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.


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/

Jul 012014

PeteStraw Image1A beautiful, sunny Llandudno greeted us on our arrival at the highly-anticipated 1000 Lives Improvement National Learning Event, a fantastic opportunity for healthcare practitioners and students to meet and discuss the notion of prudent healthcare and quality improvement within the NHS in Wales.

Welcome coffee and pastries lined the stomach for the launch session delivered by Professor Matthew Makin (Medical Director, BCUHB) and Dr Alan Wilson (Director, 1000 Lives Improvement), who introduced the concept of prudent healthcare – built on the three pillars of reducing avoidable harm, appropriately minimising intervention, and promoting co-production of health between service users and providers.

Continue reading »

May 132014
Helen Price

Anitha Uddin

In April, I was fortunate to attend the International Forum on Quality and Safety in Healthcare in Paris. It was an eye-opening experience that taught me so much.

A particular idea I took away was that quality improvement should not be considered an extra-curricular activity; it should be embedded into current practice. And since student nurses are the ones who will be working in healthcare in the coming years, it needs to remain the bedrock of our education.

That’s why I found the nursing discussion session so inspirational. I met nurses from around the globe who all shared a similar vision about healthcare and quality improvement, and we discussed everything from policy and education, to current nursing practices and quality improvement. Continue reading »

May 132014
Helen Price

Helen Price

While attending the International Forum for Quality and Safety in Healthcare in Paris last month, I felt so privileged to be given the opportunity to be part of a global community which has such passion and enthusiasm for making healthcare better.

In her keynote address, Maureen Bisognano, President and CEO of the Institute for Healthcare Improvement, set the tone for the event. She described how healthcare is stuck in a gravitational pull of existing systems, and that to escape this requires new ideas, inspiration and collective impact. She said, “The power of an audacious goal accelerates change, bringing people together to make the impossible possible”. It was truly awe-inspiring.

One theme that was much talked about in many sessions was the importance of patient engagement. As Dr Morten Pytte from DNV-GL said, the call for patient-centred care, the 6 Cs, co-production and a collective approach to care has never been louder! It is clear that we need to bridge the gap between what we preach and what happens in practice. Continue reading »

Apr 172014
Kate Carnegie

Kate Carnegie

What can we learn from patients telling their story? Taking the time to ask a simple question can make all the difference.

On the evening of March 17th, Cardiff’s Ask One Question Committee representatives came together to present our findings on the patient experience.

Ask One Question is a world-wide, student-led healthcare improvement initiative, encouraging students to ask their patients: “What can I do to improve your stay?” Continue reading »

Apr 072014
Ruth Hussey

Lloyd Evans

Clots. A word many have heard of, but I wonder how many understand the effect this five-letter word has on the health and wellbeing of our population.  The answer according to the Ask about Clots campaign launched last week: not enough!

As a final-year medical student approaching the start of a career within the NHS, I attended the launch of Ask about Clots with the realisation that in a little over four months, this topic would well and truly be hitting me square in the face.  Despite years of lectures, tutorials, and clinical attachments, I was taken aback by the facts: Continue reading »

Mar 032014

A member of our student community, Ilaria Pignatelli, is the Campaign Manager for Ask One Question. She tells us about their simple pledge for NHS Change Day.

Ilaria Pignatelli

Ilaria Pignatelli

We ask a lot of questions through medical school. History taking and skills practice bring up some valid questions, but are we always asking the right ones?

The thought of visiting hospital can be a scary and unpleasant experience for many patients, so after asking all the routine questions; why not ask: “What can I do to improve your stay?”

The Ask One Question campaign is doing just that. It’s a world-wide, student-led healthcare improvement initiative, encouraging students to ask their patients: “What can I do to improve your stay?” and, when possible, act on their requests. It was started by students in Cardiff who have already gained recognition outside of Wales.1, 2 Continue reading »

Feb 252014

Marc Franklin reflects on the Institute for Healthcare Improvement’s National Forum in Florida, and thinks about some of the lessons he left with.

Joshua Kovoor, Dr Andy Carson-Stevens, Marc Franklin, Don Berwick, Gney Mehta, Amy Butlin, Hope Ward, and Beth McIldowie at the IHI Open School Congress

Above: Joshua Kovoor, Dr Andy Carson-Stevens, Marc Franklin, Don Berwick, Gney Mehta, Amy Butlin, Hope Ward, and Beth McIldowie at the IHI Open School Congress

Just before Christmas, along with  five other members of the 1000 Lives Student and Educator Community and the Cardiff Medics Student-Patient Chapter, I headed for Orlando, Florida to attend the Institute for Healthcare Improvement’s 25th Annual National Forum on Quality Improvement in Healthcare. We boarded the plane excited to join over 5000 other delegates, and join the discussion on patient safety and quality improvement.

We began by attending the Institute for Healthcare Improvement (IHI) Open School Chapter Congress, along with many of the Forum’s other student delegates from universities around the world. Don Berwick (President Emeritus and Senior Fellow at the IHI), who led the Congress, emphasised the importance of students approaching healthcare systems with “fresh eyes”, and the significance of students’ position as the future of healthcare.

We were then set the modest task of saving the NHS £1 billion! We worked together to put forward a suggestion for quality improvement – our idea was  moving away from the use of non-essential sterile swabs when cannulating a patient, toward the use of cheaper, non-sterile swabs. This was an idea which had the potential to make real savings, and it shows that a small change has the possibility of making a big impact. Continue reading »

Apr 242013
Mikaela Alexander

Mikaela Alexander

How do you motivate health care professionals to think innovatively, safely and improve quality? The president and CEO of Institute for Healthcare Improvement Maureen Bisognano did just that at the 18th International Forum on Quality & Safety in Healthcare.

Maureen’s inspirational speech “All teach, all learn” introduced the simple reminder to embrace empathy to accomplish effective, high-quality patient-centred care. Continue reading »

Apr 182013
Waikitt Chee

Waikitt Chee

I have been fortunate to attend the BMJ/IHI International Forum this week thanks to 1000 Lives Plus. After day one of the Forum, I am really inspired after listening to ideas from around the world about healthcare improvement projects.  

One session explored how you can improve both the quality and efficiency of a service, yet save cost at the same time. It sounded impossible to me before I learnt about the Aravind Eye Care System from Dr Ravindran, one of the keynote speakers.

Continue reading »