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Preventing thrombosis A Chief Executive’s view

Preventing thrombosis A Chief Executive’s view. Guy Vautier. James Paget University Hospitals NHS Foundation Trust. Consultant Physician. adrian.pennington@jpaget.nhs.uk guy.vautier@jpaget.nhs.uk. Background.

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Preventing thrombosis A Chief Executive’s view

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  1. Preventing thrombosisA Chief Executive’s view

  2. Guy Vautier James Paget University Hospitals NHS Foundation Trust Consultant Physician adrian.pennington@jpaget.nhs.uk guy.vautier@jpaget.nhs.uk

  3. Background • Great Yarmouth and Waveney has a population of 240,000, which is ageing faster than national averages, 37% increase in 65 to 75 year age group in next 10 years • Both Great Yarmouth and Lowestoft have significant levels of deprivation (Top 10 in UK) • Of the 27,000 inpatients seen at the James Paget, 80% are acute emergency • Nearest other acute facilities are: • Norfolk and Norwich University Hospital 35 miles west • Ipswich Hospital 50 miles south

  4. History • Successful organisation – second wave NHS Trust 1993 • Always achieved financial targets without brokerage, breakeven as NHS, surplus as FT • Only Three Star Trust in Norfolk, Suffolk and Cambridge SHA, 2004/05 • Became FT 1st August 2006, the first in Norfolk and Suffolk • University Hospital status 1st August 2006 • Health Care Commission rating Excellent / Excellent 2007/08

  5. Turning point - Audit • Audit Conclusion: • Still need to increase thromboprophylaxis awareness • Prescribers not necessarily dose aware • Opt in verses opt out debate (99% medical patients eligible)

  6. Main focus • Opt out is a positive approach • All will be given unless • Unification of documentation • Make the right thing to do, the easiest thing to do (For example pre-printing documentation) • Changing ownership • Nurse intensified (not Haematology) • Pharmacy • Team / Group approach

  7. Exemplar Status - opportunity • Opportunity for our health system to be accredited in • terms of exemplar status. • This is important because: • a. It will gives confidence and to reassure our community • b. It will consolidate our position of partnership with our PCT • c. It will give recognition to the clinical teams that are delivering the service • In real terms: • Improvement in the management of DVT • Improvement in the management of PE • Reduction in the number of deaths CHOICE PARTNERSHIPS CLINICAL LEADERSHIP PATIENT EXPERIENCE PATIENT SAFETY CLINICAL EFFECTIVENESS

  8. Ongoing work Where are we now? • Rolling programme of audit (Pharmacy) • Emergency • Elective programme • Spot checking (Anticoagulation Nurse) • Undergraduate projects (UEA partnership)

  9. Impact • VTE – Compliant, Continually reviewing, Growing knowledge • Wider implications • Improvement in patient safety agenda • Improvement in clinical outcome • Improvement in attitude toward change • Improvement in patient experience & information • Improvement in multi-disciplinary working • Improvement in quality

  10. Challenge • To continue learning • To share knowledge • To save lives • HCC / CQC core standards unchanged • SHA have a responsibility to influence commissioners • PCT must include in contract negotiations: • Patient safety • Clinical effectiveness • Patient experience • Quality reports / accounts • Acute hospitals have a “responsibility”

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