May 112018
 

Joanna Doyle, All Wales Nurse Staffing Programme Lead speaking at Quality 2018

I attended the IHI Forum in Amsterdam in May 2018 as part of the 1000 Lives team, showcasing the quality and safety work that is being undertaken in Wales. The Nurse Staffing Programme supports NHS Wales in meeting the requirements of the Nurse Staffing Levels (Wales) Act, which places a legal duty upon Health Boards and Trusts to ensure that they are providing sufficient nurses to allow the nurses time to care for patients sensitively. As Wales is the first country in Europe to legislate on nurse staffing levels, the forum provided the opportunity to showcase the ground breaking work that is being undertaken in Wales, which is generating international interest. As the All Wales Nurse Staffing programme lead, I was delighted to have the opportunity to deliver a poster presentation on the programme of work to healthcare professionals and managers from across the world. The Nurse Staffing Act will prove influential in empowering nurses, providing them with the evidence they need to support their professional judgement when determining the nurse staffing levels they require to deliver safe and effective care to their patients.

The Forum provided the unique opportunity expand my knowledge on a range of quality and safety projects and initiatives. I was able to network with professionals who are actively involved in quality improvement, and have a keen interest in improving the quality and safety of care provided to patients who access healthcare services. The breadth and scope of experience and expertise was extensive and enlightening, providing much food for thought.

I also gained further experience presenting on the national nurse staffing work, this time on an international platform, I was able to talk to delegates from different countries about the challenges they are encountering in relation to nurse staffing within their areas and  how they envisage the Nurse Staffing Programme will benefit patients, nurses and health boards within Wales. Many delegates were keen to find out more about the national programme of work which they acknowledged was a positive way forward with many benefits for stakeholders.

I gained a wealth of knowledge about new and existing quality and safety initiatives that are being introduced in different countries, and this information has provided me with lots of ideas to share with members of the All Wales Nurse Staffing group and colleagues involved in this programme of work.

May 112018
 

Joanna Doyle, Rheolwr Rhaglen Staff Nyrsio Cymru Gyfan

Mynychais Fforwm IHI yn Amsterdam ym mis Mai 2018, fel rhan o dîm 1000 o Fywydau, yn arddangos y gwaith ansawdd a diogelwch sy’n cael ei gyflawni yng Nghymru. Mae’r Rhaglen Staff Nyrsio yn cefnogi GIG Cymru i fodloni gofynion Deddf Lefelau Staff Nyrsio (Cymru), sy’n gosod dyletswydd gyfreithiol ar Ymddiriedolaethau a Byrddau Iechyd i sicrhau eu bod nhw’n darparu digon o nyrsys i ganiatáu amser i’r nyrsys ofalu am gleifion yn sensitif. Gan mai Cymru oedd y wlad gyntaf yn Ewrop i ddeddfu ar lefelau staff nyrsio, rhoddodd y fforwm gyfle i arddangos y gwaith arloesol sy’n cael ei wneud yng Nghymru, sy’n ennyn diddordeb rhyngwladol. Fel arweinydd Rhaglen Staff Nyrsio Cymru, roeddwn yn falch iawn o gael cyfle i gyflwyno poster ar y rhaglen waith i weithwyr gofal iechyd proffesiynol a rheolwyr o bob cwr o’r byd. Bydd y Ddeddf Staff Nyrsio yn ddylanwadol o ran grymuso nyrsys a rhoi’r dystiolaeth sydd ei hangen arnynt i ategu eu barn broffesiynol wrth bennu’r lefelau staff nyrsio sydd eu hangen arnynt i gynnig gofal diogel ac effeithiol i’w cleifion.

Fe wnaeth y Fforwm ddarparu cyfle unigryw i ehangu fy ngwybodaeth ar amrywiaeth o brosiectau a mentrau ansawdd a diogelwch. Roeddwn i’n gallu rhwydweithio gyda gweithwyr proffesiynol sy’n ymglymedig â gwella ansawdd, ac mae gen i ddiddordeb brwd mewn gwella ansawdd a diogelwch gofal a ddarperir i gleifion sy’n cyrchu gwasanaethau gofal iechyd. Roedd ehangder a chwmpas y profiad a’r arbenigedd yn helaeth, yn goleuo, ac yn darparu llawer i feddwl amdano.

Hefyd, enillais fwy o brofiad yn cyflwyno ar waith staff nyrsio cenedlaethol, ar lwyfan rhyngwladol y tro hwn. Bu modd i mi siarad â chynrychiolwyr o wledydd gwahanol am yr heriau y maen nhw’n eu hwynebu mewn perthynas â staff nyrsio yn eu hardaloedd nhw a sut maen nhw’n rhagweld y bydd y Rhaglen Staff Nyrsio o fudd i gleifion, nyrsys a byrddau iechyd yng Nghymru. Roedd llawer o gynrychiolwyr yn awyddus i ddarganfod mwy am y rhaglen waith genedlaethol, y gwnaethant gydnabod yr oedd yn ddatblygiad cadarnhaol â llawer o fuddion i randdeiliaid.

Enillais gyfoeth o wybodaeth am fentrau ansawdd a diogelwch newydd a phresennol, sy’n cael eu cyflwyno mewn gwledydd gwahanol, ac mae’r wybodaeth hon wedi rhoi llawer o syniadau i mi eu rhannu ag aelodau o grŵp Staff Nyrsio Cymru a chydweithwyr sy’n ymwneud â’r rhaglen waith hon.

 

Feb 132018
 

Senior Organisational Development Manager and NHS Wales Awards judge

The NHS Wales Awards are a national showcase for excellence and celebrate good practice in delivering improved, high quality patient care across Wales. There are eight categories and each category has an independent judging panel. In the first round, the panel score all entries and shortlist three to go through to the second round of judging which takes place as a site visit.

We’ve grabbed a few minutes with Grant Evans, Senior Organisational Development Manager and NHS Wales Awards judge to hear more about what the role involves…

Q – What are the judges looking for in NHS Wales Awards entries?

A – At a basic level, judges are looking for applicants to have met specific criteria relating to each award category.  Most applicants will meet the criteria so we quickly look beyond to try to gauge the increased levels of compassion and questioning of existing clinical or managerial practice to gauge the consequence of the clinical team’s intent.  Clinical teams embark on change without fully knowing where it will take them, it’s a process of unknown exploration in which the intent provides the impetus that eventually shapes the patients improved experience of the service.

Q – What is the most memorable project you’ve visited?

A – Having judged for several years there are so many memorable projects to choose from.  It’s a privilege to be a judge.  Over the past two years I have visited a Mental Health team that has transformed its treatment of Dementia patients by identifying personal objects or symbols which substantially calmed anxiety. I have visited a ward whose staff demonstrated unbelievable compassion which transformed the lives of vulnerable women.  Also, I met with a community healthcare team that dramatically improved the quality of life of a chronically ill patient by enabling her to move out of a secondary care setting in to her home towards the end of life.

Q – What is the benefit of entering?

A – Clinicians are delivering compassionate care each and every day.  It’s hard work and can be a relentless process.  The awards cause applicants to stop, reflect and write up their achievements.  In this part of the process applicants frequently identify actions and consequences that they hadn’t previously seen.  Then they share this with a team of impartial observers who provide some feedback and compare their work with other applicants.  This raises the profile of their improvements both within their organisation and nationally.  Recognition such as this is good for morale and the further development of a culture of improvement.

Entries for this year’s awards are open until 23rd April – read more about the categories here and apply online today here

Feb 132018
 

Grant Evans, Uwch Reolwr Datblygu Sefydliadol a beirniad Gwobrau GIG Cymru

Mae gwobrau GIG Cymru yn llwyfan cenedlaethol ar gyfer rhagoriaeth ac yn dathlu arfer da o ran cyflwyno gofal gwell ac o ansawdd uchel i gleifion ledled Cymru. Mae wyth categori ac mae gan bob categori banel beirniadu annibynnol. Yn y rownd gyntaf, mae’r panel yn rhoi sgôr i bob ymgeisydd ac yn dewis rhestr fer o dri i fynd ymlaen i’r ail rownd o feirniadu sy’n digwydd trwy ymweliad â safle.

Rydym wedi treulio rhai munudau gyda Grant Evans, Uwch Reolwr Datblygu Sefydliadol a beirniad Gwobrau GIG Cymru, er mwyn glywed rhagor ynglŷn â beth mae’r rôl yn ei olygu…

C – Beth mae’r beirniaid yn chwilio amdano yng ngheisiadau Gwobrau GIG Cymru?

A – Ar lefel sylfaenol, mae beirniaid yn chwilio am ymgeiswyr sydd wedi diwallu meini prawf penodol yn ymwneud â phob categori gwobrwyo. Bydd y rhan fwyaf o’r ymgeiswyr wedi diwallu’r meini prawf felly rydym yn cymryd cipolwg y tu hwnt i hyn er mwyn ceisio mesur y lefelau cynyddol o dosturi a chwestiynu arfer clinigol neu reolaethol presennol er mwyn deall canlyniadau bwriad y tîm clinigol. Mae timau clinigol yn ymgymryd â newid heb wybod yn llawn ble y bydd yn eu cymryd, mae’n broses o archwilio diarwybod lle mae’r bwriad yn darparu’r ysgogiad sydd yn y pendraw yn ffurfio profiad gwell y cleifion o’r gwasanaeth.

C – Beth yw’r prosiect mwyaf cofiadwy yr ydych wedi ymweld ag ef? A – Ar ôl beirniadu am sawl blwyddyn, mae cymaint o brosiectau cofiadwy i ddewis ohonynt.  Maen fraint bod yn feirniad. Dros y ddwy flynedd ddiwethaf rwyf wedi ymweld â thîm Iechyd Meddwl sydd wedi trawsnewid y modd y mae’n trin cleifion dementia trwy sylweddoli  bod gwrthrychau neu symbolau personol yn tawelu gorbryder yn sylweddol. Rwyf wedi ymweld â ward ble roedd y staff yn arddangos tosturi anhygoel a wnaeth drawsnewid bywydau merched oedd yn agored i niwed.  Hefyd, fe gwrddais â thîm gofal iechyd yn y gymuned a wellodd ansawdd bywyd claf oedd yn sâl iawn drwy ei galluogi hi i symud allan o leoliad gofal eilaidd ac i’w chartref tuag at ddiwedd ei bywyd.

C – Beth yw’r fantais o wneud cais?

A – Mae clinigwyr yn darparu gofal tosturiol bob dydd. Mae’n waith caled a gall fod yn broses ddiddiwedd.  Mae’r gwobrau’n gwneud i ymgeiswyr oedi, meddwl ac ysgrifennu am eu cyflawniadau.  Yn y rhan hon o’r broses mae ymgeiswyr yn aml yn adnabod gweithredoedd a chanlyniadau nad ydynt wedi eu gweld o’r blaen.  Yna maent yn rhannu hyn gyda thîm o wylwyr diduedd sy’n darparu peth adborth ac yn cymharu eu gwaith gydag ymgeiswyr eraill.  Mae hyn yn codi  proffil eu cyflawniadau o fewn eu sefydliad ac yn genedlaethol.  Mae cydnabyddiaeth fel hyn yn dda i forâl a datblygiad pellach o fewn y diwylliant gwella.

Gellir gwneud cais ar gyfer gwobrau eleni tan 23 Ebrill – darllenwch ragor am y categorïau yma a gwnewch gais ar-lein heddiw yma

 

Nov 172017
 

Kate Mackenzie, Senior Measurement Improvement Manager

So my last blog was about hard-nosed numbers…facts, figures and full of great (!) advice like “Know your baseline” (please follow that one). Perhaps I came over a bit too ‘Wall street’ and you have visions of being stuck to a calculator or spreadsheet? If I did, then I hope you shouted at your screen that chasing numbers can often lead to trouble. And it can…I am with you on that one…IF it’s the only thing that is considered.

So what else is there? What can you do to ensure that your improvement project is not boiled down to one dry number?

Time to go jackanory.

What are you telling your patients, your colleagues, your bosses? How are you communicating? How often?

My answer to these questions is generally lost in an arm-waving fluff and bluster. What’s your response?

For anyone who has undertaken improvement training*, you can be under no illusion that time spent on developing a clear measurement plan is time well spent. But how many of us expend the same energy or time on planning our communications? Isn’t it just talking?

I wonder if you are pondering the questions posed above or rather querying why a data bod is talking about talking.

The thing is comms and measurement aren’t such different beasts when it comes to planning.

Take, for instance, the 6 questions that my wonderful communication colleague, Andrew Cooper has developed for “communications for improvement”

And now if you were to talk to me about your measurement plan:

Okay – there is some different terminology, but the key elements aren’t so different.

So just like Astaire and Rogers made a match whilst Ella Fitzgerald mused whether to just call the whole thing off, comms and measurement are happy bedfellows… perhaps even a new tweetably attractive combination of “commeasurement”.

By planning your communications strategy in tandem with measurement plan, it can actually save you time as you are explore the same questions from two aspects rather than undertaking separate tasks. And there is likely to be crossover – for instance, you may need to track twitter activity if you are raising awareness. And you definitely will need to present your data to someone, somewhere. To be effective, you need to think of the full picture in order to position yourself in that sweet spot of “Change” – where people understand and are engaged to do something differently and want to improve.

With thanks to the Scottish Improvement Leaders Course for introducing me to Brent Dykes: https://www.forbes.com/sites/brentdykes/2016/03/31/data-storytelling-the-essential-data-science-skill-everyone-needs/#39bc0e1a52ad

In this seemingly fear-mongering age, some might immediately declare that you are doomed if you neglect one of these but I prefer to say you are a stronger force for improvement when you appeal to the hearts AND minds of your team, patients, bosses.

If you are despairing of now needing to factor in yet another thing into your planning, here is a handy video to help remind you of those key steps…

Happy commeasuring!

*Big up for Improving Quality Together colleagues (if you haven’t already then please check out the website: Bronze training is an online cracker)

Nov 172017
 

Kate Mackenzie

Roedd fy mlog diweddaraf yn trin a thrafod rhifau oer a chaled…ffeithiau, ffigurau a chyngor gwych (!) megis “Byddwch yn ymwybodol o’ch llinell sylfaen” (mae’n werth dilyn y cyngor hwn). Efallai fy mod wedi swnio ychydig fel rhywun ar ‘Wall Street’, a’ch bod yn dychmygu eich hun yn gaeth i gyfrifiannell neu daenlen? Os felly, yna rwy’n gobeithio eich bod wedi gweiddi at y sgrin bod rhedeg ar ôl rhifau yn gallu arwain at bob math o drafferthion. Ac yn wir fe all…rwy’n cytuno’n llwyr â chi…OS mai dyna’r unig beth a gaiff ei ystyried.

Felly beth arall sydd yna? Beth allwch chi ei wneud i sicrhau nad un rhif sych yw hanfod eich prosiect gwella?

Mae’n amser stori.

Beth ydych chi’n ei ddweud wrth eich cleifion, eich cydweithwyr, eich penaethiaid? Sut ydych chi’n cyfathrebu? A pha mor aml?

Yn gyffredinol, mae fy ateb i’r cwestiynau hyn yn cael ei golli mewn pwl o chwifio breichiau a rhefru di-sail. Beth yw eich ymateb chi?

I unrhyw un sydd wedi cymryd rhan mewn hyfforddiant gwella*, fe wyddoch fod treulio amser yn datblygu cynllun mesur clir yn ddefnydd da o amser. Ond sawl un ohonom sy’n buddsoddi’r un faint o egni neu amser yn cynllunio’r hyn rydym yn ei gyfathrebu? Onid siarad yn unig yw hynny?

Tybed ydych chi wrthi’n ystyried y cwestiynau a ofynnwyd uchod neu’n cwestiynu pam mae person data yn sôn am siarad.

Yn y bôn, nid yw cyfathrebu a mesur mor wahanol i’w gilydd pan mae’n fater o gynllunio.

Ysytyriwch, er enghraifft, y 6 chwestiwn mae fy nghydweithiwr cyfathrebu gwych, Andrew Cooper,  wedi’u datblygu ar gyfer  “cyfathrebu er mwyn gwella ansawdd”

  1. Beth ydych chi eisiau ei gyflawni?
  2. Beth sydd ei angen arnoch i ennyn diddordeb?
  3. Beth mae angen i chi ei ddweud?
  4. Sut byddwch chi’n cyrraedd eich cynulleidfa?
  5. Sut byddwch chi’n ennyn diddordeb eich cynulleidfa?
  6. Beth fyddwch chi’n ei ddysgu ar gyfer y tro nesaf?

A phe byddech yn siarad â mi am eich cynllun mesur:

  1. Beth ydych chi eisiau ei gyflawni?
  2. Beth yw’r sefyllfa bresennol?
  3. Beth sydd angen i chi gadw llygaid arno?
  4. Sut byddwch chi’n cadw llygaid arno?
  5. Sut byddwch chi’n ennyn diddordeb eich cynulleidfa?
  6. Beth fyddwch chi’n ei ddysgu ar gyfer y tro nesaf?

Iawn – mae’r derminoleg ychydig yn wahanol, ond nid yw’r prif elfennau mor wahanol â hynny.

Felly yn union fel yr oedd Astaire a Rogers yn cydweddu’n berffaith tra bod Ella Fitzgerald yn pendroni a ddylai roi’r gorau iddi, mae cyfathrebu a mesur gyfuniad da… efallai hyd yn oed yn gyfuniad newydd atyniadol gwerth ei drydar, sef “cyfesur”.

Drwy gynllunio eich strategaeth gyfathrebu ar y cyd â’ch cynllun mesur, gall arbed amser i chi mewn gwirionedd wrth i chi archwilio’r un cwestiynau o ddwy agwedd wahanol yn hytrach nag ymgymryd â thasgau gwahanol. Ac mae’n debygol y bydd meysydd yn gorgyffwrdd – er enghraifft, efallai y bydd angen i chi ddilyn gweithgaredd ar twitter os ydych chi’n codi ymwybyddiaeth. Ac yn ddi-os bydd angen i chi gyflwyno eich data i rywun yn rhywle. Er mwyn bod yn effeithiol, mae angen i chi feddwl am y darlun cyflawn er mwyn rhoi eich hun yn y lle perffaith i gyflawni “Newid” – lle mae pobl yn deall, ac yn ymroddedig i wneud rhywbeth yn wahanol, ac yn awyddus i wella.

Yn yr oes hon lle mae pawb fel pe baent yn codi bwganod, efallai y bydd rhai yn datgan ar unwaith eich bod yn wynebu eich tranc os byddwch yn esgeuluso un o’r rhain, ond mae’n well gen i ddweud eich bod yn fwy grymus o ran sicrhau gwelliannau os byddwch yn apelio at galonnau YN OGYSTAL Â meddyliau eich tîm, eich cleifion a’ch penaethiaid.

Os ydych yn anobeithio oherwydd bod angen cynnwys rhywbeth arall eto yn eich gwaith cynllunio, dyma <https://www.youtube.com/watch?v=tU2i2Qzv1-4> fideo defnyddiol i’ch atgoffa o’r camau allweddol hynny…

Pob hwyl wrth gyfesur!

*Llongyfarchiadau i gydweithwyr Gwella Ansawdd Gyda’n Gilydd – os nad ydych wedi gwneud eisoes, cymrwch gip ar eu gwefan: mae Hyfforddiant Efydd yn wych.

Oct 112017
 

HeatherJane Coombs – SANDS

In 2004, I thought after your 12 week scan you were home and dry in your pregnancy and you just waited for the little of bundle of joy to join you. How naïve was I! I had heard of stillbirth and babies dying but only from soap operas, it didn’t happen in real life to normal people… Did it?

On the 1 September 2004 I realised that yes stillbirth DOES happen to normal people like myself when I was told at 10.31pm that my son Xander had died inside of me due to a placenta abruption. I wasn’t sure how I expected him to come out, but to then realise I was going to have to give birth to a baby that would never cry broke me in two.

I was in labour for the next 2 days and finally gave birth at 2.43pm to a gorgeous (yes I’m biased, but he was) 5lb 5.5oz baby boy who we named Xander Dangerfield Coombs. I can tell you every single detail of the time spent in that room waiting to give birth, even how uncomfortable the bed was and the posters of babies on the wall. That first night I heard 7 babies being born and knowing my baby would never cry like their babies was torture.

When I was told my baby had no heart beat and then the news that he had died, it was a student midwife who held my hand and cried with me. Her compassion stays with me.  My midwife Cath who was there for the days of my labour and helped me through some tough hours is on a pedestal and will always remain Queen of Midwives to me, she was amazing.  I also know that her shift finished at 2pm on that Wednesday, but she was still there looking after her “poppet” as she referred to Xander and me until gone 9pm when I left.  She dressed him, talked to him and gave us the time to be with him, whilst still being there when we needed something, she was amazing.  I am in awe of a midwife who can deal so lovingly and perfectly with a family in heartbreak and then go next door to a family whose lives have changed in another way differently to ours.

Through my work with Sands (Stillbirth and neonatal death charity), first as a volunteer and then as an employee I have heard so many stories and met so many health professionals, some good and some not so good.  When I was asked to join the National Stillbirth Working Group I was both elated and scared!  My work back ground was a team leader in a call centre and my first few meetings I felt like I was a rabbit caught in the head lights, I was just waiting for someone to tell me I was an imposter and ask me what I was doing there.  The medical talk went right over my head, and often I went home with lots of notes so that I could google what words meant so I could understand what the conversation was about. I would like to think that over time though I have started contributing as the voice of the parents and made a small difference within the group.

Being part of the launch of the Safer Pregnancy Wales Campaign and fortunate enough to be able to share Xander with everyone was amazing and the partnership between Sands and the Maternity Network/1000 Lives Improvement seems to have gone from strength to strength, the upcoming launch of the Pathway being even more exciting.  When we start seeing the stillbirth rates reduce as they did in Scotland then that will really be amazing. His feet may have been small, but Xander’s foot print gets deeper with time.

We will be joining in raising awareness during baby loss awareness week. For more details of events please go to http://www.babyloss-awareness.org

Oct 112017
 

HeatherJane Coombs – SANDS

Yn 2004, roeddwn yn meddwl eich bod yn ddiogel ar ôl eich sgan 12 wythnos yn ystod eich beichiogrwydd, ac mai aros i’ch babi gyrraedd oedd y cam nesaf. Dyna naïf roeddwn i! Roeddwn wedi clywed am fabis marw-anedig ac am fabis yn marw ar ôl cael eu geni ond dim ond mewn operâu sebon. Doedd hyn ddim yn digwydd mewn bywyd go iawn ac i bobl arferol….Nag oedd?

Ar 1 Medi 2004, sylweddolais fod pobl arferol fel fi yn cael babis marw-anedig pan ddywedwyd wrthyf am 10.31pm fod fy mab Xander wedi marw y tu mewn i mi oherwydd toriad yn y brych. Doeddwn ddim yn gwybod sut roeddwn yn disgwyl iddo ddod allan, ond fe wnaeth y sylweddoliad fy mod yn mynd i roi genedigaeth i fabi na fyddai byth yn crio dorri fy nghalon yn ddwy.

Parhaodd yr enedigaeth am y 2 ddiwrnod nesaf ac, yn y diwedd, am 2.43pm ganwyd bachgen bach 5lb 5.5oz hynod hardd (ydw, dw i’n unochrog, ond mae’n wir) a enwyd gennym yn Xander Dangerfield Coombs.  Gallen i ddweud pob manylyn wrthoch chi am yr amser y treuliais yn yr ystafell honno yn aros i roi genedigaeth, hyd yn oed pa mor anghyffyrddus oedd y gwely a’r posteri o fabis ar y waliau. Y noson gyntaf honno, fe glywais 7 babi yn cael eu geni ac roedd gwybod na fyddai fy mabi i byth yn crio yn artaith.

Pan ddywedwyd wrthyf nad oedd gan fy mabi guriad calon ac yna’r newyddion ei fod wedi marw, myfyrwraig o fydwraig ddaliodd fy llaw a chrio gyda mi. Mae ei thosturi hi wedi aros gyda mi. Dwi wedi rhoi fy mydwraig, Cath, oedd yna am ddyddiau’r enedigaeth ac a’m helpodd i drwy oriau anodd iawn, ar bedestal a hi fydd brenhines y bydwragedd am byth yn fy marn i. Roedd hi’n anhygoel. Dw i hefyd yn gwybod bod ei shifft gwaith hi wedi dod i ben am 2pm ar y dydd Mercher hwnnw, ond roedd hi’n dal yna yn gofalu am ei “poppet”, sef yr enw roddodd hi ar Xander, a mi tan wedi 9pm pan adewais i. Fe’i gwisgodd, siaradodd ag e a rhoi amser i ni gael bod gydag e, ac roedd hi yno pan oedd angen unrhywbeth arnon ni. Roedd hi’n anhygoel… Dw i’n rhyfeddu at fydwraig sy’n gallu ymdrin mor gariadus a pherffaith â theulu yn ystod torcalon ac yna’n mynd drws nesaf at deulu y mae eu bywydau wedi newid mewn ffordd arall, yn wahanol i’n bywyd ni.

Trwy fy ngwaith gyda  Sands (elusen ar gyfer babis marw-anedig a marwolaeth ar ôl genedigaeth), yn gyntaf fel gwirfoddolwr ac yna fel gweithiwr, dw i wedi clywed gymaint o straeon ac wedi cwrdd â chymaint o weithwyr iechyd proffesiynol, rhai’n dda a rhai nad ydynt cystal. Pan ofynnwyd i mi ymuno â’r Gweithgor Marw-anedig Cenedlaethol, roeddwn wrth fy modd ac yn ofnus! O ran fy ngwaith, roeddwn yn arweinydd tîm mewn canolfan alwadau, ac yn ystod fy nghyfarfodydd cyntaf roeddwn yn teimlo allan o fy nyfnder, yn aros i rywun ddweud wrthyf fy mod yn twyllo a gofyn i mi beth oeddwn i’n ei wneud yno. Doeddwn i ddim yn deall y siarad meddygol, a byddwn yn aml yn mynd adref â llawer o nodiadau fel y gallwn chwilio ystyr geiriau ar y we, er mwyn deall am beth oedd y sgwrs. Serch hynny, hoffwn feddwl fy mod wedi dechrau cyfrannu dros amser, fel llais y rhieni, ac wedi gwneud rhywfaint o wahaniaeth o fewn y gweithgor.

Roedd bod yn rhan o lansio’r Ymgyrch Beichiogrwydd Mwy Diogel Cymru a bod yn ddigon ffodus i allu rhannu Xander gyda phawb yn anhygoel, ac mae’r bartneriaeth rhwng Sands a’r Rhwydwaith Mamolaeth/Gwella 1000 o Fywydau i’w weld wedi mynd o nerth i nerth, gyda lansio’r Llwybr hyd yn oed yn fwy cyffrous. Pan fyddwn yn dechrau gweld niferoedd y marw-anedig yn gostwng fel y gwnaethon nhw yn yr Alban, bydd hynny wir yn ardderchog. Efallai bod ei draed yn fach, ond mae Xander yn sicr yn gadael ei ôl.

Byddwn yn ymuno i godi ymwybyddiaeth yn ystod wythnos ymwybyddiaeth o golli babis. Am ragor o fanylion am ddigwyddiadau, ewch i www.babyloss-awareness.org

Aug 292017
 

Can you remember when you visited the theatre? What was memorable and enjoyable? Are you looking forward to visiting again?

If it was an operating theatre, would you feel differently? Imagine if:

  • You couldn’t understand what was happening, or why;
  • You were made to wear someone else’s clothes (a hospital gown);
  • On your way to the theatre the people stared/ looked away;
  • The theatre smelled and the lights were very bright;
  • In the theatre noisy machines had flashing lights;
  • You didn’t know any of the people who all wore the same clothes;
  • You kept saying you were confused and scared, but no one noticed;
  • You wanted to leave, but they stopped you. The people appeared to be annoyed?

It would be memorable, but would you want to visit again?

Can we comprehend how a person with a learning disability experiences a hospital? Do we understand how previous experiences influence future behaviour? It may be a typical day for healthcare workers but a very different day for hospital users. It is essential we demonstrate empathy, compassion and understand how the environment and processes within a hospital may be very difficult for others. Whether, we are aware through the learning disability hospital passport, our knowledge or because we have listened to the person and their carers, it is essential we meet those essential reasonable adjustments for treatment.

Our team developed the Soothing Patients Anxiety “SPA” Experience to deliver a less distressing day and a positive experience within the theatre in a hospital. We achieved this by using iterative Plan Do Study Act cycles and other techniques taught by the Silver IQT course to ensure constant refinement of our processes. Patients and/or their carers are equal partners in planning their care. Reflection on every interaction and constant feedback provide new learning for continuous service improvement. An enjoyable memorable day is achieved through patient choice distraction techniques during induction of the general anaesthetic that we call “stealth or themed anaesthesia” which minimises/avoids sedation/and or positive behavioural management (restraint). All techniques are practiced within the theatre with the patient and carers prior to the day of operation, “a dress rehearsal”.

  • Stealth anaesthesia – covert administration of the anaesthetic whilst the individual involved in their favourite activity and chosen distraction technique.
  • Themed anaesthesia- the journey is built around a favourite thing. A gentleman with a learning disability during our dedicated pre anaesthetic assessment clinic remarked that the anaesthetic facemask reminded him of what fighter pilots used in his favourite film Top Gun. The morning of the operation he watched the movie. Walking to theatre he listened to the theme music. In theatre he was involved in a pre flight/anaesthetic checklist. He drifted off to sleep holding his facemask he watched an aerial flight scene via an i-pod in front of his eyes. On waking he received a Top Gun flight certificate.

Awards embody the opportunity to share learning and influence care external to your organisation. Last year the team won the NHS Wales Citizens at the Centre of Service Redesign Award and this year BMJ Anaesthesia Team of the Year. We are honoured to work with people with learning disabilities and the intrinsic opportunity to challenge the norms of healthcare. Our diverse and unique service users ensures constant learning and quality improvement as they each inspire new possibilities/options for future users.

Question: What would you need for a memorable and enjoyable visit to theatre?

For more information email: Paul.Harris@wales.nhs.uk

YouTube: NHS Wales Awards The Spa experience

Aug 292017
 

Allwch chi gofio pryd aethoch chi i’r theatr? Beth oedd yn gofiadwy ac yn bleserus?
Ydych chi’n edrych ymlaen at ymweld â’r theatr eto?

Petai’n theatr llawdriniaethau, a fyddech chi’n teimlo’n wahanol? Dychmygwch:

  • Pe na fyddech yn deall pam neu beth oedd yn digwydd.
  • Petai’n rhaid i chi wisgo dillad rhywun arall (gŵn ysbyty).
  • Ar eich ffordd i’r theatr, roedd pobl yn syllu/ edrych i ffwrdd.
  • Bod y theatr yn arogleuo a bod y goleuadau’n llachar iawn.
  • Yn y theatr, bod golau’n fflachio ar y peiriannau swnllyd.
  • Nad oeddech chi’n adnabod dim un o’r bobl, a oedd yn gwisgo’r un dillad.
  • Eich bod chi’n parhau i ddweud eich bod chi wedi drysu ac yn ofnus, ond bod neb yn cymryd unrhyw sylw. Eich bod chi eisiau gadael, ond eu bod nhw wedi eich atal chi. Bod y bobl yn ymddangos yn flin?

Byddai’n gofiadwy, ond a fyddech chi eisiau ymweld eto?

Allwn ni amgyffred beth yw profiad unigolyn ag anabledd dysgu o ysbyty? A ydym ni’n deall sut mae profiadau blaenorol yn dylanwadu ar ymddygiad yn y dyfodol? Efallai ei fod yn ddiwrnod nodweddiadol ar gyfer gweithwyr gofal iechyd, ond yn ddiwrnod gwahanol iawn i ddefnyddwyr ysbyty. Mae’n hanfodol ein bod ni’n dangos empathi, tosturi, a deall sut gall yr amgylchedd a’r prosesau mewn ysbyty fod yn anodd iawn i bobl eraill. P’un ai a ydym ni’n ymwybodol yn sgil y pasbort ysbyty anabledd dysgu, ein gwybodaeth, neu oherwydd ein bod ni wedi gwrando ar yr unigolyn a’i ofalwyr, mae’n hanfodol ein bod ni’n bodloni’r addasiadau hanfodol, rhesymol hynny ar gyfer triniaeth.

Datblygodd ein tîm Profiad Lleddfu Pryder Cleifion (Soothing Patients Anxiety) “SPA”, i gyflwyno diwrnod llai gofidus a phrofiad cadarnhaol yn y theatr mewn ysbyty. Cyflawnom hyn trwy ddefnyddio cylchau ailadroddol Cynllunio, Gwneud, Astudio, Gweithredu, a thechnegau eraill a addysgwyd gan y cwrs IQT Arian i sicrhau y caiff ein prosesau eu mireinio’n barhaus. Mae cleifion a/neu eu gofalwyr yn bartneriaid cyfartal wrth gynllunio eu gofal. Mae myfyrio ar bob rhyngweithiad ac adborth cyson yn cynnig dysgu newydd i wella’r gwasanaeth yn barhaus. Cyflawnir diwrnod cofiadwy a phleserus trwy dechnegau tynnu sylw y mae’r claf yn eu dewis, wrth roi’r anesthetig cyffredinol, yr ydym yn ei alw’n “anaesthesia diarwybod neu anaesthesia â thema”, sy’n lleihau/osgoi tawelyddiad a/neu reoli ymddygiad yn gadarnhaol (ataliaeth). Caiff yr holl dechnegau eu hymarfer yn y theatr gyda’r claf a’i ofalwyr cyn diwrnod y llawdriniaeth, sesiwn “ymarfer”.

  • Anaesthesia diarwybod – rhoi’r anaesthetig tra bod yr unigolyn dan sylw yn cymryd rhan yn ei hoff weithgarwch a’r dechneg tynnu sylw dewisol.
  • Anaesthesia â thema – caiff y daith ei hadeiladu o gwmpas hoff beth. Fe wnaeth dyn ag anabledd dysgu wneud sylw yn ystod ein clinig asesu cyn anaesthetig pwrpasol, bod y mwgwd wyneb anaesthetig yn ei atgoffa o beth yr oedd peilotiaid awyrennau ymladd yn eu defnyddio yn ei hoff ffilm, Top Gun. Fore’r llawdriniaeth, gwyliodd ef y ffilm. Wrth gerdded i’r theatr, gwrandawodd ar gerddoriaeth thema’r ffilm. Yn y theatr, cymerodd ran mewn rhestr wirio cyn hedfan/anaesthetig. Aeth i gysgu yn dal ei fwgwd wyneb wrth wylio golygfa hediad awyrol trwy i-pod o’i flaen. Ar ôl deffro, derbyniodd dystysgrif hedfan Top Gun.

Mae’r Gwobrau’n ymgorffori’r cyfle i rannu dysgu a dylanwadu ar ofal y tu allan i’ch sefydliad. Y llynedd, enillodd y tîm Wobr Dinasyddion wrth Wraidd Ail-ddylunio Gwasanaeth GIG Cymru, ac eleni, Tîm Anaesthesia  y Flwyddyn BMJ. Mae’n anrhydedd cael gweithio gyda phobl ag anableddau dysgu a’r cyfle cynhenid i herio normau gofal iechyd. Mae ein defnyddwyr gwasanaeth amrywiol ac unigryw yn sicrhau dysgu parhaus a gwella ansawdd, gan fod pob un ohonynt yn ysbrydoli posibiliadau/dewisiadau newydd ar gyfer defnyddwyr yn y dyfodol.

Cwestiwn:

Beth fyddech chi ei angen ar gyfer ymweliad cofiadwy a phleserus â’r theatr?

I gael mwy o wybodaeth:

E-bost: Paul.Harris@wales.nhs.uk