Medways Nursing and Midwifery

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Benchmarking Measuring Patient Safety

• Medways Nursing and Midwifery
• Accountability System NMAS

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The Medway NHS Foundation Trust

• Foundation Trust 1/4/08
• Gillingham, Kent
• 360000 population
• 80000 AE attenders
• Level 3 Neonatal
• Integrated stroke team
• Vascular development

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Nursing and Midwifery

• Top team
• Nursing and Midwifery strategy
• Leadership development
• Succession planning
• Essence of care
• Top 100 Employers since 2006

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Compstat

• Set of performance indicators
• Data collected regularly
• Regular meeting
• Accountability

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IMPROVE THE QUALITYREDUCE THE RISK
PATIENT SAFETY
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NMAS

• Hold matrons to account
• To make care safer
• To improve the standard of care
• To empower the matrons
• To share good practice

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Performance Indicators Sept 2004

• MRSA C.Difficile
• Bed days lost
• Documentation
• Nursing uniform
• Agency use
• Pressure sores
• Nursing complaints
• Short term sickness

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Implementing NMAS

• Definitions
• Data collection
• Data collated and disseminated
• Friday NMAS meetings

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NMAS Meetings

• Focus on three matrons
• Accompanied by team
• Look back at performance
• Share interventions
• Explain poor performance
• Trust totals

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Indicators April 2005

• MRSA admitted acquired
• C Difficile admitted acquired
• Short term sickness lt7 days
• Bank Usage
• Pressure sores admitted acquired

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Current Mean 86.22
26th Sep 04
Sept 04 Feb 05 Aug 05
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Current Mean 0.3 patients
26th Sep 04
April 05 June 05 Sept 05
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Current Mean 236.33 hours
26th Sep 04
Sept 04 Feb 05 Jul 05
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Current Mean 9 patients
26th Sep 04
Nov 04 Apr 05 Aug 05
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Current Mean 3047.17 hours
26th Sep 04
Apr 05 Jun 05 Sept 05
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Performance Indicators September 2007

• Not measure Bank and Agency
• Started to measure patient falls
• Changed focus to senior sisters

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Benefits of NMAS

• Flexible
• Relevant data
• Agreed objectives
• Focused on performance
• Meet weekly
• Accountable staff
• Transferable
• Improved Patient Safety
• Won HSJ Patient Safety Award

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Impact on quality of care

• Immediate initial impact
• Everyone understands performance
• Focuses attention
• Ward to the Board

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NMAS Phase II

• Strategic Direction launch
• Focused on Excellent Patient Experience
• Clinical competence
• Environment
• Customer Care
• Staff Experience
• Productivity

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Performance Indicators May 2008

• IC audit
• Housekeeping
• Commode audit
• Hand Hygiene
• Annual competencies
• ID bands

• Single sex bays
• Budget
• Off duty
• Appraisal
• Mentors/ward
• Protected mealtimes

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Framework for Improvement

• Performance Indicators
• Baseline
• Trust and individual targets
• Support
• Supernumerary
• Leadership development
• Mentors

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Conclusion

• NMAS since 2004
• Embedded
• SHA project
• Phase II
• Further Improvement