The South East London Coronary Heart Disease Collaborative is one 30 national service improvement programmes led by the Modernisation Agency The programme‟s goal is to improve the expe

Document Sample
The South East London Coronary Heart Disease Collaborative is one 30 national service improvement programmes led by the Modernisation Agency The programme‟s goal is to improve the expe Powered By Docstoc
					      The South East London Coronary Heart Disease Collaborative is one 30 national
   service improvement programmes led by the Modernisation Agency. The programme‟s
    goal is to improve the experience and outcomes for people who have, or are at risk
    of developing heart disease, by re-designing the whole pathway of care. It has six
      workstreams, each with clinical teams working together to achieve the goal of
    improving care and outcomes for local patients. The aim is to concentrate on small
   changes, build on them and eventually spread best practice matching local needs.The
     collaborative team has three Project Managers, a Programme Administrator and a
      Programme Manager. There are plans to increase the existing establishment to
                              support the SE London sector.
 Heart Failure Project (Imran Devji)                    Secondary Prevention Project (Sue Bicheno)
  The project team is successfully sampling in all        This project has been strengthened by the
  measures. Booked appointments for ECHO is               appointment of a CHD Specialist Nurse in
  currently being revised. Capacity for all ECHOs is      November. We have successfully prepared a
  increased as a result of redesigning systems and        bid for funding, from Patient Choice monies,
  investing in an upgrade of an ECHO machine. Time        to set up CHD “Cluster” Clinics in the
  from referral to results being obtained for all         Community. Interviews are taking place at the
  ECHOs has improved. Other areas making progress         end of May for the Lead Nurse for this new
  are palliative care, pathways of care for Heart         service. Jointly agreed between the Cardiac
  Failure, rule out test for ECHO (B-NP tests) and        Rehabilitation    and    Secondary   Prevention
  individualised care for patients in the community       Teams, we have agreed a discharge letter for
  which will be further strengthened by the Heart         patients    who     have   completed    Cardiac
  failure post. In addition to this, an attempt has       Rehabilitation. Practices are advised of
  been made to link across the sector for Heart           patients latest test readings for BP, BMI,
  failure Nurse posts covering 6 PCTs. In the             Cholesterol, Heart Rate and Smoking Status
  process of putting a bid together. A demand and         as well as dates that patients received
  capacity exercise to be done for ECHO services          lifestyle advice.
  with the aim of exploring ways to reduce backlog
  and waiting times for patients. Heart failure          Acute Myocardial Infarction (Vacant Post)
  register to be set up in the PCT.
                                                          Sampling in 5 out of 7 measures. Door to
 Revascularisation Project (Catherine Sykes)             needle times improved (Median 17 minutes).
  Catherine has facilitated three process-mapping         Work on pain to needle time underway with
  events. She has validated the results through           ambulance services. Clinical protocols set up
  further sessions, individual meetings, a support        and made available on intranet for staff.
  group, one patient and a carer. Numerous change         Transfer of MI patients from A&E to CCU
  ideas have been identified and several PDSA             now seamless with minimal delay. Pathology
  cycles are in the process of being implemented.         services for Troponin levels now available 7
  For example, patient information has been               days a week improving time for diagnosis and
  provided at University Hospital Lewisham (UHL)          appropriate management of patient care. MI
  Cardiology Department, an email referral system         ICP in progress with all clinical stake holders
  for in-patient referrals to King‟s College Hospital     involved in its development. Work in progress
  (KCH) is being set up and CCU staff at UHL have         to ensure appropriate management of patients
  had a staff development day at KCH. Catherine           in the community and an effective system in
  has also been actively involved in the preparation      place for a follow up clinic including Cardiac
  and submission of bids directly related to the          rehabilitation.
  project. For example, piloting a „Treat and Return     Angina Project (Catherine Sykes/Graenne
  Initiative.‟ She has discussed introducing booked       Johnston)
  PTCA's and CABG's with KCH Booked Admissions.
  She has taken forward the idea of a 'centrally          As this project is co-managed by two Project
  managed list'. Clare Powell has been seconded           Managers – Liz and Catherine there has been
  from St Thomas‟ Hospital to design and implement        varied progress. As Liz is relatively new in
  a pre-surgery intervention for patients on the          post she has managed to meet to discuss the
  waiting list.                                           project with Catherine and to identify the
                                                          next steps to be taken to progress the
                                                          project further. Liz has also met with key
 Cardiac Rehabilitation Project (Sue Bicheno)            individuals within the Lewisham patient slice.
  There    have    been    many    innovative  ideas      Catherine has process mapped part of the
  implemented in this project. In September, the          Angina pathway. She has also introduced a
  first one-day post-PTCA Lifestyle Review Day was        booked admissions system for UHL patients
  held. This was attended by 20 patients. Carers          needing an angiogram at KCH. However there
  were also invited. This format was so successful,       have been several problems with this PDSA
  it has become part of the on-going Cardiac Rehab        cycle.This PDSA cycle will be revisited.
 The South East London Coronary Heart Disease Collaborative is one 30 national
     service improvement programmes led by the Modernisation Agency. The
programme‟s goal is to improve the experience and outcomes for people who have,
or are at risk of developing heart disease, by re-designing the whole pathway of
   care. It has six workstreams, each with clinical teams working together to
achieve the goal of improving care and outcomes for local patients. The aim is to
 concentrate on small changes, build on them and eventually spread best practice
   matching local needs.The collaborative team has three Project Managers, a
Programme Administrator and a Programme Manager. There are plans to increase
           the existing establishment to support the SE London sector.

    Heart Failure Project (Imran Devji)                 Cardiac Rehabilitation Project (Sue Bicheno)
     The project team is successfully sampling in         There have been many innovative ideas
     all measures. Booked appointments for ECHO           implemented in this project. In September,
     is currently being revised. Capacity for all         the first one-day post-PTCA Lifestyle
     ECHOs is increased as a result of redesigning        Review Day was held. This was attended by
     systems and investing in an upgrade of an            20 patients. Carers were also invited. This
     ECHO machine. Time from referral to results          format was so successful, it has become part
     being obtained for all ECHOs has improved.           of the on-going Cardiac Rehab programme.
     Other areas making progress are palliative           The first session of any rehabilitation
     care, pathways of care for Heart Failure,            programme is now dedicated to The Patient
     rule out test for ECHO (B-NP tests) and              Experience. This approach to improving
     individualised care for patients in the              patient care will form one of the workshops
     community which will be further strengthened         at the July conference.
     by the Heart failure post. In addition to
     this, an attempt has been made to link across
     the sector for Heart failure Nurse posts
     covering 6 PCTs. In the process of putting a
     bid together. A demand and capacity exercise        Angina Project (Catherine Sykes/Graenne
     to be done for ECHO services with the aim of         Johnston)
     exploring ways to reduce backlog and waiting         As this project is co-managed by two Project
     times for patients. Heart failure register to        Managers – Liz and Catherine there has been
     be set up in the PCT.                                varied progress. As Liz is relatively new in
                                                          post she has managed to meet to discuss the
    Revascularisation Project (Catherine Sykes)          project with Catherine and to identify the
     Catherine has facilitated three process-             next steps to be taken to progress the
     mapping events. She has validated the results        project further. Liz has also met with key
     through further sessions, individual meetings,       individuals within the Lewisham patient slice.
     a support group, one patient and a carer.            Catherine has process mapped part of the
     Numerous change ideas have been identified           Angina pathway. She has also introduced a
     and several PDSA cycles are in the process of        booked admissions system for UHL patients
     being implemented. For example, patient              needing an angiogram at KCH. However there
     information has been provided at University          have been several problems with this PDSA
     Hospital Lewisham (UHL) Cardiology                   cycle.This PDSA cycle will be revisited.
     Department, an email referral system for in-
     patient referrals to King‟s College Hospital
     (KCH) is being set up and CCU staff at UHL
     have had a staff development day at KCH.
     Catherine has also been actively involved in
     the preparation and submission of bids
     directly related to the project. For example,
     piloting a „Treat and Return Initiative.‟ She
     has discussed introducing booked PTCA's and
     CABG's with KCH Booked Admissions. She has
     taken forward the idea of a 'centrally
     managed list'. Clare Powell has been seconded
     from St Thomas‟ Hospital to design and
     implement a pre-surgery intervention for
     patients on the waiting list.
 The South East London Coronary Heart Disease Collaborative is one 30 national
     service improvement programmes led by the Modernisation Agency. The
programme‟s goal is to improve the experience and outcomes for people who have,
or are at risk of developing heart disease, by re-designing the whole pathway of
   care. It has six workstreams, each with clinical teams working together to
achieve the goal of improving care and outcomes for local patients. The aim is to
 concentrate on small changes, build on them and eventually spread best practice
   matching local needs.The collaborative team has three Project Managers, a
Programme Administrator and a Programme Manager. There are plans to increase
           the existing establishment to support the SE London sector.
   Secondary Prevention Project (Sue Bicheno)         Overall Progress of the programme:
    This project has been strengthened by the
    appointment of a CHD Specialist Nurse in                 Plans to increase our establishment to one
    November. We have successfully prepared a                 project manager per PCT/Secondary Care. In
    bid for funding, from Patient Choice monies,              addition to this, 2 project Managers based in
    to set up CHD “Cluster” Clinics in the                    the tertiary centres for Cardiac Surgery.
    Community. Interviews are taking place at                Revascularisation now split into Cardiac
    the end of May for the Lead Nurse for this                Surgery and interventional cardiology which
    new service. Jointly agreed between the                   will be part of Angina workstream.
    Cardiac Rehabilitation and Secondary
    Prevention Teams, we have agreed a                       Spread to commence in September/October
    discharge letter for patients who have                    2003.
    completed Cardiac Rehabilitation. Practices              Our website and newsletter currently being
    are advised of patients latest test readings              developed - hope to have it live by july 2003.
    for BP, BMI, Cholesterol, Heart Rate and                 LREC/MREC approval received for Discovery
    Smoking Status as well as dates that                      interviews
    patients received lifestyle advice.                      Finally….
                                                       We would like to Thank everyone involved for their
   Acute Myocardial Infarction (Vacant Post)                 continued support. We hope to continue our
    Sampling in 5 out of 7 measures. Door to                  efforts in maintaining and strengthening our
    needle times improved (Median 17 minutes).                existing efforts in facilitating service
    Work on pain to needle time underway with                 improvements within the sector. We will
    ambulance services. Clinical protocols set up             achieve this with our partner organisations
    and made available on intranet for staff.                 including PCTs, secondary care, SEL SHA and
    Transfer of MI patients from A&E to CCU                   other Collaboratives.
    now seamless with minimal delay. Pathology         Please speak to one of the team members for
    services for Troponin levels now available 7              further details/information.
    days a week improving time for diagnosis and
    appropriate management of patient care. MI         We will be looking to recruit staff soon……interested?
    ICP in progress with all clinical stake holders
    involved in its development. Work in progress
    to ensure appropriate management of
    patients in the community and an effective
    system in place for a follow up clinic including
    Cardiac rehabilitation.