Sep 102019
 

After our big news last week that 1000 Lives Improvement will become Improvement Cymru on 25 November 2019 – we catch up with Dr John Boulton, now the permanent Director of 1000 Lives Improvement/Improvement Cymru to find out more.

Why rebrand 1000 Lives Improvement to Improvement Cymru?

I first became aware of 1000 Lives Improvement when I was working as a physician in Sheffield over a decade ago. It’s a well-respected and established brand. Since the 1000 Lives patient safety campaign 11 years ago it has been synonymous with improving patient safety across Wales. But that’s exactly why we need to change and evolve our brand. The Parliamentary Review and A Healthier Wales both suggested that we needed to consider how we support improvement within health care as well as begin to work with social care organisations. So, although patient safety will remain very important to improvement work in Wales, we must now offer an improvement service to support the wide range of challenges facing both health and social care. We need a brand to reflect this and Improvement Cymru fits the bill – it’s short, simple and self-explanatory.

What is different about Improvement Cymru?

As Improvement Cymru we will be even more focussed on  working collaboratively with our partners in Wales and beyond. For us it’s not about Improvement Cymru, it’s about Improvement – promoting and enabling improvement as a vehicle for transformation to achieve great care for the people of Wales. We are already working to support organisations to embed a culture of improvement and we want to elevate this further, and unite everyone to develop a new shared ‘Vision for Improvement’ for health and social care in Wales that we can all work together to achieve.

What does the change to Improvement Cymru mean for improvement in Wales?

If all health and social care organisations across Wales are working together to achieve the same ‘Vision for Improvement’, this will mean more and more people across Wales will experience and receive consistently great care. Our staff in health and social care are so important and valued and we want to support them by offering them improvement training and coaching – that’s why we are establishing the Improvement Cymru Academy. So when they see something that could be made better for the people they are caring for, they have the skills and confidence to improve it. We hope that this will give them an even bigger sense of achievement, to be able to sit on their sofa at the end of a busy day knowing that they and made something better and delivered great care. This is what we want for our staff and the people of Wales.

How will the 1000 Lives Improvement Programmes change?

You won’t notice any immediate changes to our programmes as we rebrand to Improvement Cymru. Over time, however, we will be reviewing all of our programmes of work, ensuring that they reflect the new approach.

What’s next for Improvement Cymru?

Over the next few months the  team will be engaging with people across health and social care, working with our colleagues and partners to develop a new shared ‘Vision for Improvement’ for health and social care in Wales. We’ll be exhibiting at a range of partner events to do this, starting at the Social Care Wales conference this week. If you don’t catch us at an event you’ll be able to engage with us online.

The next big milestone for us will be our conference on 25 and 26 November. This is when we’ll relaunch as Improvement Cymru and share the new ‘Vision for Improvement’ for health and social care in Wales. If you are interested in being part of improvement in Wales I really encourage you to register, places are filling up fast – we’ve had 150 registrations in just 3 days! We are keen for this to be a platform to showcase the amazing improvement work already going on across Wales and beyond – if you have been involved in great improvement work that you want to share, please submit your abstracts here.

This is a really exciting time for improvement in Wales and I hope even more people will join this journey with us and be a part of the future of improvement.

Sep 102019
 

Ar ôl ein newyddion mawr yr wythnos ddiwethaf y bydd 1000 o Fywydau – Gwasanaeth Gwella yn newid i fod yn Gwelliant Cymru ar 25 Tachwedd 2019 – rydyn ni’n sgwrsio gyda Dr John Boulton, Cyfarwyddwr parhaol 1000 o Fywydau – Gwasanaeth Gwella/Gwelliant Cymru i ddarganfod mwy.

Pam ail-frandio 1000 o Fywydau – Gwasaaneth Gwella i fod yn Gwelliant Cymru?

Cefais fy ngwneud yn ymwybodol o 1000 o Fywydau – Gwasaaneth Gwella am y tro cyntaf pan roeddwn i’n gweithio fel meddyg yn Sheffield dros ddegawd yn ôl. Mae’n frand sefydledig, uchel ei barch. Ers ymgyrch diogelwch cleifion 1000 o Fywydau 11 mlynedd yn ôl, mae wedi bod yn gyfystyr â gwella diogelwch cleifion ledled Cymru. Ond dyna pam mae angen i ni newid a datblygu ein brand. Fe wnaeth yr Adolygiad Seneddol, a Chymru Iachach awgrymu bod angen i ni ystyried sut rydyn ni’n cefnogi gwelliant ym maes gofal iechyd, yn ogystal â dechrau gweithio gyda sefydliadau gofal cymdeithasol. Er y bydd diogelwch cleifion yn parhau’n bwysig iawn i waith gwella yng Nghymru, rhaid i ni nawr gynnig gwasanaeth gwella i ategu’r ystod eang o heriau sy’n wynebu iechyd a gofal cymdeithasol.  Mae angen brand arnom sy’n adlewyrchu hyn ac mae Gwelliant Cymru yn ateb i ddiben – mae’n gryno, yn syml ac yn hunanesboniadol.

Beth sy’n wahanol am Gwelliant Cymru?

Bydd Gwelliant Cymru yn canolbwyntio hyd yn oed yn fwy ar gydweithio gyda’r partneriaid yng Nghymru a thu hwnt. I ni, nid yw’n ymwneud â Gwelliant Cymru, mae’n ymwneud â gwelliant – mae hyrwyddo a galluogi gwelliant yn gerbyd i drawsnewid i gyflawni gofal gwych i bobl Cymru. Rydyn ni eisoes yn gweithio i gefnogi sefydliadau i fewnosod diwylliant o wella, ac rydyn ni eisiau cynyddu hyn ymhellach, ac uno pawb i ddatblygu ‘Gweledigaeth ar gyfer Gwelliant’ ar y cyd newydd, ar gyfer iechyd a gofal cymdeithasol yng Nghymru, y gallwn weithio gyda’n gilydd i’w chyflawni.

Beth mae’r newid i Gwelliant Cymru yn ei olygu ar gyfer gwelliant yng Nghymru?

Os bydd yr holl sefydliadau iechyd a gofal cymdeithasol ledled Cymru yn gweithio gyda’i gilydd i gyflawni’r un ‘Gweledigaeth ar gyfer Gwelliant’, bydd hyn yn golygu y bydd mwy o bobl ledled Cymru yn cael profiad o ofal gwych, cyson ac yn ei dderbyn. Mae ein staff ym maes iechyd a gofal cymdeithasol mor bwysig ac yn cael eu gwerthfawrogi, ac rydyn ni eisiau eu cefnogi nhw drwy gynnig hyfforddiant gwella – dyna pam rydyn ni’n sefydlu Academi Gwelliant Cymru. Felly, pan fyddan nhw’n gweld rhywbeth y gellir ei wella ar gyfer y bobl y maen nhw’n gofalu amdanynt, bydd ganddynt y sgiliau a’r hyder i’w wella. Rydyn ni’n gobeithio y bydd hyn yn rhoi ymdeimlad hyd yn oed yn fwy o gyflawni iddyn nhw; byddan nhw’n gallu eistedd i lawr ar ddiwedd diwrnod prysur, gan wybod eu bod nhw wedi gwneud rhywbeth yn well, a’u bod nhw wedi cyflwyno gofal gwych. Dyma beth rydyn ni ei eisiau ar gyfer ein staff a phobl Cymru.

Sut bydd Rhaglenni 1000 o Fywydau – Gwasaaneth Gwella yn newid?

Ni fyddwch chi’n sylwi ar unrhyw newidiadau ar unwaith i’n rhaglenni wrth i ni ailfrandio i Gwelliant Cymru. Fodd bynnag, dros amser, byddwn ni’n adolygi ein rhaglenni gwaith, gan sicrhau eu bod nhw’n adlewyrchu’r ymagwedd newydd.

Beth nesaf ar gyfer Gwelliant Cymru?

Dros y misoedd nesaf, bydd y tîm yn ymgysylltu â phobl ledled iechyd a gofal cymdeithasol, gan weithio gyda’r cydweithwyr a’n partneriaid i ddatblygu ‘Gweledigaeth ar gyfer Gwelliant’ ar y cyd newydd ar gyfer iechyd a gofal cymdeithasol yng Nghymru. Byddwn ni’n arddangos mewn amrywiaeth o ddigwyddiadau partneriaid i wneud hyn, gan ddechrau yng nghynhadledd Gofal Cymdeithasol Cymru yr wythnos hon. Os na fyddwch chi’n cael gafael arnom mewn digwyddiad, gallwch ymgysylltu â ni ar-lein.

Y garreg filltir fawr nesaf i ni fydd ein cynhadledd ar 25 a 26 Tachwedd. Dyma pryd fyddwn ni’n ail-lansio fel Gwelliant Cymru ac yn rhannu’r ‘Gweledigaeth ar gyfer Gwelliant’ ar y cyd newydd, ar gyfer iechyd a gofal cymdeithasol yng Nghymru. Os oes gennych ddiddordeb mewn bod yn rhan o welliant yng Nghymru, byddwn yn eich annog i gofrestru (gosod dolen), gan fod lleoedd yn cael eu llenwi’n gyflym – mae 150 o bobl wedi cofrestru mewn tridiau’n unig! Rydyn ni’n awyddus iddo fod yn llwyfan i arddangos y gwaith gwella ardderchog sydd eisoes yn digwydd ledled Cymru a thu hwnt – os ydych chi wedi bod yn gysylltiedig â gwaith gwella yr hoffech ei rannu, cyflwynwch grynodebau yma.

Mae hwn yn gyfnod cyffrous iawn i Gymru, a gobeithiaf y bydd hyd yn oed mwy o bobl yn ymuno â’r daith hon gyda ni a bod yn rhan o ddyfodol gwelliant.

 

May 292019
 

My name is Christine Welburn, I am the thromboprophylaxis clinical nurse specialist (CNS) at Ysbyty Glan Clwyd (YGC). When I started my job in August 2017 along with my clinical lead Mr Hanna, I identified the issue of poor compliance in completing the thromboprophylaxis risk assessment. The initial audit showed that we was only 34% compliant, I discussed this with the Quality Improvement manager Mel Baker who encouraged me to complete the Silver IQT training which would equipped me with the knowledge and skills of using different methods in order to get engagement and change practice.

I enrolled on the Silver IQT training and decided to do my project on increasing compliance in completing the thromboprophylaxis risk assessment. I decided to get engagement from front line staff and drive the improvement by completing weekly thromboprophylaxis walk around.  The walk around team consists of myself (CNS), Mr Hanna (Clinical Lead) and Haimon (Lead pharmacist), this team has a lead from each discipline we wanted to be engaged in changing practice. Every week we walk around the wards (initially targeting the acute admission wards and now including in-patient wards) and randomly select 5 – 10 case notes on each ward to audit and review.  We assess if the thromboprophylaxis risk assessment has been completed (and if it is correct), if the VTE box on the drug card is completed and if the prescription is correct. We also assess if mechanical and chemical thromboprophylaxis is prescribed, given, contraindicated and any missed doses.  This gives us the opportunity to give on the spot feedback and education to all the clinical staff involved, correct any prescription errors that we find and give lessons learnt and advice in the clinical area.

After ten months of the walk around intervention our compliance had increased to 84% and after eighteen months of the intervention the acute admission wards achieved 100%.  This project was spread across site with Ysbyty Wrexham Maelor achieving the same results within six months of adopting YGC finial walk around procedure.  We adapted the walk around audit technique after several PDSA cycles until we was happy we was capturing the relevant information and feedback technique.  This quality improvement project has led Ysbyty Glan Clwyd becoming an exemplar site for VTE prevention, winning the first place award for harm free care in the BCU quality improvement and research conference and a becoming a finalist in the upcoming HSJ national award for acute service redesign award.

Prior to learning about quality improvement, I recognised what needed to change in practice but not necessarily the best way to implement the change.  After completing the Silver IQT training at YGC, it equipped me with the knowledge and skills on how to assess and implement change using different methods in order to get the desired outcome. I would advise anyone who is looking to do a quality improvement project to complete the IQT training and complete a project on their idea, as often a small change in practice can have a big impact on our patients safety.

May 292019
 

Fy enw i yw Christine Welburn ac rydw i’n nyrs glinigol arbenigol thromboproffylacsis yn Ysbyty Glan Clwyd. Pan ddechreuais y swydd ym mis Awst 2017, ar y cyd â Mr Hanna, yr arweinydd clinigol, nodais fod cydymffurfiaeth wael o ran cwblhau’r asesiad risg thromboproffylacsis. Dangosodd yr archwiliad cychwynnol mai 34% yn unig o asesiadau risg oedd yn cael eu cwblhau. Trafodais y sefyllfa gyda Mel Barker, y Rheolwr Gwella Ansawdd, a anogodd fi i fynychu hyfforddiant Gwella Ansawdd Gyda’n Gilydd (Arian), a fyddai’n fy arfogi gyda’r wybodaeth a’r sgiliau angenrheidiol i ddefnyddio dulliau gwahanol er mwyn sicrhau ymgysyllted ac i newid arferion.

Cofrestrais ar gyfer yr hyfforddiant Gwella Ansawdd Gyda’n Gilydd (Arian), a phenderfynais wneud prosiect ar wella cydymffurfiaeth o ran cwblhau asesiadau risg thromboproffylacsis. Penderfynais ymgysylltu ag aelodau staff rheng flaen a gyrru’r gwelliant trwy gwblhau taith gerdded thromboproffylacsis wythnosol o amgylch yr ysbyty. Mae tîm y daith gerdded yn cynnwys fi (Nyrs Glinigol Arbenigol), Mr Hanna (Arweinydd Clinigol) a Mr Haimon (Fferyllydd Arweiniol), sef arweinydd o bob maes sydd angen ymgysylltu â hwy er mwyn newid arferion. Bob wythnos, rydym yn cerdded o amgylch y wardiau (gan dargedu’r wardiau derbyn aciwt i gychwyn, ond bellach yn cynnwys wardiau cleifion mewnol) ac yn dewis 5-10 o nodiadau achos ar hap ar bob ward er mwyn eu harchwilio a’u hadolygu. Rydym yn asesu a yw’r asesiad risg thromboproffylacsis wedi cael ei lenwi (ac a yw’n gywir), a yw’r blwch thromboemboledd gwythiennol ar y cerdyn cyffuriau wedi’i lenwi ac a yw’r presgripsiwn yn gywir. Yn ogystal, rydym yn asesu a yw thromboproffylacsis mecanyddol a chemegol wedi cael ei ragnodi, ei weinyddu, ei wrthgymeradwyo ac a yw’r claf wedi methu unrhyw ddosau. Mae hynny’n rhoi cyfle i ni ddarparu adborth uniongyrchol i bob aelod staff clinigol perthnasol, cywiro unrhyw gamgymeriadau rhagnodi a rhannu gwersi a chyngor yn yr ardal glinigol.

Ar ôl deg mis o gynnal taith gerdded wythnosol, cynyddodd ein cydymffurfiaeth i 84% ac, ar ôl deunaw mis o ymyrraeth, cydymffurfiodd y wardiau derbyn aciwt 100%. Lledaenwyd y prosiect ledled y safle a chyflawnodd Ysbyty Maelor Wrecsam yr un canlyniad o fewn chwe mis o fabwysiadu gweithdrefn Ysbyty Glan Clwyd. Addaswyd ein techneg archwilio ar ôl nifer o gylchdroeon PDSA tan ein bod yn hapus gyda’r dechneg adborth ac ein bod yn casglu gwybodaeth berthnasol. Mae’r prosiect gwella ansawdd hwn wedi sicrhau bod Ysbyty Glan Clwyd yn safle blaenllaw o ran atal thromboemboledd gwythiennol, gan ennill y brif wobr ym maes gofal heb niwed yng Nghynhadledd Ymchwil a Gwella Ansawdd Bwrdd Iechyd Prifysgol Betsi Cadwaladr a chyrraedd rownd derfynol Gwobr Genedlaethol HSJ (Ail-ddylunio Gwasanaeth Aciwt).

Cyn dysgu am wella ansawdd, roeddwn yn gallu adnabod beth oedd angen newid o ran arferion, ond ddim o reidrwydd y ffordd orau o weithredu’r newid. Ar ôl cwblhau hyfforddiant Gwella Ansawdd Gyda’n Gilydd (Arian) yn Ysbyty Glan Clwyd, cefais fy arfogi gan y wybodaeth a’r sgiliau i asesu a gweithredu newid, gan ddefnyddio dulliau gwahanol er mwyn cyflawni’r deilliant delfrydol.  Byddem yn cynghori unrhyw un sy’n chwilio am brosiect gwella ansawdd i gwblhau hyfforddiant Gwella Ansawdd Gyda’n Gilydd ac i gwblhau prosiect ar ei syniad, oherwydd, yn aml, gall newid bach ymarferol gael effaith pellgyrhaeddol ar ddiogelwch cleifion.

May 142019
 

We catch up with Paul Gimson, Medicine Safety Programme Lead, 1000 Lives Improvement to talk about the plans for the Medicine Safety programme.

1.What is your background in medicine safety?

I’m a pharmacist by background so medicines safety is in my blood! I’ve worked in community pharmacy and as a prescribing advisor in local health boards. I’ve was the lead for Medicines Safety at the Royal Pharmaceutical Society.

  1. What are the plans for the Medicine Safety Programme?

The programme is being established in response to both the World Health Organisations Global Safety Challenge ‘Medication without Harm’ and the Welsh Governments Long Term plan for Health and Social Care: A Healthier Wales. We aspire to make Wales the safest place in the World to take medicines.

Our programme will be focussed on addressing four key challenges;

  • Systems – how can we improve the systems and processes that underpin prescribing, safety and medicines management? We will focus on prescribing practices, interfaces of care and applying the evidence base that exists around systems thinking and safety.
  • Harm – how can we tackle specific areas of harm that we know contribute significantly to avoidable admissions to hospital? Areas of concern include admissions due to falls, bleeds and acute kidney injury.
  • Prudent Prescribing – how can we apply the principles of prudent healthcare to prescribing? How can we improve areas such as polypharmacy, medication review and antimicrobial resistance? Can we make better use of the multidisciplinary team?
  • Person Centred-Care – how can we support a more person-centred approach to medicines safety in Wales? How can we best apply the principles of co-production and behavioural change psychology to medicines use?
  1. How do you plan to achieve the key outcomes of the programme?

As the title suggests it will be a challenge, and it won’t happen overnight. I have found myself wondering –what are the elements of a high performing medicines safety system. Is it better use of data? Is it better learning from error? Is it improved multidisciplinary working? What does any of his look like in an improved system?

In order to find out we plan to bring together the improvement expertise of 1000Lives with the knowledge and experience of those in NHS who have an interest in medicines safety, as well as the public, to co-produce a series of high impact interventions that have the potential to transform medicines safety in Wales. We will then test those interventions with a view to spreading them nationally via a national Medicines Safety Collaborative.

  1. Why are you excited to be working on it?

I have been involved in medicines safety all of my career. For me personally it is an opportunity to apply all I have learnt about improvement to a topic that I am passionate about. By bringing together pharmaceutical and improvement expertise we can make a real difference to peoples’ lives through safer and more effective use of medicines.

Paul wants to hear from you – what ideas do you have to improve medicines safety? What projects are you involved in that you want to share? If you want to get involved then please contact him at paul.gimson@wales.nhs.uk

May 142019
 

Cawsom sgwrs gyda Paul Gimson, Arweinydd Rhaglen Diogelwch Meddyginiaethau, 1000 o Fywydau – Gwasanaeth Gwella, i drafod y cynlluniau ar gyfer y Rhaglen Diogelwch Meddyginiaethau.

1.Beth yw’ch cefndir ym maes diogelwch meddyginiaethau?

Rwyf wedi bod yn fferyllydd, felly mae diogelwch meddyginiaethau yn fy ngwaed! Rwyf wedi gweithio ym maes fferylliaeth gymunedol ac fel cynghorydd rhagnodi mewn byrddau iechyd lleol. Roeddwn i’n arweinydd ar gyfer diogelwch meddyginiaethau yn y Gymdeithas Fferyllol Frenhinol.

  1. Beth yw’r cynlluniau ar gyfer y Rhaglen Diogelwch Meddyginiaethau?

Caiff y rhaglen ei sefydlu mewn ymateb i Her Diogelwch Byd-eang Sefydliad Iechyd y Byd, ‘Meddyginiaeth heb Niwed’, a chynllun tymor hir Llywodraeth Cymru ar gyfer iechyd a gofal cymdeithasol, Cymru Iachach. Rydym ni’n ceisio gwneud Cymru’r lle mwyaf diogel yn y byd i gymryd meddyginiaethau.

Bydd ein rhaglen yn canolbwyntio ar fynd i’r afael â phedair her allweddol;

  • Systemau – sut gallwn ni wella’r systemau a’r prosesau sy’n tanategu rhagnodi, diogelwch a rheoli meddyginiaethau? Byddwn ni’n canolbwyntio ar arferion rhagnodi, rhyngwynebau gofal, a chymhwyso’r gronfa dystiolaeth sy’n bodoli ynghylch meddwl a diogelwch systemau.
  • Niwed – sut gallwn ni fynd i’r afael â meysydd penodol o niwed rydym ni’n gwybod sy’n cyfrannu’n sylweddol at dderbyniadau osgoadwy i’r ysbyty? Mae’r meysydd o bryder yn cynnwys derbyniadau i ysbyty yn sgil cwympiadau, gwaedu, ac anaf acíwt i’r arennau.
  • Rhagnodi darbodus – sut gallwn ni gymhwyso egwyddorion gofal iechyd darbodus i ragnodi? Sut gallwn ni wella meysydd fel polyfferylliaeth, adolygu meddyginiaethau, ac ymwrthedd i gyffuriau? Allwn ni wneud defnydd gwell o’r tîm amlddisgyblaeth?
  • Gofal sy’n canolbwyntio ar yr unigolyn – sut gallem ni gefnogi ymagwedd sy’n canolbwyntio fwy ar yr unigolyn at ddiogelwch meddyginiaethau yng Nghymru? Beth yw’r ffordd orau i gymhwyso egwyddorion cynhyrchu ar y cyd a seicoleg newid ymddygiadau at y defnydd o feddyginiaethau?
  1. Sut ydych chi’n bwriadu cyflawni canlyniadau allweddol y rhaglen?

Fel y mae’r teitl yn ei awgrymu, bydd yn her ac ni fydd yn digwydd dros nos. Rwyf wedi bod yn tybio -beth yw elfennau system diogelwch meddyginiaethau o’r radd flaenaf. A yw’n ddefnydd gwell o ddata? A yw’n well dysgu o wall? A yw’n gweithio amlddisgyblaeth well? Sut beth fydd hyn mewn system well?

Er mwyn darganfod mwy, rydym ni’n bwriadu dod ag arbenigedd gwella 1000 o Fywydau, a gwybodaeth a phrofiad y rheiny yn y GIG sydd â diddordeb mewn diogelwch meddyginiaethau, yn ogystal â’r cyhoedd, at ei gilydd, i gynhyrchu ar y cyd cyfres o ymyriadau effaith uchel sydd â’r potensial i drawsnewid diogelwch meddyginiaethau yng Nghymru. Wedyn, byddwn ni’n profi’r ymyriadau hynny gyda’r bwriad o’u lledaenu nhw’n genedlaethol, trwy Gydweithrediaeth Diogelwch Meddyginiaethau genedlaethol.

  1. Pam ydych chi’n gyffrous cael gweithio ar hyn?

Rwyf wedi bod yn gysylltiedig â diogelwch meddyginiaethau ar hyd fy ngyrfa. I mi yn bersonol, mae’n gyfle i gymhwyso popeth rydw i wedi’i ddysgu am wella i bwnc rwy’n frwdfrydig yn ei gylch. Trwy ddod ag arbenigedd fferyllol a gwella at ei gilydd, gallwn wneud gwahaniaeth gwirioneddol i fywydau pobl trwy ddefnydd mwy diogel a mwy effeithiol o feddyginiaethau.

Hoffai Paul glywed oddi wrthych chi – pa syniadau sydd gennych chi i wella diogelwch meddyginiaethau? Pa brosiectau ydych chi’n gysylltiedig â nhw yr hoffech eu rhannu? Os hoffech gymryd rhan, cysylltwch ag ef ar paul.gimson@wales.nhs.uk

 

Apr 092019
 

In March over 3350 attendees from 70 different countries got together at the International Quality Forum 2019 in Glasgow to learn and share knowledge on improving the quality and safety of care for patients across the world. We catch up with Dr John Boulton, Interim Director of NHS Quality Improvement and Patient Safety, 1000 Lives Improvement to find out what his key reflections were from the event.

What were the team doing at the event this year? 

The Quality Forum is an important event for us as it provides an opportunity for us to interact with a large number of improvement experts from all over the world under the one roof. As a team we’ve attended for a number of years and always take away really valuable learning that we can bring back to Wales.

This year the 1000 Lives team had a good presence at the event. We jointly hosted a pre-day session with colleagues from Scotland, Brazil, Australia, England on designing and managing large scale collaborative quality based improvement projects, where the Welsh OBS Cymru team spoke about their experience of measurement for improvement.

Joanna Doyle, All Wales Nurse Staffing Programme Manager delivered a poster presentation on the Nurse Staffing Levels (Wales) Act and we also made some great connections on our stand where we were introducing delegates to the concept of using Lego® Serious Play® to create models of leadership.

Personally, I was delighted to host two extremely full sessions discussing leadership for improvement (utilising Lego) with Dr Sara Long, Clinical Fellow, Aneurin Bevan Continuous Improvement. In addition I co-led a plenary session on learning from failure with Dr Barbara Grey, Director of Quality Improvement and SLaM Partners, South London and Maudsley NHS Foundation Trust. We addressed identifying failure early on, what to do next, working creatively with the messiness of change and also explored the psychology of failure in QI.

It was a privilege to be there with colleagues from PHW and HEIW as part of the wider NHS Wales team.

What were your main reflections from the event? There was a vast amount of great work that was showcased at the forum that we could usefully learn from in Wales. However, we should also be increasingly taking the opportunity to learn from programmes that are less successful. At the conference Wales was well represented and I think we should be proud of the excellent work that is taking place within the country

And what will you take away from the Forum?

That improvement science in healthcare is perhaps more important than ever. This has spurred us on even more to finalise and share our framework for improvement and our plan for how we are going to work with health and social care to support them to deliver improvements for Wales. It’s going to be a significant year for improvement in Wales and we look forward to working with our many partners together on this.

 

Apr 092019
 

Ym mis Mawrth, daeth 3350 o fynycheion o 70 o wledydd gwahanol at ei gilydd yn Fforwm Ansawdd Rhyngwladol 2019 yng Nglasgow, i ddysgu a rhannu gwybodaeth am wella ansawdd a diogelwch gofal ar gyfer cleifion ledled y byd. Rydym ni wedi bod yn siarad â Dr John Boulton, Cyfarwyddwr Dros Dro Gwella Ansawdd a Diogelwch Cleifion y GIG, 1000 o Fywydau – Gwasanaeth Gwella, i ddarganfod beth oedd ei fyfyrdodau allweddol am y  digwyddiad.

Beth oedd y tîm yn ei wneud yn y digwyddiad eleni?

Mae’r Fforwm Ansawdd yn ddigwyddiad pwysig i ni gan ei fod yn rhoi cyfle i ni ryngweithio â nifer fawr o arbenigwyr gwella o bob cwr o’r byd, o dan un to. Fel tîm, rydym ni wedi mynychu’r digwyddiad ers nifer o flynyddoedd, a bob amser yn dysgu pethau gwerthfawr iawn y gallwn ni ddod nôl gyda ni i Gymru.

Eleni, roedd gan dîm 1000 o Fywydau bresenoldeb da yn y digwyddiad. Cynhaliom sesiwn ymlaen llaw ar y cyd â chydweithwyr o’r Alban, Brasil, Awstralia, a Lloegr, ar ddylunio a rheoli prosiectau gwella cydweithredol, ar sail ansawdd, ar raddfa fawr, lle siaradodd tîm OBS Cymru am eu profiad o fesur er gwella.

Cyflwynodd Joanna Doyle, Rheolwr Rhaglen Staff Nyrsio Cymru Gyfan, gyflwyniad poster ar Ddeddf Lefelau Staff Nyrsio (Cymru), a llwyddom i wneud cysylltiadau gwych ar ein stondin, lle buom yn cyflwyno cynrychiolwyr i’r cysyniad o ddefnyddio Lego® Serious Play® i greu modelau arweinyddiaeth.

Yn bersonol, roeddwn wrth fy modd yn cael cynnal dwy sesiwn lawn iawn, yn trafod arweinyddiaeth er gwella (gan ddefnyddio Lego) gyda Dr Sara Long, Cymrawd Clinigol, Gwelliant Parhaus Aneurin Bevan. Hefyd, arweiniais sesiwn lawn ar y cyd, ar ddysgu yn sgil methu, gyda Dr Barbara Grey, Cyfarwyddwr Gwella Ansawdd, a SLaM Partners, South London and Maudsley NHS Foundation Trust. Fe aethom i’r afael ag amlygu methiant yn gynnar, beth i’w wneud nesaf, gweithio’n greadigol ag aflerwch newid, ac archwilio seicoleg methiant wrth wella ansawdd.

Roedd yn fraint cael bod yno gyda chydweithwyr o Iechyd Cyhoeddus Cymru ac Addysg a wella Iechyd Cymru, fel rhan o dîm ehangach GIG Cymru.

Beth oedd eich prif fyfyrdodau am y digwyddiad?

Roedd llawer iawn o waith gwych yn cael ei arddangos yn y fforwm, y gallem ni ddysgu oddi wrtho yng Nghymru. Fodd bynnag, dylem ni hefyd fod yn achub ar y cyfle yn gynyddol i ddysgu o raglenni sy’n llai llwyddiannus. Yn y gynhadledd, roedd cynrychiolaeth dda o Gymru, a chredaf y dylem ni fod yn falch iawn o’r gwaith gwych a gyflawnir yn y wlad.

Beth ddysgoch chi o’r Fforwm?

Efallai bod gwyddor gwella ym maes gofal iechyd yn bwysicach nag erioed. Mae hyn wedi ein hysgogi ni hyd yn oed yn fwy i orffen a rhannu ein fframwaith gwella, a’n cynllun ar gyfer sut i weithio gydag iechyd a gofal cymdeithasol i’w cefnogi nhw i gyflwyno gwelliannau yng Nghymru. Bydd yn flwyddyn arwyddocaol ar gyfer gwella yng Nghymru, ac rydym ni’n edrych ymlaen at gydweithio â’n partneriaid niferus ar hyn.

 

 

Apr 052019
 

Midwifery is renowned for being one of the most rewarding professions there is; however as so many midwives will testify it is also at times one of the most challenging. It is however incredibly rare to be given the opportunity to take part in quality improvement projects which not only see almost immediate benefits to the women we care for; but which also shape the profession and wider clinical practice. OBS Cymru – the Obstetric Bleeding Strategy for Wales- has been one such project. OBS Cymru is the result of research which began in Cardiff over 10 years ago, and developed over time into an evidence based, highly effective strategy for managing Postpartum Haemorrhage. This approach has now been rolled out to every health board in Wales and has significantly changed practice, seemingly overnight (no mean feat as I’m sure you’ll agree).

Each Consultant Led Unit’s (CLU) OBS Cymru Champion Team have overseen the implementation of the project. I have had the honour of being one of the Champion Midwives in Ysbyty Glan Clwyd in North Wales and I can honestly say it has been more rewarding and equally more influential to my practice than anything I’ve been a part of previously. Simple evidence based interventions with an emphasis on early recognition of PPH through Risk Assessment and measuring blood loss rather than estimating it. This was a major change in practice but one which was adopted by all staff and with remarkable results. Change is inevitable in Maternity care but it is not always so easily achieved!

As Champion Midwives we have encouraged truly multidisciplinary team working and training, generating remarkable and undeniable results for women in our care. The success for OBS Cymru in our unit has been largely due to the engagement of the support workers and midwives. They led the change to measuring blood loss and instigating early recognition and management of PPH.

OBS Cymru as a QI project has now drawn to a close. However, I don’t see this as signifying the end of the OBS Cymru work. Rather, primarily it is an opportunity to reflect on just how far we have come as a nation that is leading the way in effective management of PPH. But in addition it is an opportunity to look to the future and plan our own strategies for ensuring this invaluable work continues and embeds even further into everyday practice.

I feel fortunate to have worked with such an enthusiastic, motivated and knowledgeable team who will help this work continue and who will drive forward change to achieve the best for the women in our care. For us OBS Cymru is here to stay!

Apr 052019
 

Caiff bydwreigiaeth ei gydnabod fel un o’r meysydd proffesiynol mwyaf gwobrwyol sy’n bodoli. Fodd bynnag, fel mae cymaint o fydwragedd yn tystio, mae’n faes hynod heriol hefyd. Prin yw’r cyfleoedd i gyfrannu at brosiectau gwella ansawdd sydd o fudd uniongyrchol i’r menywod yn ein gofal ac sydd hefyd yn siapio’r maes proffesiynol ac arferion clinigol ehangach. Mae Strategaeth Gwaedu Obstetreg i Gymru (OBS Cymru) yn brosiect o’r fath. Eginodd OBS Cymru o ganlyniad i waith ymchwil a ddechreuodd yng Nghaerdydd dros ddeg mlynedd yn ôl, gan ddatblygu dros amser yn strategaeth seiliedig ar dystiolaeth hynod effeithiol ar gyfer rheoli gwaedu ôl-enedigol. Bellach, mae’r dull wedi cael ei gyflwyno ym mhob bwrdd iechyd yng Nghymru, gan newid arferion yn sylweddol, a hynny dros nos i bob golwg.

Mae pob Tîm Hyrwyddo OBS Cymru sy’n rhan o Uned o dan Arweiniad Ymgynghorydd wedi goruchwylio cyflwyniad y prosiect. Rydw i wedi cael y fraint o fod yn Hyrwyddwr Bydwragedd yn Ysbyty Glan Clwyd yng ngogledd Cymru, a gallaf ddatgan yn gwbl ddiffuant bod y profiad wedi bod yn hynod wobrwyol a’i fod wedi cael mwy o ddylanwad ar fy arferion nag unrhyw beth rydw i wedi bod yn rhan ohono yn y gorffennol. Ymyriadau syml, seiliedig ar dystiolaeth, gyda phwyslais ar adnabod gwaedu ôl-enedigol yn gynnar trwy asesiadau risg a mesur colledion gwaed, yn hytrach nag amcangyfrifo. Mabwysiadwyd y newid arfer mawr hwn gan bob aelod staff gan arwain at ganlyniadau nodedig. Mae newidiadau yn anochel ym maes bydwreigiaeth, er nad yw’n cael ei gyflawni mor hawdd fel arfer!

Fel Hyrwyddwyr Bydwragedd, rydym ni wedi annog gwaith tîm a hyfforddiant amlddisgyblaethol go iawn, sydd wedi arwain at ganlyniadau nodedig ac anwadadwy i’r menywod yn ein gofal. Mae llwyddiant OBS Cymru yn ein huned yn seiliedig ar ymgysylltu â’r gweithwyr cynorthwyol a’r bydwragedd. Nhw arweiniodd y newid i fesur colledion gwaed a chydnabod a rheoli gwaedu ôl-enedigol yn gynnar.

Fel prosiect QI, mae OBS Cymru wedi dod i ben. Fodd bynnag, nid dyma ddiwedd gwaith OBS Cymru. Yn hytrach, dyma gyfle i fyfyrio ar ba mor bell rydym wedi dod fel cenedl sy’n arwain y ffordd o ran rheoli gwaedu ôl-enedigol yn effeithiol. Yn ogystal, dyma gyfle i ni edrych tua’r dyfodol a chynllunio strategaethau er mwyn sicrhau bod y gwaith amhrisiadwy hwn yn parhau ac yn dod yn rhan annatod o arferion bob dydd.

Teimlaf yn ffodus o fod wedi cael cyfle i weithio gyda thîm mor frwdfrydig, gwybodus a llawn cymhelliant, a fydd yn sicrhau bod y gwaith yn parhau ac yn gyrru newidiadau er lles y menywod yn ein gofal. I ni, mae OBS Cymru yma i aros!