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Win for West Quay Medical Centre picks up at HSJ Patient Safety Awards

 

West Quay Medical Centre in Barry has won the Quality Improvement Initiative of the Year 2020 at this year’s HSJ Patient Safety Awards.

The award was for its project : Improving Patient Safety through Better Access to Appropriate Professionals in Primary Care: A Whole System Approach and recognising their contribution to healthcare.

Following an intensive judging process, WQMC was handed the prestigious accolade ahead of a highly competitive shortlist.  Over 1000 guests tuned in to the Patient Safety Awards this year, which took a virtual format on Tuesday, 10th November 2020, to celebrate the very best achievements and innovations driving the national patient safety agenda.

WQMCwas recognised for their ambition, visionary spirit and the demonstrable positive impact that their project has had on patient and staff experiences within the health and social care sector. 

The Improvement Team at WQMC came together during this nine-month project, to focus on what matters to patients: our Patient Participation Group (PPG) had identified access and continuity of care as areas for improvement. A baseline PPG survey established that 95% of patients considered their care to be good or very good, but that 54% had experienced difficulty in obtaining an appointment with a nominated HCP. Working in co-production with the PPG was a key feature of the Access Project. A PPG representative was a key member of our weekly Quality Improvement meetings, and fed back to the wider patient group.

The three main drivers were:

  1. Changing the cultural norm of “G.P first” for an appointment request.
  2. Redesigning the Appointment System
  3. Reducing unwarranted variation & waste in the system

The team considered that patient safety could be improved if we adopted the Principles of Prudent Healthcare more fully, and in particular, ensured equity of access & caring for those with the greatest health need first. We took a systems approach to patient access, improving patient safety over 75 PDSA cycles of iterative change, all within existing resources.

The outcomes included:

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  • An increase in core clinical capacity of 5% and including an increase in allied Healthcare Professionals (AHPs) a total of 9.6% total appointment capacity.
  • Improvements in medication safety: included an eight-fold increase in the number of bespoke medication optimisation reviews with a clinical pharmacist, radical changes to the repeat prescribing system to reduce waste and medication errors, and a focus on high risk medications, such as opioids, resulting in a downward trend of overall prescribing in these drug categories.
  • Holistic assessments for very frequent attender patients identified unmet needs, and improved their care, whilst also increasing the interval between subsequent appointments, in an example of improvements both for an individual and for the larger patient cohort.
  • And others beyond the scope of this summary.

We found that public understanding of the different roles of all the AHPs in the team was poor, and that raising awareness of the skills of all team members reduced unfilled appointments, and enabled GPs to concentrate more on patients with complex needs.

The culture at WQMC is such that GP Partners and senior management prioritise resources for QI, and the sustainability of this culture is preserved through home-grown QI expertise.  Front-line ideas drove the access project, and our receptionists were key members of the Improvement Team. The focus on patients as equal partners in co-design of services, use of front-line staff improvement ideas, and small tests of change  added real quality to the project,  and improved patient access as well as staff engagement at a time of increasing workload in Primary Care. Value was created by maintaining a focus on improving outcomes for patients, in areas that mattered to them, within existing resources.

The judges said:

  • The project demonstrated outstanding work with extremely good use of QI methodology and marked improvements.
  • They particularly liked the way that patient/service users were engaged, and how their experience remained central to the QI project.
  • They were also impressed by the scaling up of the project, with other GPs using the project outcomes and methodology.

Dr Sue Goodfellow, GP Quality Improvement Lead comments; “A team approach in co-production with patients using QI methodology, has delivered meaningful outcomes. Most importantly, the wider team learnt QI skills during the project,   which means this approach has been adopted for ongoing improvement work since this HSJ Awards nomination.

Mr Gareth Thomas, Business Manager at WQMC said “We are absolutely delighted to have been named as the winners in the Quality Improvement Initiative of the Year. It means a great deal to all of our staff to be recognised in this way, particularly where we have had to adapt our way of working due to the coronavirus pandemic using QI tools. We are confident that the positive impact of this Award will help to create a long-lasting legacy, in addition to our NHS Wales awards. This Award will provide a tremendous boost to both staff and patients at West Quay Medical Centre and I am sure it will bolster our efforts to develop and continually improve our services.”    

The full list of winners for the 2020 HSJ Patient Safety Awards can be found on https://awards.patientsafetycongress.co.uk/winners-2020.  

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