1. SAFETY
Safety Thermometer
On one day each month we check to see how many of our patients suffered certain types of harm whilst in our care. We call this the NHS Safety Thermometer. The safety thermometer looks at four harms: pressure ulcers, falls, blood clots and urine infections for those patients who have a urinary catheter in place. This helps us to understand where we need to make improvements. The score below shows the percentage of patients who did not experience any harm within our care. The target The Trust is expected to meet is set for 90%;
92.1% / of patients did not experience any of the four harms in this community trustPressure Ulcers contribute to those patients who were identified as having harm caused to them.
Health care associated infections (HCAIs)
HCAIs are infections acquired as a result of healthcare interventions. Clostridium difficile (C.difficile) and methicillin-resistant staphylococcus aureus (MRSA) bacteraemia are nationally monitored and our staff work hard to try and reduce the incidence of these infections.
Clostridium difficile is a type of bacterial infection that can affect the digestive system, causing diarrhoea, fever and painful abdominal cramps - and sometimes more serious complications. The bacterium does not normally affect healthy people, but because some antibiotics remove the 'good bacteria' in the gut that protect against Clostridium difficile , people on these antibiotics are at greater risk.
The MRSA bacteriaare often carried on the skin and inside the nose and throat. It is a particular problem in hospitals because if it gets into a break in the skin it can cause serious infections and blood poisoning. It is also more difficult to treat than other bacterial infections as it is resistant to a number of widely-used antibiotics.
In November NCH&C have no reported MRSA patients reported and no Clostridium difficile (C.difficile).
Norovirus (Winter Vomiting Bug)
There have been very low levels of Norovirus across the Norfolk, NCH&C has had no cases of Norovirus in November within our Inpatient Hospitals.
Flu Campaign
We are pleased to confirm that we have had a higher than normal response for our clinical staff receiving the Flu vaccine. This is good news for our patients and our staff.
Pressure ulcers
Pressure ulcers are localised injuries to the skin and/or underlying tissue as a result of pressure. They are sometimes known as bedsores. They can be classified into four categories, with one being the least severe and four being the most severe.
NCH&C investigate all of the pressure ulcers patients acquire in our care and assess if they are:
- Avoidable - having reviewed our patients care we identified we could have undertaken further assessment or provided equipment more quickly, which may or may not have prevented the pressure ulcer occurring. We apologise to our patients informing them this has occurred.
- Unavoidable – having reviewed the care provided to our patients we conclude nothing more could have been done to prevent the pressure ulcer occurring.
The following table shows the total number of avoidable ulcers, Grade 3 & 4 acquired within the care of NCH&C;
Apr 2015 / May 2015 / June 2015 / July 2015 / August 20-15 / Sept 2015 / Oct 2015Inpatient / 0 / 0 / 0 / 1 / 0 / 1 / 0
Community - Patients Home / 12 / 8 / 14 / 9 / 19 / 10 / 5
Community - Residential Home / 4 / 4 / 5 / 6 / 10 / 9 / 2
Total / 16 / 12 / 19 / 16 / 29 / 20 / 7
Key
Figures ValidatedSome figures not yet validated
All Figures not validated
The following table shows the number of unavoidable pressure ulcers, Grade 2, 3 & 4 acquired within the care of NCH&C;
2015 04 / 2015 05 / 2015 06 / 2015 07 / 2015 08 / 2015 09 / 2015 10Grade Two / 81 / 95 / 78 / 95 / 90 / 88 / 81
Grade Three / 20 / 15 / 17 / 21 / 10 / 18 / 32
Grade Four / 1 / 3 / 2 / 3 / 1 / 2 / 8
Totals: / 102 / 113 / 97 / 119 / 101 / 108 / 121
Key
Figures ValidatedSome figures not yet validated
All Figures not validated
2. EXPERIENCE
To measure patient and staff experience we ask a number of questions. The idea is simple: if you like using certain
products or doing business with a particular company you like to share this experience with others.
The answers given are used to give a score which is the percentage of patients who responded that they would
recommend our service to their friends and family.
Patient experience
The Friends and Family Test
The Friends and Family Test (FFT) requires all patients to be asked;
‘How likely are you to recommend our service to friends and family if they needed similar care or treatment?’
Trust Recommend % for October / Trust 2015/16 Year TotalA patient's story
As well as the wealth of feedback received from patients, carers and families in the Friends and Family Test and other surveys, the trust has many other sources of patient feedback:
The Patient Advice and Liaison Service (PALS) is part of our overall commitment to provide high standards of care and to support patients, carers and the public who use NCH&C services. PALS provides an informal and impartial way to resolve the concerns of patients, carers, relatives and the public.PALS aims to manage concerns, comments and enquiries effectively, promote service user satisfaction, reduce the number of issues that may escalate to a complaint where appropriate and ensure that the patient’s voice is at the heart of the service.
PALS worksclosely with patients, carers and NCH&C staff to resolve concerns and where required, provides advice and guidance to enquirers to access NCH&C Complaints procedure.PALS ensure lessons are learnt from specific concerns and feedback leading to continuous improvement of services to patients, carers and relatives, members of the public, key stakeholders and commissioners.
For example, this month PALS received an enquiry from a daughter concerned about her father who had been in an inpatient hospital for rehabilitation. The daughter felt herfather had deteriorated rapidly physically, emotionally and mentally. The daughter also had concerns about inconsistencies in communication and record management when a care review meeting had not taken place. With consent of the daughter, and acting on behalf of the daughter, PALS liaised with the Wardstaff who confirmed that a family meeting was arranged for the following day to talk through concerns. The daughter was informed of this meeting and given the option that if she felt she was unsatisfied with the outcome of the meeting, PALS would continue to seek further resolution. No further contact was received.
NCH&C PALS is available Mon – Fri 9am – 5pm. Contact PALS Free phone tel 0800 0884449.
Staff experience - The Friends and Family Test
The Friends and Family Test (FFT) requires staff to be asked, at periodic points;
How likely are you to recommend our organisation to friends and family if they needed care or treatment?’ and ‘How likely are you to recommend our organisation to friends and family as a place to work?’
Number of Respondents"How likely are you to recommend this organisation to friends and family if they needed care or treatment" / 64 / 162 / 86 / 12 / 11 / 6 / 15 / 350 / 65.00%
"How likely are you to recommend this organisation to friends and family as a place to work" / 36 / 101 / 91 / 61 / 44 / 2 / 15 / 350 / 40%
NCH&C are undergoing a period of change and transition which has impacted on our results. We are currently running a series of staff engagement workshops to hear how we can improve our staff satisfaction.
3. IMPROVEMENT
Improvement story: we are listening to our patients and making changes
Patient led service improvement example;
The Patient Environment group meets regularly to review feedback about and plan improvements related to, the Trust’s Community Inpatient Rehabilitation Units and clinic environments. Through our internal and external assessments of these areas plus feedback through our patients and the Friends and Family Test feedback, patientsreported that theyfelt safe, secure and well looked after. Patient stated some areas for improvement in respect of the lack of Wi-Fi connection, limited TV and other entertainment media options available. NCH&C have already commenced a Project to instate WI-FI connection and this will be finished in June next year.
Further improvements following these inspections have resulted in colour coding ward walls and doors plus dining areas to support those patients who have dementia. In addition more clocks have been put in key areas for all of our patients.
Supporting information – Contact us
Contact Norfolk Community Heath and Care with any comments about this report at;
Head Office:Woodlands House; Norwich Community Hospital,
Norwich, Norfolk, NR2 3TU
Online:
Telephone: 01603 697300
@NCHC_NHS
There will be no publication of this report in December due to internal verification of data
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Norfolk Community Health and Care- Open and Honest Report November 2015.