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Applying a qualityimprovement approach tomobilising knowledge inCOPD: developing andimplementing a care bundleLaura Lennox...
CLAHRC NWL ApproachQualityImprovementQuality Improvement MethodsPatient andPublicEngagementEngaging Patients and StaffRese...
• 5thLeading cause of death inthe UK• Leading reason for hospitaladmission and readmission• Large economic burden tothe NH...
Distilling the evidence• 5 key elementsfor acuteexacerbation ofCOPD• Ideal fordevelopment intoa Care Bundle• Piloted in 1 ...
CLAHRC NWL QI tools and methodsSystematic andscientificapproach toimplementationusing qualityimprovementtools andtechniques
ACTIONEFFECTTo improve qualityof care for patientswith an acuteexacerbation ofCOPD at Hospital XAppropriateprovision ofcli...
Model for ImprovementAimsMeasuresTesting changeIn Practice:
Bundle design andadministration
• Increased compliance with care standards• Over 1400 patients have been put on the bundle• 945 have received all elements...
Challenges and FacilitatorsChallenges and Facilitators1) Staff too busy“Having multidisciplinary people getinvolved helps ...
In summary QI methods aidteams to…• Act Scientifically and Pragmatically• Engage and empower patients and staff• Embrace c...
Contact informationLaura Lennoxl.lennox@imperial.ac.uk369 Fulham RoadSW10 9NHLondonUnited Kingdomhttp://www.clahrc-northwe...
Applying a quality improvement approach to mobilising knowledge in COPD: developing and implementing a care bundle
Applying a quality improvement approach to mobilising knowledge in COPD: developing and implementing a care bundle
Applying a quality improvement approach to mobilising knowledge in COPD: developing and implementing a care bundle
Applying a quality improvement approach to mobilising knowledge in COPD: developing and implementing a care bundle
Applying a quality improvement approach to mobilising knowledge in COPD: developing and implementing a care bundle
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Applying a quality improvement approach to mobilising knowledge in COPD: developing and implementing a care bundle

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2013 Canadian Knowledge Mobilization Forum
Laura Lennox
NIHR CLAHRC for Northwest London

Published in: Education, Health & Medicine
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  • Although this seems like a relatively simple intervention, maintaining 100% delivery was very difficult. We wanted to find out not only the key challenges to implementing the bundle but also understand the solutions used by the teams to overcome these barriers to inform future implementation. 3 focus groups: Collated documentary evidence and asked team to rate their biggest challenges. The top three staffing challenges were: Staff too busy Lack of staff engagement Added workload of the bundle Facilitators: Bundle responsibility: Having a multidisciplinary team deliver the bundle emerged as a common solution across all sites. Finding Bundle champions : aided in education and motivation to complete the bundles. Message was better received from a person seen as being part of the team. Changing Perceptions: Participants identified that a solution to some of the staffing issues included changing the perceptions of those delivering the bundle. Take home messages: Even something as easy as the bundle is not easy to implememnt. There has been increasing enthusiasm to adopt the COPD bundle across the region but the implementation of new interventions poses challenges to both those planning and delivering such initiatives. Understanding and learning from the challenges faced by previous endeavours and the facilitators to overcoming these barriers provides an opportunity to mitigate issues that cost time and resource and ensure training tailored to the anticipated challenges.
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  • Transcript of "Applying a quality improvement approach to mobilising knowledge in COPD: developing and implementing a care bundle"

    1. 1. Applying a qualityimprovement approach tomobilising knowledge inCOPD: developing andimplementing a care bundleLaura LennoxNIHR CLAHRC for NorthwestLondon
    2. 2. CLAHRC NWL ApproachQualityImprovementQuality Improvement MethodsPatient andPublicEngagementEngaging Patients and StaffResearchRigorous Design and Use ofDataEducationTraining, Support andCollaborationA collision of different worlds…NIHR CLAHRCFor Northwest LondonHealth OutcomesPatient ExperienceImprove health outcomes and patient experience through translatingresearch evidence into practice.Primary aim:
    3. 3. • 5thLeading cause of death inthe UK• Leading reason for hospitaladmission and readmission• Large economic burden tothe NHS• NICE – COPD guidelines:183 recommendationsWhy COPD?Chronic Obstructive Pulmonary Disease
    4. 4. Distilling the evidence• 5 key elementsfor acuteexacerbation ofCOPD• Ideal fordevelopment intoa Care Bundle• Piloted in 1 site
    5. 5. CLAHRC NWL QI tools and methodsSystematic andscientificapproach toimplementationusing qualityimprovementtools andtechniques
    6. 6. ACTIONEFFECTTo improve qualityof care for patientswith an acuteexacerbation ofCOPD at Hospital XAppropriateprovision ofclinical careCOPD CarebundleReferral to pulmonaryrehabilitation whereappropriateInformation oncondition provided topatientReferral to smokingcessation if patient issmokerPatients taughtcorrect inhalertechnique13421. Readmissions2. Attendances at Smoking cessation3. Referrals to smoking cessation4.Number of bundles completedAA GuidelinesAA
    7. 7. Model for ImprovementAimsMeasuresTesting changeIn Practice:
    8. 8. Bundle design andadministration
    9. 9. • Increased compliance with care standards• Over 1400 patients have been put on the bundle• 945 have received all elements (67.2%)Impact on Quality of Care
    10. 10. Challenges and FacilitatorsChallenges and Facilitators1) Staff too busy“Having multidisciplinary people getinvolved helps with the initiation ofthe bundle. Because even if oneperson misses it a physio or nursecomes and starts it and even apharmacist can say this patient isnton a bundle and start one.”(Physiotherapist)2) Lack of staff engagement“Having a nurse champion or abundle nurse aided in getting peopleon board and motivated staffmembers to complete thebundles.”(Consultant)3) Added workload of the bundle“A large part was changing theperception of the bundle, theyenvisaged it as more time consumingthan it actually was, because they areconstantly being given more paperworkaround various diseases and to them itwas just another piece of paper thatthey thought would be a lot of work.”(Nurse)
    11. 11. In summary QI methods aidteams to…• Act Scientifically and Pragmatically• Engage and empower patients and staff• Embrace complexity• Support long term success
    12. 12. Contact informationLaura Lennoxl.lennox@imperial.ac.uk369 Fulham RoadSW10 9NHLondonUnited Kingdomhttp://www.clahrc-northwestlondon.nihr.ac.uk/
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