Jul 092018
 

OBS Cymru, the all-Wales collaborative quality improvement project aiming to reduce harm from postpartum haemorrhage, has been shortlisted for two awards this year at the Patient Safety Awards and NHS Wales Awards.

We’ve been getting an update on the project from its two national lead midwives, Elinore Macgillivray and Kathryn Greaves.

 

For anyone who hasn’t heard of OBS Cymru, can you start by giving an overview?

Elinore: Postpartum haemorrhage (excessive bleeding after childbirth) is the second leading cause of direct maternal death in the UK, and accounts for 80% of maternal morbidity.1 in 20 women will experience a postnatal blood loss in excess of 1 litre, and for 1 in 200 life threatening bleeding will occur, leading to a number of adverse physical and emotional consequences. Rarely (around once every 3 years in Wales) postpartum haemorrhage (PPH) will result in a baby that goes home without its mother. This being so, there was a clear need for quality improvement in the management of PPH, with all the Health Boards in Wales agreeing to take part in the project.

Kathy: PPH is in the top five quality and safety risks identified for every maternity unit in Wales. OBS Cymru – the Obstetric Bleeding Strategy for Wales is a three year national quality improvement project, now in its second year, aiming to reduce harm from PPH. The primary aim of the project is to reduce the number of women suffering a massive obstetric haemorrhage.

How is the project meeting its aims?

Elinore:  Since the project was first launched in November 2016 a number of interventions have been put in place across all Obstetric led labour wards in Wales, and having positive results:

  • Risk Assessment for PPH is now becoming a routine part of the admission process in obstetric led birth settings, leading to increased awareness of and early planning for PPH detection, prevention and management.
  • Early identification by means of Measuring Blood Loss is quickly becoming embedded in practice, with over 90% of women having their postnatal blood loss measured.
  • Multidisciplinary Team Working is improving as a result of the training provided by OBS Cymru teams. Clinicians including Midwives, HCAs, anaesthetists, obstetricians, ODPs, and students working in maternity settings have received OBS Cymru training, and have embraced the 4 stage approach to PPH management.
  • ROTEM point of care testing machines have been installed in every labour ward in Wales to allow access to rapid coagulation results and guide blood product management. Early data suggests this is leading to a decrease in the administration of blood products for the reason of PPH.

Kathy:   These interventions are supported by a robust system of data collection by local OBS Cymru champion teams, we have a dedicated team in every obstetric led labour ward in Wales.  Local teams utilise this data collection to analysis and establish areas for improvement within their own health boards.  The Champion teams attend national meetings in which clinical examples presented show how the OBS Cymru principles supported resolution and improved outcomes for women.  In addition the Midwives from each of the health boards meet annually to review and share learning and take this back to their health boards to disseminate good practice.

Are you seeing any changes since the project was first launch in May 2016?

Elinore – Early data is showing that now over 90% of women are having their blood loss measured, which empowers clinicians to provide the right treatment to the right women at the right time. Blood product usage due to PPH is also beginning to decrease.

Kathy: OBS Cymru is a live quality improvement project and there are daily conversations about good practice happening in the health boards and about it’s impact on practice.  One health board has incorporated the risk assessment as part of their multidisciplinary handover when reviewing the women in labour so that as a team they know and are aware of any potential risks and make appropriate preparations as a team prior to delivery.  Others have noted a potential risk when using drapes during delivery and the hidden blood loss which is collected.  A simple solution of using the suction tubing during a procedure placed in the drape has fixed this potential to miss the slow steady bleed which goes unrecognised.  These gems of learning are being shared across Wales so that others can benefit from practice examples and our Champion teams are integral to the dissemination of this.  We are absolutely thrilled that the project has been recognised in the Patient Safety and NHS Wales Awards.  We are privileged to have been shortlisted and recognise that we are fortunate to be representing all of Wales maternity services and that this award is for them and their hard work and commitment to the project.

What makes you both so passionate about this project?

Kathy:  It’s always humbling to see the growth in confidence of myself as a practitioner and my midwifery colleagues as a profession and their integral role in managing PPH.  The 4 stage paper work has given midwives an indicative tool that is diagnostic of PPH and that it has formalised defined trigger points for action that supports the team’s situational awareness when managing obstetric bleeding. Everyday midwifery teams go to work intent on doing a good job, this is one tool in their armoury to achieve this day in day out, from Bangor in the North to Carmarthen in the West and Cardiff in the South, once for Wales.

Elinore: It’s a privilege to be involved in a project that is not only improving outcomes for women, but also empowering teams to use the skills they have acquired to have the confidence to provide the right treatment to the right women at the right time. Measured blood loss is becoming a powerful tool for communication during postpartum haemorrhage, improving team working.  An important part of the project is the women’s experience. Our patient survey shows that although PPH can be a frightening experience, women and their birth partners feel confident that they are receiving a high standard of care, which is very pleasing.

Two years into a three year project, what does the future hold for OBS Cymru?

Elinore:  Although we have made great inroads towards improving care during a PPH, we will continue to work on sustaining these changes beyond the lifespan of the project. The OBS Cymru approach to PPH management has now been incorporated into All Wales PROMPT as an integral part of sustaining the principles of risk assessment, measuring blood loss, early MDT involvement, and ROTEM POCT testing. We are also keen to see how the data reflects these changes.

Find out more about OBS Cymru here and follow the conversation on Twitter #OBSCymru

Jul 092018
 

Mae OBS Cymru, prosiect gwella ansawdd cydweithredol Cymru gyfan sydd â’r nod o leihau niwed yn sgil gwaedlif ôl-enedigol, wedi cyrraedd y rhestr fer ar gyfer dwy wobr eleni yn y Gwobrau Diogelwch Cleifion a Gwobrau GIG Cymru.

Rydym ni wedi bod yn cael diweddariad ar y prosiect gan ei ddwy fydwraig arweiniol genedlaethol, Elinore Macgillivray a Kathryn Greaves.

 

Ar gyfer unrhyw un sydd heb glywed am OBS Cymru, allwch chi ddechrau trwy roi trosolwg?

Elinore: Gwaedlif ôl-enedigol (gwaedlif gormodol ar ôl geni plentyn) yw’r ail achos mwyaf o farwolaethau mamol uniongyrchol yn y DU, ac mae’n cyfrif am  80% o farwolaethau mamol. Bydd 1 o bob 20 menyw yn colli dros 1 litr o waed ôl-enedigol, ac ar gyfer 1 o bob 200, bydd gwaedu sy’n bygwth bywyd yn digwydd, sy’n arwain at nifer o ganlyniadau corfforol ac emosiynol niweidiol. Mewn achosion prin (oddeutu unwaith bob 3 blynedd yng Nghymru), bydd gwaedlif ôl-enedigol (PPH) yn arwain at faban yn mynd adref heb ei fam. Gan ystyried hyn, roedd angen amlwg i wella ansawdd rheoli gwaedlif ôl-enedigol, a chytunodd yr holl Fyrddau Iechyd yng Nghymru i gymryd rhan yn y prosiect.

Kathy: Mae gwaedlif ôl-enedigol yn un o’r pum prif risg ansawdd a diogelwch a amlygwyd ar gyfer pob uned famolaeth yng Nghymru. Mae OBS Cymru – Strategaeth Gwaedu Obstetrig i Gymru yn brosiect gwella ansawdd tair blynedd cenedlaethol, bellach yn ei ail flwyddyn, sy’n ceisio lleihau niwed yn sgil gwaedlif ôl-enedigol. Prif nod y prosiect yw lleihau nifer y menywod sy’n dioddef gwaedlif obstetrig enfawr.

Sut mae’r prosiect yn cyflawni ei nodau?

Elinore:  Ers lansio’r prosiect ym mis Tachwedd 2016, mae nifer o ymyriadau wedi cael eu rhoi ar waith ar draws wardiau geni dan arweiniad obstetrig yng Nghymru, gan arwain at ganlyniadau cadarnhaol:

  • Mae asesu risg ar gyfer gwaedlif ôl-enedigol nawr yn dod yn rhan arferol o’r broses dderbyn mewn lleoliadau geni dan arweiniad obstetrig, sydd wedi arwain at ymwybyddiaeth gynyddol o ganfod, atal a rheoli gwaedlif ôl-enedigol a chynllunio’n gynnar ar gyfer hynny.
  • Mae amlygu cynnar trwy fesur colli gwaed yn cael ei ymsefydlu mewn ymarfer, a chaiff faint o waed ôl-enedigol a gollir gan dros 90% o fenywod ei fesur.
  • Mae gwaith tîm amlddisgyblaethol yn gwella o ganlyniad i’r hyfforddiant a ddarparwyd gan dimau OBS Cymru. Mae clinigwyr, gan gynnwys bydwragedd, cynorthwywyr gofal iechyd, anesthetyddion, obstetryddion, ymarferwyr yr adran lawdriniaethau, a myfyrwyr sy’n gweithio mewn lleoliadau mamolaeth, wedi derbyn hyfforddiant OBS Cymru, ac maent wedi defnyddio’r ymagwedd 4 cam i reoli gwaedlif ôl-enedigol.
  • Mae peiriannau profi pwynt gofal ROTEM wedi cael eu gosod ym mhob ward geni yng Nghymru i ganiatáu mynediad at ganlyniadau tolchi cyflym ac arwain rheoli cynhyrchion gwaed. Mae data cynnar yn awgrymu bod hyn yn arwain at ostyngiad mewn rhoi cynhyrchion gwaed yn sgil gwaedlif ôl-enedigol.

Kathy:   Caiff yr ymyriadau hyn eu cefnogi gan system gadarn o gasglu data gan dimau hyrwyddo OBS Cymru lleol, ac mae gennym ni dîm pwrpasol ym mhob ward geni dan arweiniad obstetrig yng Nghymru. Mae timau lleol yn defnyddio’r data a gesglir i ddadansoddi a sefydlu meysydd i’w gwella o fewn eu byrddau iechyd eu hunain. Mae’r timau hyrwyddo yn mynychu cyfarfodydd cenedlaethol lle mae enghreifftiau clinigol a gyflwynir yn dangos sut mae egwyddorion OBS Cymru wedi cefnogi penderfyniadau a chanlyniadau gwell i fenywod.  Yn ogystal â hyn, mae bydwragedd o bob bwrdd iechyd yn cyfarfod yn flynyddol i adolygu a rhannu dysgu, a chyflwyno hyn i’w byrddau iechyd i ledaenu arfer da.

Ydych chi wedi gweld unrhyw newidiadau ers lansio’r prosiect ym mis Mai 2016?

Elinore – Mae data cynnar yn dangos bod faint o waed a gollir gan dros 90% o fenywod yn cael ei fesur, sy’n grymuso clinigwyr i roi’r driniaeth gywir i’r menywod cywir, ar yr adeg gywir. Mae’r defnydd o gynhyrchion gwaed yn sgil gwaedlif ôl-enedigol hefyd yn dechrau gostwng.

Kathy: Mae OBS Cymru yn brosiect gwella ansawdd byw a chynhelir sgyrsiau dyddiol yn y byrddau iechyd am arfer da a’i effaith ar arferion. Mae un bwrdd iechyd wedi ymgorffori asesu risg yn rhan o drosglwyddo amlddisgyblaethol wrth adolygu’r menywod sy’n esgor, fel bod y tîm yn ymwybodol o unrhyw risgiau posibl ac yn gwneud paratoadau priodol fel tîm, cyn i’r menywod roi genedigaeth. Mae eraill wedi nodi risg bosibl wrth ddefnyddio gorchuddion yn ystod  esgor, a’r gwaed cudd a gollwyd sy’n cael ei gasglu. Mae ateb syml, sef gosod y tiwb sugno a ddefnyddir yn ystod gweithdrefn yn y gorchudd, wedi datrys y posibilrwydd o fethu gwaedu araf, cyson, na sylwir arno. Mae’r perlau dysgu hyn yn cael eu rhannu ledled Cymru, er mwyn i eraill allu elwa ar enghreifftiau o ymarfer, ac mae ein timau hyrwyddo yn rhan annatod o ledaenu hyn. Rydym ni wrth ein bodd bod y prosiect wedi cael ei gydnabod yn y Gwobrau Diogelwch Cleifion a Gwobrau GIG Cymru. Mae’n fraint cyrraedd y rhestr fer ac rydym ni’n cydnabod ein bod ni’n ffodus i gael cynrychioli holl wasanaethau mamolaeth Cymru, a bod y wobr hon ar eu cyfer nhw, a’u gwaith caled a’u hymrwymiad i’r prosiect.

Beth sy’n eich gwneud chi’ch dwy mor frwdfrydig am y prosiect hwn?

Kathy:  Mae bob amser yn galonogol gweld twf yn fy hyder i fel ymarferwr, a fy nghydweithwyr bydwreigiaeth fel proffesiwn, a’u rôl annatod o ran rheoli gwaedlif ôl-enedigol. Mae’r gwaith papur 4 cam wedi rhoi offeryn dangosol i fydwragedd sy’n mesur gwaedlif ôl-enedigol yn ddiagnostig, ac mae wedi ffurfioli pwyntiau sbardun penodol ar gyfer gweithredu, sy’n ategu ymwybyddiaeth sefyllfaol y tîm wrth reoli gwaedu obstetrig. Bob dydd, mae timau bydwreigiaeth yn mynd i’r gwaith gyda’r bwriad o wneud gwaith da, a dyma un o’r dulliau sydd ganddyn nhw i allu cyflawni hyn bob dydd, o Fangor yn y gogledd, i Gaerfyrddin yn y gorllewin, a Chaerdydd yn y de, unwaith i Gymru.

Elinore: Mae’n fraint bod yn gysylltiedig â phrosiect sydd nid yn unig yn gwella canlyniadau i fenywod, ond hefyd yn grymuso timau i ddefnyddio’r sgiliau y maen nhw wedi’u caffael i gael yr hyder i ddarparu’r driniaeth gywir, i’r menywod cywir, ar yr amser cywir. Mae mesur colli gwaed yn dod yn offeryn pwerus i gyfathrebu yn ystod gwaedlif ôl-enedigol, sy’n gwella gwaith tîm. Rhan bwysig o’r prosiect yw profiad y menywod. Mae ein harolwg cleifion yn dangos, er y gall gwaedlif ôl-enedigol fod yn brofiad brawychus, mae menywod a’u partneriaid geni yn teimlo’n hyderus eu bod nhw’n derbyn gofal o safon uchel, sy’n rhoi boddhad mawr.

Ar ôl dwy flynedd o brosiect tair blynedd, beth yw dyfodol OBS Cymru?

Elinore:  Er ein bod ni wedi cymryd camau breision tuag at wella gofal yn ystod  gwaedlif ôl-enedigol, byddwn ni’n parhau i weithio ar gynnal y newidiadau hyn y tu hwnt i oes y prosiect. Mae ymagwedd OBS Cymru at reoli gwaedlif ôl-enedigol wedi cael ei hymgorffori yn PROMPT Cymru Gyfan, fel rhan annatod o gynnal egwyddorion asesu risg, mesur colli gwaed, ymwneud cynnar gan dîm amlddisgyblaethol, a phrofi pwynt gofal ROTEM. Rydym ni hefyd yn awyddus i weld sut mae’r data’n adlewyrchu’r newidiadau hyn.

Darganfyddwch fwy am OBS Cymru yma a dilynwch y sgwrs ar Twitter #OBSCymru

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