Spotlight projects
Service improvement
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Establishing Paediatric Trainee Clinics During the COVID-19 Pandemic
Redesign of outpatient clinics delivered by paediatric trainees during the COVID-19 pandemic to incorporate telephone and video consults with some continued face-to-face consultations.
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Children’s Outpatients Reopening Post-COVID19
A rapid quality improvement project to restart outpatient services at Great North Children's Hospital following the impact of COVID-19.
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Healthier Together – Improving the Quality of Care for Children and Young People in Wessex
The Healthier Together Programme is developed in partnership with parents and healthcare professionals across Dorset, Hampshire and Isle of Wight.
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‘Keeping Sick Children Out of Hospital’- The Ambulatory Care Experience (ACE) service
Developing a standard ambulatory care model for managing acute illness in children and young people at home.
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A&E and Short Stay Asthma Pathway
Pathway to ensure every patient seen with asthma in A&E or the short stay unit receives a written asthma plan with appropriate follow up arranged on discharge home.
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Neurotic About Notes: A Quality Improvement Project to Improve Note Safety
Reducing the incidence of notes being incorrectly stored away from a secure trolley on the paediatric ward using peer champions and staff posters.
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A Discharge Summary on Discharge
Ensuring all PAU patients with a stay of less than 4 hours are discharged home with a copy of their discharge summary.
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Improving Phlebotomy Services
Decreasing the number of blood tests done by junior doctors overnight and improve the patient experience of routine blood taking by optimising phlebotomy services on inpatient wards.
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Leeds Children’s Hospital Junior Doctors Forum
Leeds Children's Hospital Junior Doctors Forum works on areas to improve training and the working environment supported by senior management.
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Medicines Optimisation in Specialist Schools
A relatively new area for medicines optimisation where pharmacy workforce transformation can make a huge impact to support, tackle and raise awareness of health inequalities in the special education needs or disabilities sector, with a particular focus on improving medication safety standards and processes at school.
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Patient safety
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The ‘Achieving Clinical Excellence’ Newsletter
Creation of regular newsletters sharing learning from morbidity and mortality meetings in a concise and engaging way for all members of the paediatric multidisciplinary team.
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Implementing Multidisciplinary Ward Safety Huddles To Improve Situation Awareness
Improving patient safety on a general paediatric ward 6N at the Royal Free Hospital London, a pilot site for the national Situational Awareness for Everyone Programme.
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Augmenting the Safety Netting Process and Reducing Unnecessary Re-Presentations
Identifying areas for improving the safety netting process and the scale of unnecessary re-presentations to implement changes to reduce re-presentations to PAU.
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Learning from PICU transfers from a Paediatric Emergency Department and Paediatric ward
Establishing a monthly multi-disciplinary analysis of all paediatric cases transferred from the paediatric emergency department and paediatric ward to PICU.
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Using Quality Improvement Methodology to Reduce Central Line Associated Blood Stream Infections
Reducing harm from Central Line Associated Blood Stream Infection as part of the Scottish Patient Safety Programme and Maternal & Children’s Quality Improvement Collaborative.
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Recognition and Response to Sepsis in the Paediatric Emergency Care Setting
The Paediatric Sepsis Network provides an open clinical forum to formulate meaningful changes in sepsis care based on national guidance.
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Family centred care
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Involving Children and Young People in Specialised Commissioning
A resource for clinical reference groups developed with children and young people to support approaches for children and young people’s voice to inform and influence specialised commissioning.
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Involving Children, Young People and Family Voice in Committees
Guidance on involving patient voice in committees in a meaningful way developed with children, young people, families, committee members and College staff,
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Recipes for Engagement
A resource for healthcare professionals full of games and activities to support interactive and meaningful participation and engagement in service level decision making with children and young people.
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The Communication of Care Plans With Patients and Carers
Improving communication of care plans with patients and carers using whiteboards - a simple and low cost tool.
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Neonatal care
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Optimal timing of antenatal corticosteroids to improve outcomes in preterm birth
This QI project aimed to increase the proportion of women at less than 34 + 0 weeks’ gestation with threatened preterm labour receiving a full course of antenatal corticosteroids within one week prior to delivery to 95% or greater by March 2023.
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Snuggle and PEEP – Increasing use of non-invasive respiratory support and reducing bronchopulmonary dysplasia rates
This QI project aimed to increase the use of non-invasive respiratory support and reducing BPD rates.
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More than meets the eye: understanding the impact of guideline changes on retinopathy of prematurity screening performance
This QI project analysed National Neonatal Audit Programme (NNAP) ROP data to drive improvement and reduce the risk of preventable sight loss.
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Implementing a care bundle to reduce the incidence of severe intraventricular haemorrhages in a UK tertiary neonatal intensive care unit
This QI project aimed to reduce the incidence of all intraventricular haemorrhages in babies born at 30 weeks’ gestation or less by 30% over a three-year period.
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Use of non-synchronised non-invasive positive pressure ventilation (NS-NIPPV) to reduce extubation failure in preterm infants
This QI project aimed to use NIPPV as a mode of extubation for all preterm infants born at <28 weeks’ gestation and for all high-risk infants <32 weeks gestation.
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Using the NNAP measure for neonatal nurse staffing to support benchmarking, oversight of safe staffing and quality improvement
This QI project reviewed nurse staffing data to drive forward improvements in: shift leadership, QIS nursing ratios and skill mixing for safer staffing and inform recruitment, workforce planning and investment via budget setting in each Trust.
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Improving Rates of Optimal Cord Management in Preterm Infants Including Delivery of PEEP During Transition with an Intact Cord
This case study from Southmead Neonatal Unit in Bristol outlines how a multidisciplinary team worked together to achieve improved rates of optimal cord management. This quality improvement project was part of the PERIPrem (Perinatal Excellence to Reduce Injury in Premature Birth) initiative launched in the South West Neonatal Network.
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Optimal Cord Management in preterm infants – a Quality Improvement project
A low-cost project that a multidisciplinary team at Singleton Hospital implemented to improve rates of optimal cord management in preterm babies. This work highlights how data from the National Neonatal Audit Programme was used to improve quality of care.
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Using National Audit Data for Service Improvement
Examples from teams in the Yorkshire and Humber Neonatal Network, Bradford Teaching Hospitals and Manchester University NHS Foundation Trusts using data from the National Neonatal Audit Programme to improve quality of care.
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Keeping Mothers & Babies Together: Getting It Right First Time
Introducing a 'Keeping Mothers and Babies Together' pathway at the Royal Free London NHS Foundation Trust to reduce neonatal admissions to 6% and create a single unified pathway of care for all ‘at risk’ infants.
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Prevention of Cerebral Palsy in Preterm Labour (PReCePT)
A scalable quality improvement initiative co-designed, with parents, obstetric, midwifery and neonatal clinical teams in West England to increase the uptake of Magnesium Sulphate given intrapartum during preterm labour.
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Communicating the Aims and Outputs of the National Neonatal Audit Programme to Parents and Families
Developing a briefing document to inform healthcare professionals and parents about their unit using data from the National Neonatal Audit Programme and broaden the focus of a national audit from clinical improvement to encompass the patient experience.
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Multidisciplinary Team Working to Standardise Neurodevelopmental Follow-Up
Two case examples of multidisciplinary approaches to using QI methodology to improve the delivery, uptake and recording of two-year developmental assessments for children born preterm.
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The Rate of Babies Born Less Than 27 Weeks Gestation with NICU On Site
A multi-site project to improve East of England Network's rate of babies born at less than 27 weeks gestation in a maternity unit with a NICU on site, in line with the national average.
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Reducing Necrotising Enterocolitis: A Quality Improvement Initiative
Raising awareness of the risk factors linked to necrotising enterocolitis to decrease its incidence on a neonatal unit at West Hertfordshire NHS Trust.
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Improving Early Thermal Care for Preterm Infants
Joint maternal-neonatal safety collaborative projects to increase the number of preterm neonates admitted on to a neonatal unit with an admission temperature between 36.5°C to 37.5°C.
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Safely Reducing Empirical Antibiotic Administration on Postnatal Wards
Incorporating the Kaiser Permanente Sepsis Risk Calculator (KP-SRC) into a new guideline to aid in decision-making for babies on postnatal wards with Early Onset Neonatal Sepsis risk factors.
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Establishing The Hillingdon Community Joint Neonatal Clinic During COVID-19
An initiative by the neonatal team at Hillingdon Hospital in response to the challenges of delivering specialist care during the COVID-19 pandemic and its impact on very young babies and their families.
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Deferred Cord Clamping in Preterm Infants
Improvement projects from Sheffield Teaching Hospitals, Ashford and St Peter's Hospitals, and York and Scarborough Teaching Hospitals NHS Foundation Trusts focussed on the implementation of deferred cord clamping as per national guidance.
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Optimising Early Maternal Breast Milk (MBM) for Preterm Infants
Supporting the implementation of the five Perinatal Core Elements to optimise early MBM for preterm babies across the St Mary’s Hospital Managed Clinical Service at Manchester University NHS Foundation Trust
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Project PEEP: Introduction of a Preterm Respiratory Care Bundle on NICU
Establishing a team of interdisciplinary individuals to develop strategies to reduce the incidence of bronchopulmonary dysplasia on the neonatal intensive care unit through implementation of a preterm respiratory care bundle.
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Driving Improvements in the Rates of Breast Feeding at Discharge from Neonatal Care
The neonatal team at Medway Maritime Hospital shares how national audit data has been used to drive improvements in the rates of breast feeding at discharge.
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Diabetes care
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National Diabetes Quality Improvement Pilot: Our QI Journey So Far
Improvements in the first year of our QI journey following our participation in the pilot National Diabetes QI Collaborative in 2017.
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Improving HbA1c For Children and Young People Living With Diabetes
Improving the mean HbA1c for all children and young people living with diabetes who are treated with continuous subcutaneous insulin infusion using a package of support and education.
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Epilepsy care
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Young Epilepsy App
Sharing information for young people with epilepsy and their parents, and providing a convenient and electronic way of recording details of seizure events.
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Epilepsy Passport
Designed as a paper record of relevant and up-to-date clinical information to be carried by children and young people or their parents and carers living with epilepsy.
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Sustainability QI
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The Replacement of Polystyrene Cups with a Sustainable Alternative
An eco-QIP to remove all polystyrene cups from the neonatal unit at John Radcliffe Hospital, supported with simultaneous introduction of a reusable and sustainable alternative with all proceeds benefiting a local neonatal charity.
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Reducing the Environmental Impact of Inhalers in Paediatrics at Wexham Park Hospital
Working with a local Clinical Commissioning Group to improve the carbon footprint of inhalers by establishing a decision support alert for GPs and a safe disposal and recycling scheme.
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