatest impact can be seen for those indicators associated with gastrointestinal bleed which showed a reduction of 10,599 patients (-25.9%). These early findings demonstrate the impact that PINCER is having in terms of making primary care prescribing even safer for patients.
Dr Sarah Rodgers, PINCER National Programme Manager, PRIMIS, comments, “We are delighted to have been shortlisted for the Patient Safety Team of the Year Award, recognising the collaborative efforts of PRIMIS and the AHSN Network to roll PINCER out to general practices across England. We are committed to delivering improved outcomes for patients, and to be chosen among the other incredible nominees is a wonderful achievement. This nomination has been a tremendous boost to staff at PRIMIS and the AHSN Network and I am sure it will bolster our continued efforts to achieve further scale and spread of PINCER in England. We would like to thank the practices, pharmacists and pharmacy technicians who have been implementing PINCER to make primary care prescribing even safer for patients.”
Find out more about PINCER here.
Time to ACT
Portsmouth Hospitals NHS Trust and the AHSN are delighted to announce that the Time to ACT Project Team has been shortlisted for Patient Safety Team of the Year at this year’s HSJ Patient Safety Awards, recognising their outstanding contribution to healthcare.
The Time to ACT Project Team is a multi-disciplinary team that designed and implemented a Deteriorating Patient pro forma and supporting package to improve the early recognition and response to deteriorating patients. This was rolled out across all adult in-patient wards within Portsmouth Hospitals NHS Trust between Dec 2017 – June 2018 using 'Scale Up 4 Safety' methodology supported by Wessex AHSN’s Patient Safety Collaborative (WPSC).
The Deteriorating Patient pro forma brings together essential information in a standardised way on an easy to find document. The project has increased the documentation of treatment escalation plans by 40% and increased escalation of care by 20% which has been sustained for 2 years following implementation. The team continue to use this and other related initiatives to improve patient safety within the Trust.
Sara Blakeley, Clinical Director ICU and Nicola Sayer, Resuscitation Manager, Time to ACT Project Team leads at Portsmouth Hospitals NHS Trust are delighted that the Time to ACT Project Team have been shortlisted for Patient Safety Team of the Year. “This is recognition of three years of collaborative effort and dedication of our team members in partnership with Wessex AHSN to successfully implement a Deteriorating Patient proforma across all adult in-patient wards in Portsmouth Hospitals NHS Trust.”
“We are committed to delivering improved outcomes for our patients, and to be chosen among the other incredible nominees is a fantastic achievement. This nomination has been a tremendous boost to staff at Portsmouth Hospitals NHS Trust and we’re sure it will inspire the team to continue to the next phase of the project to improve patient safety.”
Find out more about Wessex Patient Safety Collaborative here.
The full list of nominees for the 2020 HSJ Patient Safety Awards can be found here.
Winners will be selected ahead of the ceremony, which will take place virtually as part of the Patient Safety Virtual Congress and Awards in November 2020.