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GP Bulletin January 2016

Ground-breaking kidney injury project poised to enter next phase

Our new project centred on improving the identification and safe treatment of patients with acute kidney injury (AKI) moves into its next phase and wider roll-out across our wards. The team on Wards 1 and 4 at Bradford Royal Infirmary has been part of the Tackling AKI project for the last three months through its testing phase.

The initiative is being delivered here alongside four other acute trusts across the country and supported by the Health Foundation. It aims to improve the prevention, detection and management of acute kidney injury, thereby reducing patient morbidity and mortality.

The team has been testing what is known as the AKI 8 care bundle in real time and adapting it to make sure it works in practice. The knowledge learned during this test phase will help the project team to implement the changes more successfully on other wards in our Trust.

During this three month phase, through the hard work of the staff involved, there has been improvement in the care of patients with AKI. Plans are now in place to spread this good practice to other wards in the Trust.

The project's clinical lead Dr John Stoves said: "It is now three months since we introduced the laboratory AKI e-alert across the Trust and piloted the supporting AKI 8 care bundle on the Medical Admissions Unit (MAU). There has been an excellent response from the MAU team and we have been able to develop a package of measures to help with future implementation of the care bundle in other clinical areas. A sustainable reduction in the incidence of AKI in Bradford will deliver improved outcomes for our patients, and to achieve this we need a team of clinical champions to continue promoting staff and patient education and ensure that AKI remains a high priority throughout our hospitals."

We will soon be talking to primary care teams about the laboratory AKI e-alert as the new service will be extended to include primary care from April 2016. A Renal Update event is planned for Wednesday 27th January at Douglas Mill and will also include details of the AKI CQUIN and a proposed evaluation of Sick Day advice in SystmOne to help prevent AKI in the community.

New £4.75m intensive care unit will be ˜oasis of calm'

A new, innovative intensive care unit will be an ˜oasis of calm', designed to deliver the best possible patient experience and care. The £4.75million state-of-the-art unit at Bradford Royal Infirmary is part of the new £28 million wing and is due for completion at the end of this year. This new facility will provide Bradford Teaching Hospitals NHS Foundation Trust with 16 single bedrooms “ two of which are full isolation suites - replacing its current intensive care unit. The intensive care unit (ICU) has been designed by Bridger Carr Architects after extensive consultation with clinical staff in order to gain a thorough understanding of how care is delivered.

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Maternity screening service praised in inaugural inspection

BTHFT are proud to tell you that our maternity team and its associated healthcare colleagues have been praised after being judged to be providing "a good service. This follows the first formal external inspection of our antenatal and newborn national screening service. This vital provision screens mothers and their babies for conditions such as Down's Syndrome, as well as metabolic and genetic disorders, before and after birth. During their day-long visit to Bradford Royal Infirmary, five inspectors from Public Health England's National Quality Assurance Service examined our evidence and interviewed key staff.

Colleagues who spoke to the assessors included our heads of midwifery and obstetric ultrasound, consultants, antenatal screening co-ordinators, haemoglobinopathy counsellors, hearing screeners and laboratory staff. Our commissioners, the local Clinical Commissioning Groups, also had input.

Antenatal Screening Co-ordinator, Vicky Jones said: "The aim of quality assurance in NHS Screening Programmes is to confirm that minimum standards are being maintained and that continuous improvement is being promoted in antenatal and newborn screening. "It was also important to demonstrate that all women and babies were getting access to a consistent and high quality screening service, which is something we strive to provide on a daily basis here in Bradford. We are delighted and very proud with the outcome that our services more than meet the national required standards and we will continue to drive improvements following our recent accreditation."

Areas of good practice highlighted by the assessors included:

  • our screening champions both in the community and our hospitals
  • our ˜robust' standard operating procedures
  • our good electronic systems and referrals process, and
  • the efficient and timely inputting of results

The inspectors particularly commended the "very professional and collaborative team work in Bradford across all disciplines, as well as our newborn hearing screening, haemoglobinopathy counsellors and ultrasound team. Recommendations, which the team are already working on, included improvements to the audit schedule to ensure it is more refined and timely, alongside continuous advances that we are already scheduled to make to our IT infrastructure.

Julie Walker, our Head of Maternity, has stated that she was delighted with the assessment's outcome and very proud of the staff involved in their first national, external screening in pection. She also revealed that the management team will soon increase staff capacity in order to satisfy rising demand within the service. She added: "We are all really pleased with the good rating and are working hard to ensure the recommendations are in place as quickly as possible."

Extra investment in nursing tops £2.5 million

The next stage of our journey to expand our cohort of registered nurses and health care support workers has been agreed. The Board has given its full support to the investment of an extra £2.5m on additional staff.

These new posts will enable us to increase nurse staffing levels in adult inpatient wards, critical care, and paediatrics. And they will increase capacity in our Accident & Emergency department to allow us to accelerate plans to launch a new model of care. In addition, there will be a further review of staffing in both Non-Invasive Ventilation and Stroke Services.

This additional spending is a clear signal of our wider determination to ensure all aspects of quality of care - safety, patient experience, and clinical effectiveness - are outstanding. This recent investment follows on from our commitment to appoint additional midwives and to support ring fenced time for ward managers. The remaining areas for review are outpatients, day case and theatres and this work will link into our Trust-wide improvement plan. In tandem with this extra investment, we will continue our recruitment efforts to promote Bradford as a good place to work and live to help us fill these extra posts.

Trust Grand Round in January

The Foundation Trust invites all local GPs to attend the Grand Round. These meetings provide an excellent opportunity to meet with fellow professionals whilst remaining up to date with key issues and developments. The next Trust Grand will take place on Tuesday 26th January.

The Foundation Trust invites all local GPs to attend the Grand Round which are held monthly. These meetings provide an excellent opportunity to meet with fellow professionals whilst remaining up to date with key issues and developments. The following presentations will be provided -

  • ˜What can physicians, surgeons and psychiatrists do to prevent mothers dying' - Derek Tuffnell, Consultant “ Obstetrics and Gynaecology

  • ˜Stroke Presentations, Mimics and Chameleons in Bradford' - Hawraman Ramadan, Consultant “ Neurologist and Stroke Physician

The Grand Round is held in the Sovereign Lecture Theatre at Bradford Royal Infirmary on the last Tuesday of each month. Meetings start at 12.45pm and last for an hour. Lunch is available from 12.15pm.