1000 Lives Improvement

1000 Lives Improvement is the national improvement programme, supporting organisations and individuals, to deliver the highest quality and safest healthcare for the people of Wales.

Jul 262017
 

Kate Mackenzie (back), Senior Measurement Improvement Manager

So I went running on the weekend (“So what?!”).

I took part in a running event (“Oh you’re are one of those types!”).

I ran 104 miles.

Now I have your attention. I ran 28 miles on day 1, 39 miles on day 2 and 37 miles on the final day.

I should add for the millennials amongst you, that’s 167 km. Or Milford Haven to Cardigan for visualisers and geographers. Some of you are likely wondering why on earth I would do such a thing. You may even be thinking – I’d love to try something like this. And the compassionate ones might be concerned for the state of my feet (a bit weary, puffy ankles and medically taped up. My ice bath is calling!).

It is the same with improvement projects.

Rarely can you capture interest or support merely by saying “I am doing some improvement”. The only people whose heads will turn are other improvers. “I am doing an improvement project” might capture a few more as it sounds like something out of the ordinary. The third gets everyone’s attention. It’s the data.

Done right, the data is your common language. It immediately gives a frame of reference for your journey. And it explains the magnitude of your achievement. It provokes a response. It shouldn’t be complicated or onerous to collect or explain.

The words “data” or “measures” often raises groans of not being mathematically minded or it’s all too hard. It can feel that it is something extra to do on top of all the lovely improving that you are doing.

Measuring your improvement is inextricably linked to the change you are making. Your data is sitting all around you. You just need to look around with your project aim clearly in mind and think how do I check whether this has improved?

If you don’t know your numbers at the start (your baseline), how can you truly know that you are putting your effort into the right thing?

By monitoring your progress (regular measurement), you are aware of positive results which can be a massive morale boost to keep going. Or you know that blips are just blips or if there is something more determinedly awry.

And then when it comes broadcasting your success to your colleagues, your peers, your directorate manager or the finance director. You want them to recognise and celebrate your achievements but you need to tell them in a way that is meaningful to them as well as you.

You could think about another example – many people undertake a personal improvement project at some stage of their lives,  to lose some weight. In this instance, decisions are taken about what time of day to weigh, how often or whether to enlist the support of a local club. The key point is that no-one starts without knowing their weight to begin with and without recording their regular weigh-ins. Measurement is how you keep yourself on track, how you keep pushing forward with your project.

In short, DATA IS YOUR FRIEND.

It is how you prove to the detractors that your efforts are making a tangible difference. It will be how you convince your upper echelons to give you the support and investment.  And when you look back, it will be the thing that crystallises your success.

Happy measuring!

Jul 262017
 

Kate Mackenzie

Es i i redeg ar y penwythnos (“Beth am hynny?!”).

Cymerais ran mewn digwyddiad rhedeg (“O un o’r rhieni wyt ti!”).

Rhedais 104 o filltiroedd.

Nawr rwyf wedi llwyddo i ddal eich sylw. Rhedais 28 milltir ar ddiwrnod 1, 39 milltir ar ddiwrnod 2 a 37 milltir ar y diwrnod olaf.

Dylwn ychwanegu ar gyfer y mileniaid yn eich plith mai 167 km yw hynny. Neu o Aberdaugleddau i Aberteifi i ddelweddwyr a daearyddwyr.

Bydd rhai ohonoch siŵr o fod yn meddwl pam ar y ddaear y byddwn yn gwneud y fath beth. Efallai y byddwch hyd yn oed yn meddwl – Byddwn wrth fy modd yn rhoi cynnig ar rywbeth fel hyn. Ac efallai y bydd y rhai trugarog yn eich plith yn pryderu am gyflwr fy nhraed (braidd yn flinedig, wedi’u lapio mewn tâp meddygol gyda fferau chwyddedig. Mae’r bath iâ yn galw!) Mae’r un peth yn wir am brosiectau gwella.

Anaml y gallwch ddal diddordeb neu ennyn cefnogaeth rywun drwy ddweud “rwy’n gwneud ychydig o waith gwella”. Yr unig bobl y bydd eu pennau’n troi yw pobl eraill sy’n gwneud gwaith gwella. Efallai y bydd “Rwy’n gwneud prosiect gwella” yn ennyn diddordeb ychydig mwy o bobl gan ei fod yn swnio’n rhywbeth allan o’r cyffredin. Mae’r trydydd yn denu sylw pawb. Y data.

O’i wneud yn iawn, y data yw eich iaith gyffredin. Maent yn rhoi fframwaith cyfeirio ar gyfer eich taith ar unwaith. Ac maent yn esbonio maint eich cyflawniad. Maent yn ennyn ymateb.

Ac ni ddylent fod yn gymhleth neu’n feichus i’w casglu na’u hesbonio.

Mae’r geiriau “data” neu “mesurau” yn aml yn ysgogi cwynion nad oes gan rywun feddwl mathemategol neu bod y cyfan yn rhy anodd. Gall deimlo ei fod yn rhywbeth ychwanegol i’w wneud ar ben yr holl waith gwella hyfryd rydych chi’n ei wneud.

Mae cysylltiad annatod rhwng eich gwaith gwella a’r newid rydych chi’n ei wneud. Mae eich data o’ch amgylch chi. Y cyfan sydd angen i chi ei wneud yw edrych o amgylch gyda’ch prosiect mewn golwg a meddwl sut y gallwch wirio a yw hyn wedi gwella?

Os nad ydych yn gwybod y rhifau ar y dechrau (eich llinell sylfaen), sut y gallwch wybod i sicrwydd eich bod yn canolbwyntio eich ymdrechion ar y peth cywir?

Drwy fonitro eich cynnydd (mesur rheolaidd), rydych yn ymwybodol o ganlyniadau cadarnhaol a all fod yn hwb enfawr i forâl a’ch helpu i ddal ati. Neu sut mae gwybod mai gwyriadau yw gwyriadau ynteu a oes rhywbeth mwy difrifol yn bod.

Ac yna pan ddaw’n amser i roi gwybod i’ch cydweithwyr, eich cyfoedion, eich rheolwr cyfarwyddiaeth neu’r cyfarwyddwr cyllid am eich llwyddiant. Rydych am iddynt gydnabod a dathlu eich cyflawniadau ond rhaid i chi ddweud wrthynt mewn ffordd sy’n ystyrlon iddyn nhw yn ogystal â chi.

Gallech feddwl am enghraifft arall – mae llawer o bobl yn ymgymryd â phrosiect gwella personol ar ryw adeg yn ystod eu bywydau, er mwyn colli ychydig o bwysau. Yn yr achos hwn, gwneir penderfyniadau ynghylch pa amser o’r dydd i bwyso, pa mor aml, neu a ddylid troi at glwb lleol am gymorth. Y pwynt allweddol yw nad oes neb yn dechrau heb wybod eu pwysau cychwynnol a heb gofnodi eu cynnydd bob tro y byddan nhw’n pwyso eu hunain. Mesur yw sut rydych yn cadw eich hun ar y trywydd iawn, sut rydych yn parhau i wthio ymlaen gyda’ch prosiect.

Yn gryno, DATA YW EICH FFRIND.

Dyma sut rydych yn profi i’r difriwyr bod eich ymdrechion yn gwneud gwahaniaeth gwirioneddol.

Dyma sut y byddwch yn argyhoeddi’r rhai ar y lefelau uwch i’ch cefnogi ac i fuddsoddi.

A phan fyddwch yn edrych yn ôl, dyma fydd yn crisialu eich llwyddiant.

Mwynhewch y mesur!

Jun 072017
 

Sera Llewelyn Davies

I recently had the privilege of attending the International Forum on Quality and Safety in Healthcare in London. I was allowed to choose a total of nine sessions that were held over two days. I was very interested in all the sessions, so it was difficult to choose as there were many interesting events taking place.

After travelling from North Wales to London, I was looking forward to attending the forum on Thursday morning. The venue was full of individuals from across the world and I was extremely lucky to be there to learn and share ideas.

The day began with a word of welcome and announcements, which then led on to the first session, entitled ‘International Quality and Safety: where are we now and where are we going to?’ lead by Donald Berwick and Lord Darzi. The session included a discussion on what needs to be changed and how this will happen in years to come.

After attending a variety of sessions over the two days, one that stood out was the second session on the Thursday, ‘How leaders navigate the way’. The main lesson that I learnt from this session was ‘I’ve got the gift’, which is a culture within leadership to improve quality. That gift is passed on down the line to the next person. It is important to remember that it is a path and not a map, which means that it takes time to travel down that path to implement actions. There is a great deal of pressure in the health and care sector. I learnt that, in order to improve quality, this is the gift, with empowerment, engagement and culture being an important part of how we would lead within a placement. I will certainly take that message back and put it into practice on the ward in future, in order to make changes and emphasise the importance of everyone working together and being involved in any action that is taken. Questions must be asked about how to assess, improve safety and improve the service and, as a result, improve experiences. In order to make a difference, I have some ideas for helping new staff on the ward by producing an information booklet and placing an educational notice board on the ward. I learnt a lesson to take back to my workplace, namely that changing and improving quality is a process similar to cooking, and what makes it tasty is collaboration to make something work successfully.

At the end of the two days, I had learnt a great deal. My mind is full of ideas, and I will take them back to my workplace where I work as a New Registered Nurse.

I am very pleased that I entered the #Hellomynameis competition, and will continue with the work of campaigning on the ward. If you are a student nurse or a medical student, you can enter and you could be lucky enough to attend a forum such as this in the future. I am looking forward to attending another forum in the future as part of my work as a nurse. The work of improving the quality of care for patients needs to continue to ensure they have the best care possible. The forum and working with the 1000 Lives staff was extremely inspirational.

Emma Morgan-Williams

Wow! I feel so privileged, honoured and humbled to think that my entry to the “Hello my name is” competition, led to me being given the opportunity to attend this year’s International Forum on Quality and Safety in Healthcare at the Excel London. The speakers were world class and I have to confess to being a little star struck; I had to pinch myself. As a first year nursing student to be able to attend the sessions at such a renowned conference was an honour.

The opening keynote was delivered by Dr Donald Berwick, and Professor Lord Ara Darzi which then was followed by a panel that also included Margaret Murphy, External Lead Advisor for WHO Patients for Patient Safety Programme and Anya De Longh, Self management coach and patient. The panel agreed that greater patient involvement is the way forward.

Another keynote session focussed on ‘Patient Innovators’ and how the impact of technology is creating innovations from patients who proudly shout #WeAreNotWaiting for the mass market to find solutions for their conditions.

Instead these patients are researching, and developing positive solutions through self management to improve their lives and those of others with similar health conditions. I have recently been on an outpatient placement at a diabetic clinic, and I couldn’t wait to share the innovation of Tim Omer, Diabetes Advocate who developed a ‘Tic tac’ glucometer and Artificial Pancreas System. I have shared with colleagues on my placement the innovative work of Sara Riggare, a PhD student at Karolinska Instituet in Sweden and self care expert, who has developed a digital self care mapping tool for the management of her own Parkinson’s disease.

The Friday morning key note was by Jason Leitch, National Clinical Director at The Scottish Government and Derek Feely, President and CEO of IHI, who encouraged us to ask our patients ‘What matters to you?’ This simple concept really inspired me so much that I have since suggested that our Swansea University Student Chapter gets involved in a “What matters to you day 2017”. This simple, yet effective question can help us to provide more holistic and person centred care. As the mother of a child who is deaf I could easily relate; I know if I asked my son “What matters to you?” it wouldn’t be hospital appointments, or hearing aids, it would be football and swimming, demonstrating beautifully that patients are more than just their condition.

One of the real highlights for me was listening to Ingrid Brindle patient of Haughton Thornley Medical Centres and the Chair of Haughton Thornley Patient Participation Group, along with Dr Amir Hannan, GP at Haughton Thornley Medical Centres and Chair of World Health Innovation Summit, who both spoke about the patient #empowerlution – an empowerment revolution. Advocating for full disclosure and individual access to medical records, which they believe will ultimately lead to better patient care.

I also had the opportunity to speak to many people about a variety of issues. These included the 1000 Lives Improvement programmes on Safe staffing levels, sepsis and safer pregnancy campaign to name a few. This opportunity would not have presented itself had I not attended the conference. As a student I made full use of the reading materials which I know I will use in order to build my knowledge and as reference materials for my written assignments.

Listening to Colonel Chris Hadfield, former military test-pilot and astronaut, also gained me a few credibility points with my children, and taught me that the sky really is the limit when delivering quality patient centred care.

Thank you 1000 Lives Improvement for such an amazing experience! I am sure the impact of this conference will carry on throughout the rest of my professional career. I hope that you run a similar competition next year, in order to give another student like myself a learning opportunity that is incomparable to any learning opportunity I have experienced as a student.

Jun 072017
 

Sera Llewelyn Davies

Yn ddiweddar cefais y fraint o fynychu Fforwm Rhyngwladol ar Ansawdd a Diogelwch mewn Gofal Iechyd yn Llundain. Cefais ddewis naw sesiwn i gyd â oedd ymlaen ystod y ddau ddiwrnod. Roeddwn gyda  llawer o ddiddordeb ym mhob un ohonynt, ac felly yn anodd dewis rhai gan fod yna llawer o bethau diddorol ymlaen.

Ar ôl trafeilio o Ogledd Cymru i Lundain ar brynhawn Mercher, mi roeddwn yn edrych ymlaen at fynychu’r fforwm bore Iau. Mi roedd yr adeilad yn llawn o unigolion o bob man o’r byd ac roeddwn yn hynod lwcus i gael dysgu, rhannu syniadau.

Dechreuodd y diwrnod gydag Agoriad o groesawu a chyhoeddiadau gan ddilyn ymlaen i’r sesiwn cyntaf sef ‘International Quality and Safety where are we now and where we going to?’ o dan ofal Donald Berwick ac Lord Darzi. Roedd y sesiwn yn cynnwys beth fydd angen a sut i newid hyn ymhen blynyddoedd.

Wrth fynd i amrywiaeth o sesiynau dros y ddau ddiwrnod, sesiwn â wnaeth sefyll allan oedd yr ail sesiwn ar y dydd Iau, ‘How leaders navigate the way’. Prif beth dysgais o’r sesiwn yma oedd ‘ I’ve got the gift’ sef diwylliant o fewn arweinyddiaeth er mwyn gwella ansawdd ei fod yn anrheg. Mae’r anrheg hynny yn cael ei basio ymlaen lawr llwybr i’r person nesaf. Rhaid cofio mae llwybr ydyw ac nid map, sy’n golygu ei bod yn cymryd amser i fynd lawr y llwybr hynny i roi pethau ar waith. Mae yna bwysau mawr o fewn y maes iechyd a gofal. Dysgais er mwyn gwella ansawdd hyn yw’r anrheg, gyda ‘empoweremnet, engagment + culture’ yn rhan fawr o sut byddem yn arweinio o fewn lleoliad. Byddaf yn sicr mynd ar neges hyn yn ôl drwy ei weithredu ar y ward yn y dyfodol, er mwyn newid rhywbeth a’r pwysigrwydd fod pawb yn gyd weithio ac yn cynnwys pawb yn y weithred. Rhaid cwestiynu ar gyfer sut i asesu, gwella diogelwch, gwella’r gwasanaeth a drwy hynny angen profiadau. Er mwyn gwneud gwahaniaeth syniadau bach ar gyfer helpu staff newydd ar y ward drwy wneud llyfryn gwybodaeth a bwrdd hysbysfwrdd addysgol ar y ward. Dysgais gan gofio mynd ar ddyfyniad hyn yn ôl i le rwy’n gweithio bod newid a gwella ansawdd yn broses fel coginio ar hyn sydd yn rhoi blas yw’r cyd weithio i wneud rhywbeth weithio yn llwyddiannus.

Ar ddiwedd y ddau ddiwrnod, roeddwn wedi dysgu llawer o bethau. Gyda syniadau yn dod yn fyw yn fy meddwl, er mwyn mynd a nhw nôl i’r lleoliad lle rwy’n gweithio fel Nyrs Newydd Gofrestredig.

Rwy’n hynod o falch fy mod wedi ymgeisio am y gystadleuaeth #Helofyenwiydy, gan barhau gyda’r gwaith o ymgyrchu yn y ward. Os ydych yn fyfyriwr nyrsio neu myfyriwr meddygaeth ymgeisiwch ac mi fyddwch yn hynod ffodus o gael fynychu fforwm fel hyn yn y dyfodol. Mewn amser rwy’n edrych ymlaen eto i fynychu yn rhan o’r gwaith fel nyrs. Mae angen parhau gyda gwella ansawdd cleifion er mwyn iddyn nhw gael bob gofal gorau posib. Roedd y fforwm a chyd weithio gyda gweithwyr 1000 o fywydau yn hynod o ysbrydoledig.

Emma Morgan-Williams

Waw! Mae’n fraint ac anrhydedd meddwl bod fy nghais i’r gystadleuaeth “Helo fy enw i ydy…” wedi arwain at y cyfle i fynd i Fforwm Rhyngwladol ar Ansawdd a Diogelwch mewn Gofal Iechyd yn Excel Llundain eleni. Roedd y siaradwyr o’r radd flaenaf ac roeddwn i wedi gwirioni arnynt; roedd yn rhaid imi binsio fy hun. Fel myfyrwraig nyrsio blwyddyn gyntaf roedd yn anrhydedd cael mynd i’r sesiynau mewn cynhadledd mor enwog.

Rhoddwyd y brif araith agoriadol gan Dr Donald Berwick, a’r Athro yr Arglwydd Ara Darzi a ddilynwyd gan banel a oedd hefyd yn cynnwys Margaret Murphy, Cynghorydd Arweiniol Allanol Rhaglen Diogelwch Cleifion ar gyfer Cleifion Sefydliad Iechyd y Byd ac Anya De Longh, hyfforddwr hunanreoli a chlaf. Cytunodd y panel mai sicrhau mwy o gyfranogiad gan gleifion yw’r ffordd ymlaen.

Canolbwyntiodd prif sesiwn arall ar ‘Gleifion sy’n Arloesi’ a sut mae effaith technoleg yn galluogi cleifion i arloesi a gweiddi’n falch #NidYdymYnAros i’r farchnad fawr ddod o hyd i atebion ar gyfer eu cyflyrau.

Yn lle hynny mae’r cleifion hyn yn ymchwilio i atebion cadarnhaol drwy hunanreoli er mwyn gwella eu bywydau a bywydau eraill â chyflyrau iechyd tebyg a datblygu’r atebion hyn. Rwyf wedi bod ar leoliad cleifion allanol mewn clinig diabetig yn ddiweddar, ac nid oeddwn yn gallu aros i rannu arloesedd Tim Omer, Eiriolwr Diabetes a ddatblygodd fesurydd glwcos ‘Tic tac’ a System Pancreas Artiffisial. Rwyf wedi rhannu â chydweithwyr ar fy lleoliad waith arloesol Sara Riggare, myfyrwraig PhD yn Karolinska Instituet yn Sweden ac arbenigwraig hunanofal, sydd wedi datblygu offeryn mapio hunanofal i reoli ei chlefyd Parkinson ei hun.

Roedd y brif araith ar fore dydd Gwener gan Jason Leitch, Cyfarwyddwr Clinigol Cenedlaethol yn Llywodraeth yr Alban a Derek Feely, Llywydd a Phrif Swyddog Gweithredol IHI, a anogodd ni i ofyn i’n cleifion ‘Beth sy’n bwysig i chi?’ Roedd y cysyniad syml hwn wedi fy ysbrydoli cymaint ac ers hynny rwyf wedi awgrymu bod ein Cymdeithas Myfyrwyr Prifysgol Abertawe yn cymryd rhan mewn “Diwrnod beth sy’n bwysig i chi 2017”. Gall y cwestiwn syml, ond effeithiol hwn ein helpu i ddarparu gofal mwy cyfannol sy’n canolbwyntio ar y person. Fel mam plentyn sy’n fyddar gallwn uniaethu â hyn yn hawdd; rwy’n gwybod pe bawn yn gofyn i fy mab “Beth sy’n bwysig i ti?” nid apwyntiadau ysbyty na chymhorthion clyw fyddai’r ateb. Yr ateb fyddai pêl-droed a nofio, gan ddangos yn hyfryd bod cleifion yn fwy na dim ond eu cyflyrau.

Un o’r uchafbwyntiau i mi oedd gwrando ar Ingrid Brindle, claf Canolfannau Meddygol Haughton Thornley a Chadeirydd Grŵp Cyfranogi Cleifion Haughton Thornley, ynghyd â Dr Amir Hannan, meddyg teulu yng Nghanolfannau Meddygol Haughton Thornley a Chadeirydd Uwchgynhadledd Arloesi Iechyd y Byd, a siaradodd y ddau am y claf #empowerlution – chwyldro o ran grymuso. Gwnaethant eirioli ar gyfer datgelu llawn a mynediad unigol i gofnodion meddygol, a fydd, yn eu barn hwy, yn arwain at well gofal cleifion yn y pen draw.

Cefais y cyfle hefyd i siarad â llawer o bobl am amrywiaeth o faterion. Roedd y rhain yn cynnwys y rhaglenni 1000 o Fywydau a Mwy – Gwasanaeth Gwella ar lefelau staffio diogel, sepsis a’r ymgyrch beichiogrwydd mwy diogel i enwi ond ychydig. Ni fyddai’r cyfle hwn wedi codi pe na bawn wedi mynd i’r gynhadledd. Fel myfyrwraig gwnes ddefnydd llawn o’r deunyddiau darllen ac rwy’n gwybod y byddaf yn eu defnyddio er mwyn adeiladu fy ngwybodaeth ac fel deunyddiau cyfeirio ar gyfer fy aseiniadau ysgrifenedig.

Yn ogystal, drwy wrando ar y Cyrnol Chris Hadfield, cyn-beilot prawf milwrol a gofodwr, llwyddais i greu argraff ar fy mhlant, a dysgais nad oes terfyn wrth gyflwyno gofal o ansawdd sy’n canolbwyntio ar y claf.

Diolch 1000 o Fywydau a Mwy – Gwasanaeth Gwella am brofiad mor wych! Rwy’n siŵr y bydd effaith y gynhadledd hon yn parhau drwy gydol gweddill fy ngyrfa broffesiynol. Gobeithio y byddwch yn cynnal cystadleuaeth debyg y flwyddyn nesaf, er mwyn rhoi cyfle dysgu i fyfyriwr arall, cyfle na ellir ei gymharu ag unrhyw beth yn fy mhrofiad i fel myfyrwraig.

Jun 062017
 

Kathryn Topple is a second year adult nursing student and Chapter member at Bangor University.

I wanted to attend the 1000 Lives National Conference as I felt this would further my knowledge and experience of integrated care within the health service.

I felt extremely privileged to have the opportunity to attend as this also developed of my understanding of how multidisciplinary team working within NHS Wales is improving the quality of care that patients receive.

The highlight of my day was having the opportunity to meet Professor Sir Mansel Aylward, Chair of Public Health Wales who also supported the development of 1000 Lives Improvement. This was extremely interesting as we were able to discuss how the improvement service became an established its drive to improve patient care, ultimately leading to the saving of lives.

This experience was thoroughly enjoyable and worthwhile experience and I would whole-heartedly encourage future student nurses to apply to attend subsequent conferences if the opportunity arises.

Fern Williams is a second year adult field student nurse studying in Bangor University.

I was very fortunate to attend the 1000 Lives National Conference at the Celtic Manor in Newport on Wednesday 29 March. The conference involved a number of guest speakers all presenting around the theme of integrating care and the connections to make it happen. Evidence suggests that integrated care can assist in improving fragmentation in health care, but also assist in improving patients quality of life (Sun, Tang, Ye, Zhang, Bo and Zhang, 2014).

The day was very interesting, but two plenaries in particular stood out for me.

The first was by Anna Sussex who is a Frequent Attenders Case Load Manager at Cardiff and Vale UHB, who developed a Frequent Attenders’ Project. Anna stated in her presentation that the Emergency Department where she is situated has 8,000 patients who are classed as frequent attenders, and who have generated nearly 32,000 visits in the last 12 months, at a basic cost of £3.2million to the Health Board. In terms of the project, Anna set up a Multi-disciplinary team, including staff members of the emergency department, Welsh Ambulance Services NHS Trust and out of hours and also included other services such as third party and volunteers, working collaboratively together.

The project helped to identify patients who are inappropriately accessing the services due to a number of reasons. Due to this, a key worker is assigned to a frequent attender dependent in their need such as social isolation.

Anna herself stated on the day that the project has helped to promote independence and re-integrate the individuals back into their community. Statistics on her slide showed that there was an 84% decrease in frequent attenders attending the emergency services and a 95% decrease in costs.

I was also interested in the talk led by Brendan Martin on behalf of Jos De Blok, the founder of the Buurtzorg Care Model, who was unfortunately unable to attend. The Buurtzorg Care Model was founded in 2006/2007 by Jos De Blok himself. The Buurtzorg care model involves nursing teams, with 12 in each and with between 40-60 patients in each team. It was understood that the teams mean professionals are working more efficiently and effectively, helping to improve person centred care. I like the idea of around 60 patients between 12 nurses as it means each nurse has 5 patients. Jos De Blok himself has said it allows the staff to have more time with their patients, I feel that this will help to build a therapeutic relationship. As well as a therapeutic relationship, it will provide continuity of care. Barker (2017) expresses that continuity of care helps with patient satisfaction and actually improves quality of life for those patients with long term conditions.

I was also provided with the opportunity to speak with Chair of Public Health Wales, Professor Sir Mansel Aylward who was interested to know about ourselves as student nurses and what was important to us. I explained to Sir Mansel that I love working with the elderly and am extremely passionate delivering care and promoting independence in patients with dementia. I told him that as an ageing population, it is important that people should have an awareness and understanding of dementia and how it can not only affect the individual but also the individual’s family members. Palmer (2012) explains how relatives have often cared for their loved one for years and are experts but it can be psychologically and physically draining.

In the future I know I definitely would like to do something to help those individuals with dementia. For example, an idea already for my dissertation surrounds nutrition and dementia (which is what I chose for my PCAN assignment). I have actually read how patients who have dementia have a 25% increase in nutritional intake when their food is served on a red plate. As patients with dementia are often reluctant to eat for a number of reasons. I feel that with the appropriate research and time that this is something I could implement within my local health board.

References

Barker, I. (2017) Association between continuity of care in general practice and hospital admissions for ambulatory care sensitive conditions: cross sectional study of routinely collected, person level data. British Medical Journal. http://www.bmj.com/content/356/bmj.j84

Palmer, J. (2012) Caregivers’ Desired Patterns of Communication with Nursing Home Staff—Just TALKKK! Journal of Gerontological Nursing. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3670746/

Sun X., Tang, W., Ye, T., Zhang, Y., Bo, W., Zhang, L (2014). Integrated care: a comprehensive bibliometric analysis and literature review. International Journal of Integrated Care. http://www.ijic.org/articles/10.5334/ijic.1437/

Jun 062017
 

Mae Kathryn Topple yn fyfyrwraig nyrsio oedolion yn ei hail flwyddyn ac yn aelod o Gymuned Prifysgol Bangor.

Roeddwn am fynd i Gynhadledd Genedlaethol 1000 o Fywydau oherwydd roeddwn yn teimlo y byddai hyn yn hybu fy ngwybodaeth a’m profiad o ofal integredig yn y gwasanaeth iechyd.

Braint fawr oedd cael cyfle i fod yn bresennol oherwydd bod hyn hefyd wedi datblygu fy nealltwriaeth o sut mae gweithio tîm amlddisgyblaethol yn GIG Cymru yn gwella ansawdd y gofal mae cleifion yn ei dderbyn.

Uchafbwynt fy niwrnod oedd cael cyfle i gyfarfod â Syr Mansel Aylward, Cadeirydd Iechyd Cyhoeddus Cymru a gefnogodd ddatblygu 1000 o Fywydau – Gwasanaeth Gwella hefyd. Roedd hyn yn eithriadol o ddiddorol am ein bod yn gallu trafod sut y cafodd y gwasanaeth gwella ei sefydlu, ei ymgyrch i wella gofal cleifion, gan arwain at arbed bywydau yn y pen draw.

Roedd y profiad hwn yn bleserus iawn ac yn werth chweil a byddwn yn annog nyrsys sy’n fyfyrwyr yn y dyfodol i wneud cais i fynd i gynadleddau dilynol os bydd y cyfle yn codi.

Mae Fern Williams yn fyfyrwraig nyrsio maes oedolion sydd yn ei hail flwyddyn ym Mhrifysgol Bangor.

Roeddwn yn ffodus iawn cael mynd i Gynhadledd Genedlaethol 1000 o Fywydau yn y Celtic Manor yng Nghasnewydd ddydd Mercher 29 Mawrth. Roedd y gynhadledd yn cynnwys nifer o siaradwyr gwadd i gyd yn cyflwyno o amgylch y thema integreiddio gofal a’r cysylltiadau i wireddu hynny. Mae tystiolaeth yn awgrymu y gall gofal integredig gynorthwyo wrth wella darnio mewn gofal iechyd, ond y gall gynorthwyo hefyd wrth wella ansawdd bywyd cleifion (Sun, Tang, Ye, Zhang, Bo a Zhang, 2014).

Roedd y diwrnod yn ddiddorol iawn, ond roedd dwy sesiwn lawn benodol yn rhagori.

Roedd y gyntaf gan Anna Sussex sy’n Rheolwr Llwyth Achosion Mynychwyr ym Mwrdd Iechyd Prifysgol Caerdydd a’r Fro, a ddatblygodd Brosiect Mynychwyr. Nododd Anna yn ei chyflwyniad fod yr Adran Frys lle mae wedi’i lleoli yn cynnwys 8,000 o gleifion sy’n cael eu dosbarthu fel mynychwyr, ac sydd wedi cynhyrchu bron 32,000 o ymweliadau yn y 12 mis diwethaf, am gost sylfaenol o £3.2miliwn i’r Bwrdd Iechyd. O ran y prosiect, sefydlodd Anna dîm Amlddisgyblaethol, gan gynnwys aelodau staff yr adran frys, Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru a’r gwasanaeth y tu allan i oriau ac roedd hefyd yn cynnwys gwasanaethau eraill fel trydydd partïon a gwirfoddolwyr, sy’n cydweithio gyda’i gilydd.

Helpodd y prosiect i nodi cleifion sy’n cael mynediad amhriodol i’r gwasanaethau o ganlyniad i nifer o resymau. Oherwydd hyn, mae gweithiwr allweddol yn cael ei neilltuo i fynychwr sy’n ddibynnol yn ei angen fel arwahanrwydd cymdeithasol.

Nododd Anna ei hun ar y diwrnod fod y prosiect wedi helpu i hyrwyddo annibyniaeth ac ailintegreiddio’r unigolion yn ôl i mewn i’w cymuned. Dangosodd ystadegau ar ei sleid fod gostyngiad o 84% o ran mynychwyr gwasanaethau brys a gostyngiad o 95% o ran costau.

Roedd gennyf ddiddordeb hefyd yn y sgwrs a arweiniwyd gan Brendan Martin ar ran Jos De Blok, sylfaenydd Model Gofal Buurtzorg, nad oedd yn gallu bod yn bresennol yn anffodus. Sefydlwyd Model Gofal Buurtzorg yn 2006/2007 gan Jos De Blok ei hun. Mae model gofal Buurtzorg yn cynnwys timau nyrsio gyda 12 ym mhob un a chyda rhwng 40 a 60 o gleifion ym mhob tîm. Deallwyd bod y timau’n golygu bod gweithwyr proffesiynol yn gweithio’n fwy effeithlon ac effeithiol, gan helpu i wella gofal sy’n canolbwyntio ar y person. Rwy’n hoffi’r syniad o tua 60 o gleifion rhwng 12 o nyrsys gan ei fod yn golygu bod 5 claf gan bob nyrs. Mae Jos De Blok ei hun wedi dweud ei fod yn galluogi’r staff i dreulio mwy o amser gyda’u cleifion. Rwy’n teimlo y bydd hyn yn helpu i feithrin perthynas therapiwtig. Yn ogystal â pherthynas therapiwtig, bydd yn darparu parhad gofal. Mae Barker (2017) yn mynegi bod parhad gofal yn helpu gyda boddhad cleifion ac yn gwella ansawdd bywyd i’r cleifion hynny â chyflyrau hirdymor.

Cefais hefyd gyfle i siarad â Chadeirydd Iechyd Cyhoeddus Cymru, yr Athro Syr Mansel Aylward ac roedd ganddo ddiddordeb mewn gwybod amdanom fel nyrsys sy’n fyfyrwyr a’r hyn sy’n bwysig i ni. Esboniais wrth Syr Mansel fy mod yn dwlu gweithio gyda’r henoed ac rwy’n hynod angerddol ynghylch darparu gofal a hyrwyddo annibyniaeth mewn cleifion â dementia. Dywedais wrtho, fel poblogaeth sy’n heneiddio, ei bod yn bwysig y dylai pobl gael ymwybyddiaeth a dealltwriaeth o ddementia a sut y gall nid yn unig effeithio ar yr unigolyn ond ar aelodau o deulu’r unigolyn hefyd. Mae Palmer (2012) yn esbonio sut mae perthnasau yn aml wedi gofalu am eu hanwyliaid am flynyddoedd ac yn arbenigwyr ond gall fod yn straen seicolegol a chorfforol.

Yn y dyfodol rwy’n gwybod y byddwn yn bendant yn hoffi gwneud rhywbeth i helpu’r unigolion hynny â dementia. Er enghraifft, mae syniad sydd gennyf eisoes ar gyfer fy nhraethawd hir yn ymwneud â maethiad a dementia (sef yr hyn a ddewisais ar gyfer fy aseiniad PCAN). Rwyf wedi darllen sut mae gan gleifion â dementia gynnydd o 25% o ran y maeth maent yn ei gael pan fydd eu bwyd yn cael ei weini ar blât coch. Oherwydd bod cleifion â dementia yn aml yn amharod i fwyta am nifer o resymau. Rwy’n teimlo gyda’r ymchwil a’r amser priodol bod hwn yn rhywbeth y gallwn ei weithredu o fewn fy mwrdd iechyd lleol.

Cyfeiriadau

Barker, I. (2017) Association between continuity of care in general practice and hospital admissions for ambulatory care sensitive conditions: cross sectional study of routinely collected, person level data. British Medical Journal. http://www.bmj.com/content/356/bmj.j84

Palmer, J. (2012) Caregivers’ Desired Patterns of Communication with Nursing Home Staff—Just TALKKK! Journal of Gerontological Nursing. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3670746/

Sun X., Tang, W., Ye, T., Zhang, Y., Bo, W., Zhang, L (2014). Integrated care: a comprehensive bibliometric analysis and literature review. International Journal of Integrated Care. http://www.ijic.org/articles/10.5334/ijic.1437/

May 182017
 

If, like me, you have an interest in quality improvement in healthcare, chances are you are in one of two situations. You may already be part of a network of likeminded people, whether this is a formal network such as the IQT Gold Network , or an informal network with colleagues. Alternatively you may have a real interest in quality improvement, and have lots of ideas and experience, but are feeling isolated and don’t know where to go for help, inspiration, or to share ideas. Whichever of these sound most familiar, Q may be for you.

 I was lucky enough to be part of the founding cohort for Q. During 2015, 231 of us from across the UK worked together with the Health Foundation to help design, refine and test Q before wider recruitment started in 2016. It is fair to say that co-producing something with this many people was an interesting experience. At times it was confusing and even frustrating. However it was always thought provoking, it enabled me to be part of lots of brilliant conversations and most importantly, it was lots of fun!

 Now Q has moved into wider recruitment, it’s exciting to see the community grow and develop, and it will be good to see the numbers of people from Wales increase. If you are wondering whether Q is for you and are not sure whether it is worth applying, these would be my thoughts. With Q, you will get out what you put in. It is a two way process, and one that you can engage in to whatever level you wish. It may be that you undertake most of your Q activity at your desk or workplace, whether that is reading or writing blogs, speaking to other community members via the Randomised Coffee Trials, or by joining one of the many special interest groups. Alternatively there are lots of opportunities for face to face networking, with regional and national Q events, Q visits and Q labs.

 For me, Q has provided the opportunity to meet people that I wouldn’t have met, to swap ideas and to learn new things. In Wales, we are quite advanced compared to other areas in that we already have IQT and the Gold Network. With Q, your network within Wales will strengthen and you will join a community from across the rest of the UK. By far the best thing that Q has given me is to meet someone at one of the national networking events from NHS Scotland who does the same job as me. And I mean, exactly the same job. It’s like we live in a parallel universe. Our teams do the same things, are structured the same way, and face the same challenges. We now have monthly phone calls, discuss issues, solve problems together and share documents, solutions and ideas. In July the first of our reciprocal visits is taking place. The way my team and I work, has changed significantly for the better because of the person I met through Q.

 So, do I think you should you join Q? If you have a passion for quality improvement in healthcare, and are willing to be a proactive member in an exciting new community of likeminded people, then absolutely, yes you should!

 More info here, apply today here 

May 182017
 

Os ydych chi, fel finnau, yn ymddiddori mewn gwella ansawdd ym maes gofal iechyd, rydych fwy na thebyg mewn un o ddwy sefyllfa. Efallai eich bod eisoes yn rhan o rwydwaith o bobl o’r un meddylfryd, p’un a yw hynny ar ffurf rhwydwaith ffurfiol megis Rhwydwaith Lefel Aur Gwella Ansawdd gydan Gilydd neu’n rhwydwaith anffurfiol gyda chydweithwyr. Neu efallai bod gennych wir ddiddordeb mewn gwella ansawdd a bod gennych lawer o syniadau a phrofiad, ond eich bod yn teimlo’n ynysig heb wybod ble i fynd i gael cymorth, ysbrydoliaeth nac i rannu syniadau. Pa bynnag un o’r rhain sydd fwyaf cyfarwydd, gall fod yn addas i chi.

Roeddwn yn ddigon ffodus i fod yn rhan o garfan sefydlu Q. Yn ystod 2015, cydweithiodd 231 ohonom ledled y DU gyda’r Sefydliad Iechyd er mwyn helpu i gynllunio, mireinio a phrofi Q cyn dechrau recriwtio’n ehangach yn 2016. Mae’n deg dweud mai profiad diddorol oedd cyd-gynhyrchu rhywbeth gyda chymaint â hyn o bobl.  Roedd yn ddryslyd a hyd yn oed yn rhwystredig ar adegau.  Fodd bynnag, roedd bob amser yn ysgogi’r meddwl, gan fy ngalluogi i fod yn rhan o sawl sgwrs anhygoel ac yn bwysicach, roedd yn llawer o hwyl!

Bellach mae Q wedi symud i recriwtio’n ehangach, ac mae’n gyffrous gweld y gymuned yn tyfu ac yn datblygu, a bydd yn dda gweld cynnydd yn nifer y bobl o Gymru. Os ydych yn pwyso a mesur a yw Q yn addas i chi ac yn ansicr a yw’n werth gwneud cais i ymuno, dyma fy marn i. Gyda Q, byddwch yn cael yn ôl yr hyn y byddwch yn ei roi i mewn i’r gymuned. Mae’n broses ddwy ffordd, ac yn un y gallwch gymryd rhan ynddi ar ba bynnag lefel y dymunwch. Efallai eich bod yn cyflawni’r rhan fwyaf o weithgareddau Q wrth eich desg neu yn y gweithle, boed yn ddarllen neu’n ysgrifennu blogiau, siarad ag aelodau eraill o’r gymuned drwy’r Hap-dreialon Coffi, neu drwy ymuno ag un o’r sawl grŵp â diddordeb arbennig.  Neu ceir sawl cyfle i rwydweithio wyneb yn wyneb, a cheir digwyddiadau Q rhanbarthol a chenedlaethol, ymweliadau Q a labordai Q.

I mi yn bersonol, mae Q wedi rhoi’r cyfle i gwrdd â phobl na fyddwn i wedi cwrdd â nhw fel arall, gan gyfnewid syniadau a dysgu pethau newydd. Yng Nghymru, rydym yn eithaf datblygedig o gymharu ag ardaloedd eraill gan fod gennym rwydwaith Gwella Ansawdd gyda’n Gilydd a Rhwydwaith Aur eisoes.  Gyda Q, caiff eich rhwydwaith o fewn Cymru ei gryfhau a byddwch yn ymuno â chymuned sydd ar gael ledled y DU.  Y peth gorau a gefais yn sgil Q o bell ffordd oedd cwrdd â rhywun o GIG yr Alban mewn un o’r digwyddiadau rhwydweithio cenedlaethol sy’n gwneud yr un swydd â mi.  Mae ein timau yn gwneud yr un peth, wedi’u strwythuro’r un ffordd, ac yn wynebu’r un heriau.  Rydym bellach yn cael galwadau ffôn misol, yn trafod materion, yn datrys problemau gyda’n gilydd ac yn rhannu dogfennau, atebion a syniadau.  Cynhelir ein hymweliad cyfatebol cyntaf ym mis Gorffennaf.  Mae’r ffordd y mae fy nhîm a minnau yn gweithio wedi newid yn sylweddol, er gwell, yn sgil cwrdd â’r person hwn drwy Q.

Felly, a wyf yn credu y dylech ymuno â Q? Os ydych yn teimlo’n gryf ynglŷn â gwella ansawdd ym maes gofal iechyd, ac yn barod i fod yn aelod rhagweithiol o gymuned newydd gyffrous o bobl o’r un meddylfryd, yna dylech ymuno yn bendant!

Gwnewch gais ar-lein cyn 12 Mehefin yma. gwybodaeth bellach.

Mar 162017
 

The 2017 #HelloMyNameIs student competition asked healthcare students to submit a 500-word reflective piece on where they’ve used the phrase “Hello! My name is…” and how it’s helped their development as a healthcare professional. Our second winner, Sera Llywelyn Davies of Bangor University won on the strength of this submission:


Sera Llywelyn Davies, Bangor University

Hello my name is Sera and I am a third year nursing student at Bangor. A simple statement makes a big difference to patient experiences within the health service. In terms of experience, introducing yourself and generally chatting and communicating with patients is crucially important. You establish an interaction and build a relationship with the patient whilst improving the quality of care. You naturally get to know the patient, which helps with care planning, collaboration and implementing their care. By introducing yourself to patients and their families they feel valued, and uplifted as they feel safe. Being cared for through the medium of Welsh is crucial and the passion to provide a bilingual service for patients is important.  It is important that patients are able to express themselves in their mother tongue.

I reflect on my experience when I was on a clinical placement on a surgical ward. I was charged with caring for a group of patients, where patients receive pre- and post-operative care. At the beginning of duty, I would go around the patients greeting them with a smile … “Good morning, ‘Hello my name is Sera, I’m a nursing student, how are you feeling this morning?”. I felt the warmth between myself and the patient when they talked about their health, life and in general conversation about everyday life. I will focus on a day when a patient came to the bay from recovery after being treated a few hours earlier. The patient’s pain was being managed and he felt uncomfortable following surgery. I introduced myself by saying ‘Hello my name is Sera’ and welcomed the patient to the ward. The patient told me how grateful he was for being able to have a conversation in Welsh. As a nurse it’s important to respect the values and beliefs of patients through dignified care at all times. I explained what was going to happen within the first few hours, for example that a number of observations would be completed such as blood pressure, pulse, temperature, respiratory pulse etc. Secondly, I explained to the patient that he could call me if he needed anything. After ensuring that the patient was settled and content, I went to see to the other patients. As I left the bay, the patient called me to ask for pain relief medication. This demonstrated how important and effective it is to start a conversation with the simple phrase ‘Hello my name is’. It shows that small things make a big difference in relation to the care that patients receive.

The campaign must contine to encourage others to start every conversation with ‘Hello my name is’. Inspired by my experience, this will stay with me throughout my career as a nurse. I would like to see this development being rolled out and used across the health service.

Remember, always introduce yourself and wear your #Helo my name is… ID badge.

Mar 162017
 

Sera Llywelyn Davies, Prifysgol Bangor

Helo fy enw i ydy Sera, rwy’n fyfyrwraig nyrsio trydedd flwyddyn ym Mangor. Mae datganiad syml yn gwneud gwahaniaeth mawr i brofiadau cleifion o fewn gwasanaeth iechyd. O ran profiad, mae cyflwyno eich hun ac yn gyffredinol sgwrsio a chyfathrebu effeithiol gyda cleifion yn holl bwysig. Rydych yn magu rhyngweithio ac adeiladu perthynas rhwng y chi a’r claf gan sicrhau gwella ansawdd. Yn naturiol rydych yn dod i adnabod y claf,ble bydd hyn yn helpu i gynllunio gofal,annog i gyd weithio a gweithredu eu gofal.Wrth gyflwyno eich hunan i’r cleifion a’u teuluoedd maent yn teimlo’n werthfawr,ac yn galonogol drwy deimlo’n ddiogel.Credir fod cael eu gofalu drwy gyfrwng y Gymraeg yn holl bwysig, mae’r angerdd i rhoi gwasaneth dwy ieithog i gleifion yn bwysig.  Mae’n bwysig bod cleifion yn gallu mynegi eu hunain yn eu mamiaith.

Wrth adfyfyrio ar brofiad a ddigwyddodd imi, roeddwn ar leoliad clinigol ar ward llawfeddygol. Cefais ofalu am grŵp o gleifion, ble roedd cleifion yn derbyn gofal tuag at gofal cyn llawdriniaeth, ac ar ôl llawdriniaeth. Ar ddechrau dyletswydd,byddwn yn  mynd o gwmpas y cleifion gan eu cyfarch gyda gwen … “Bore da, ‘Helo fy enw i ydy Sera, rwy’n fyfyrwraig nyrsio, sut ‘ydych yn teimlo bore yma?”. Teimlais y cynhesrwydd rhwng y claf a mi pan roeddent yn siarad am eu hiechyd, eu bywyd ac yn sgwrsio yn gyffredinol am bywyd bob dydd.Canolbwyntiaf ar y diwrnod yma, yn y bae cefais glaf yn dod o adran adferiad ar ôl derbyn triniaeth ychydig oriau ynghynt. Mi roedd y claf dal o dan reolaeth at boen a teimlo’n anesmwyth o’r llawdriniaeth. Cyflwynais fy hunan ‘Helo fy enw i ydy Sera’ a croesawu’r claf i’r ward. Dywedodd y claf wrthai faint o ddiolchgar oeddo am gael sgwrs yn y Gymraeg. Fel rôl nyrs mae’n bwysig sicrhau gwerthoedd a credoau cleifion drwy gofal urddasol bob amser. Eglurais beth oedd yn mynd i ddigwydd o fewn yr oriau cyntaf er enghraifft angen cyflawni nifer o arsylwadau megis pwysau gwaed, pỳls, tymheredd, curiad resbiradol ac ati. Yn ail, eglurais wrth y claf iddo alw arnai os bydd ef angen rhywbeth. Ar ôl sicrhau bod y claf yn gartrefol ac yn fodlon, roeddwn wedi mynd at gweddill o’r cleifion. Wrth fynd allan o’r bae, roedd y claf wedi galw arnaf angen i gael meddyginiaeth tuag at boen. O’r sefyllfa yma,dangoswyd pa mor bwysig ac effeithiol yw dechrau sgwrs gyda’r frawddeg syml ‘Helo fy enw i ydy’. Dangosir fod pethau bychain yn gwneud gwahaniaeth mawr o fewn gofal mae’r cleifion yn eu derbyn.

Rhaid parhau i ymgyrchu ac annog eraill i ddechrau bob sgwrs gyda Helo fy enw i ydy. Yn ysbrydoledig a drwy brofiad, mi fydd hyn yn parhau imi drwy gydol fy ngyrfa fel Nyrs. Hoffwn i weld y datblygiad yma yn ehangu ac yn cael ei ddefnyddio ar draws y gwasanaeth iechyd.

Cofiwch,gyflwyno eich hunain bob amser a gwisgwch eich bathodyn adnabod #Helo fy enw i ydy…