Cheshire and Merseyside Palliative and End of Life Care Network Annual Audit Review Meeting 03/03/2016 Welcome
Today s Agenda 1. Welcome and Overview Dr Alison Coackley 2. Review of 2015/2016 Highlights and Challenges Dr Alison Coackley/ Dr Dan Monnery/ GDG Leads 3. Education Update Dr Andrew Khodabukus 4. New Horizons in 2016 and Beyond: Localised Reporting/ Quality improvement Timeframes Website vs Book or Both? NICE Accreditation Dr Alison Coackley 5. Regional Audit Programme 2016-2017 Dr Alison Coackley / Dr Dan Monnery 6. Asking the Right Clinical Question. Interactive Workshop Dr Catriona Mayland 7. Summary and Close Dr Alison Coackley
Review of 2015/16 Highlights and Challenges
2015/16 PROGRAMME Date Topic Supporting Consultants Trainee leads Other contributors May 2015 Bisphosphonates July 2015 Showcase of local audits N&V S&G September 2015 EDUCATION Bisphosphonates S&G November 2015 Hydration Dr Alison Coackley, Dr Catherine Hayle Dr Aileen Scott Dr Emma Longford Dr Najia Shah Claire Cadwallader, Ann Griffiths January 2016 Bereavement Hydration S&G Dr Laura Chapman / Dr Andrew Khodabukus Dr Grace Ting Dr Joanna Roberts Susan Oakes, Rachel Buckle, Jan Roberts March 2016 REVIEW MEETING May 2016 Delirium Bereavement S&G Dr Clare Finnegan Dr Dan Monnery Dr Kath Gaunt Dr Penelope Shepherd Dr Fawad Ahmad, Amanda Cunliffe, Susan Aireton, Kate Nolan, Rebecca Telfer July 2016 EDUCATION September 2016 Hypercalcaemia Delirium S&G Dr Melanie Brooks Dr Ami Nwosu Dr Rachel Macdonald Dr Jenny Smith, Susan Cureton, Debbie Alexander, Andrea Graham, Helen Ferguson
Charting Progress of Standards and Guidelines
What Happens to the Standards and Guidelines after the Presentation? Phase 1 S and G are refined and presented 4 months later to the group Further changes then made. No time limit for sending to the Audit Subgroup Audit subgroup review at the same time as sent to external reviewer. Time allowed 6-8 weeks but varies
What Happens to the Standards and Guidelines after the Presentation? Phase 2 Audit subgroup chair meets with GDG lead. Each comment is reviewed and an action made against it e.g. accepted or not accepted. Record kept Final draft of S and G is then sent to the Audit Subgroup Chair. No time limit given S and G reviewed and formatted. Supporting paperwork collected and uploaded onto master database
What Happens to the Standards and Guidelines after the Presentation? Phase 3 Proof read Upload to audit website Email alert sent to registered members
What Happens to the Standards and Guidelines after the Presentation? Symptom Control Medication Presented in November 2014 Redrafted S and G presented in March 2015 Sent to ER in June 2015. Returned July 2015 Uploaded onto website November 2015
What Happens to the Standards and Guidelines after the Presentation? Malignant Bowel Obstruction Presented in September 2014 Redrafted S and G presented in January 2015 Sent to ER in July 2015. Returned October 2015 Uploaded onto website February 2016
Oxygen September 2013 Sent to ER/ returned by ER Uploaded onto website March 2016 Pathological Fractures November 2013/March 2014 Summary of S and G Progress October 2014/Jan 2015 March 2015 Neuropathic Pain May 2014 August 2015/October 2015 Awaited Malignant Bowel Obstruction September 2014/ January 2015 July 2015/October 2015 February 2016 Symptom Control Medication November 2014/March 2015 June 2015/ August 2015 November 2015 Nausea and Vomiting January2015/May 2015 February 2016/ awaited Bisphosphonates May 2015/Sept 2015 Not yet out to ER
REGIONAL AUDITS DISSEMINATION UPDATE Bisphosphonates- J. Smith, C. Forshaw, D. Monnery, J. Roberts Planning to submit poster to EAPC, Madrid, 2017 Hydration- A. Coackley, C. Hayle. A. Scott, E. Longford Planning to submit poster to EAPC, Madrid, 2017 Bowel Obstruction- S. Fradsham, F. Ahmad, C. Jeffries, E. Longford Poster- Marie Curie Research Conference, London, 2015 Neuropathic pain- E. Sulaivany, K. Marley, S. Coyle, L. McGlynn, G. Ting Poster- EAPC, Copenhagen, 2015 Oxygen- H. Bonwick, A. Scott, C. Robinson, A. Thompson Poster- EAPC, Copenhagen, 2015 Pathological fracture- J. Smith, M. Debattista Poster- Palliative Care Congress, 2014 Symptom control- A. Fountain, A. Khodabukus. A Nwosu Poster- EAPC, Copenhagen, 2015
Highlights
Highlights Completed 4 regional audits and updated 4 sets of Standards and Guidelines
Highlights Completed 4 new sets of Standards and Guidelines. Is it getting slightly easier? High level of clinical engagement. Participation across the Network
Bereavement 45 health care professionals Highlights and Challenges Bisphosphonates 13 clinical cases 65 health care professionals Bowel Obstruction 62 clinical cases 23 healthcare professionals Hydration 321 clinical cases Symptom Control medication 267 clinical cases 122 healthcare professionals
Highlights Completed 4 new sets of Standards and Guidelines. Is it getting slightly easier? High level of clinical engagement. Participation across the Network in GDG work Robust process. Increasing confidence Other Networks want to use our guidelines
Highlights and Challenges Completed 4 new sets of Standards and Guidelines. Is it getting slightly easier? High level of clinical engagement. Participation across the Network in GDG work Robust process. Confidence. Other Networks want to use our guidelines High level of website activity. Website is developing
Hits to Website March 2015 March 2016
Most Popular Pages viewed in PEoLC Pages: March 2015 March 2016
Highlights Completed 4 new sets of Standards and Guidelines. Is it getting slightly easier? High level of clinical engagement. Participation across the Network Robust process. Confidence. Other Networks want to use our guidelines High level of website activity Education and Training
Highlights Completed 4 new sets of Standards and Guidelines. Is it getting slightly easier? High level of clinical engagement. Participation across the Network Robust process. Confidence. Other Networks want to use our guidelines High level of website activity Education and Training Patient and carer participation
Challenges Maintaining the momentum Network support Can we make our process slicker NICE accreditation What do we put on the website?
Essential Skills in Using Evidence & Audit to Improve Palliative Care 3 rd March 2016
2015 Programme Date Topic 6 th March 2015 Defining the Clinical Question 20 th May 2015 Searching the Literature 7 th October 2015 Sifting through the Evidence 27 th January 2016 Appraising the Literature 7 to 22 delegates at each session
Delegate Feedback What went well Half day sessions Relaxed atmosphere Practical application Multiprofessional attendance I feel more confident about the audit programme enjoyable session of what could be a dry subject thank you Sarah and Ami
Delegate Feedback Improvements & Suggestions Recurring programme More time to go through some of the more complex ideas Environmental issues e.g room quality
2016 Programme Aims To improve quality and content based on feedback To complete all training before first presentation of the 2016-17 programme Potential to book onto one, two or all three of the sessions depending on learner need To continue external CPD approval
2016 Programme Date Topic Location 3 rd March 2016 (Today) Friday 13 th May 2016 0930-1230 Thursday 14 th July 2016 1430-1730 Wednesday 21st September 2016 0930-1630 Defining the Clinical Question Searching the Literature 3 external CPD Points Sifting through the Evidence 3 external CPD points Appraising the Evidence & Auditing Practice 6 External CPD Points Marie Curie Hospice, L25 8QA Cancer Research Centre, L3 9TA Marie Curie Hospice, L25 8QA TBC
2016 Programme Additional Resources To update the electronic resources available from the Network website (http://www.cmscnsenate.nhs.uk/strategicclinical-network/our-networks/palliative-and-endlife-care/audit-group/guidelines/) As ever, Audit Subgroup here to help
New Horizons
New Horizons 1 Clinical Audit vs Quality Improvement and the Importance of Localised Reporting/ Local Action
New Horizons 2 Electronic versus Paper Is it Time to bring Back the Book (or a form of the book)
New Horizons 3 It s Now or Never NICE accreditation application is just weeks away
2016/2017 Regional Audit Programme
Regional Survey Results Survey to establish audit preferences and feedback regarding the regional audit programme undertaken February 2016. Total responses: 61.
In 2015/2016 there were six Regional Audit Meetings. Please indicate how many you were able to attend:
Audit Choices for 2016-17 Top 8: Agitation Diabetes Cardiopulmonary resuscitation Constipation Opioid Substitution Blood Transfusion Pruritis Corticosteroids
Chosen Audit Topics Date Topic Supporting Consultants Trainee leads Other contributors November 2016 Diabetes Hypercalcaemia S&G Dr Julie Raj Dr Dan Monnery Dr Teena Cartwright- Terry January 2017 CPR Diabetes S&G Dr Anthony Thompson Dr Joanna Roberts Dr Rachel Macdonald March 2017 REVIEW MEETING May 2017 Blood Transfusion CPR S&G Dr Clare Forshaw Dr Grace Ting Dr Rebekah Wilmington July 2017 EDUCATION September 2017 Agitation Blood Transfusion S&G Dr Helen Bonwick Dr Penelope Shepherd Dr Najia Shah (Agitation S&G in November 2017)
Cheshire and Merseyside Palliative and End of Life Care Network Next Meeting 19/5/2016