We are delighted to announce our 2019 Bright Ideas in Health Awards finalists.
Demonstrating an Impact upon Patient Safety
Avoiding Falls Level of Observation Assessment Tool – Northumbria Healthcare NHS Foundation Trust
The number of frail older people in hospital who are at risk of falling is increasing year on year. This not only presents a significant safety issue, but also necessitates an unsustainable increase in resource in terms of one to one care. AFLOAT (Avoiding Falls Level of Observation Assessment Tool) was developed by the team, with the aim of supporting ward nursing teams in the observation of patients at risk of falling. Staff use AFLOAT to help them to decide the appropriate level of observation for the patient, and in this way, staff are made to feel more supported, without service users feeling that the observations are overly intrusive.
A Collaborative Approach to Responding to and Reducing Falls in Older Adults in the Community –
Gateshead Health NHS Foundation Trust
Falls are the most common cause of death from injury in the over 65s, accounting for 40% of ambulance call outs. Despite this, falls are not always dealt with in the most appropriate way, which can result in problems for the health and social care system. The pilot Project provides a truly collaborative approach to the problem, avoiding unnecessary hospital admissions and ensuring that patients are safe to remain at home, reducing pressure on both A and E departments and ambulance services.
Community Nursing Sepsis Screening and Action Tool – Northumbria Healthcare NHS Foundation Trust
Sepsis in the community is a significant problem, and there is a need for improved focus upon the early recognition and escalation of patients who are suspected to have the condition. The Screening and Action Tool, which can be carried to patients’ homes by healthcare professionals in the community, as well as being used within clinics, assists with the recognition of the early symptoms of sepsis. It facilitates quick action, addresses the keys questions to ask, and presents an escalation plan to follow if sepsis is suspected.
Cardiac Arrest Reduction Strategy – County Durham and Darlington NHS Foundation Trust
Cardiac arrests in hospital are normally attended by a cardiac arrest team of skilled individuals who have received appropriate training to ensure that they know how to respond. Despite this, the survival rate is low, and it has remained so for the last fifty years. The aim of the Project is to reduce the incidence of cardiac arrest calls within the Trust, thereby improving patient outcome and experience. The Project began with a change in title from a ‘Resuscitation Service’ to a ‘Cardiac Arrest Prevention (CAP) Team’, in recognition of the fact that resuscitation often means that it is too late. The focus of the CAP Team is the prevention of avoidable harm, to achieve the best possible outcomes for patients accessing healthcare in the Trust.
Demonstrating an Impact upon Quality Improvement
Implementation of Direct Carbapenemase Producing Enterobacteriaceae PCR screening for Peri-Operative ICCU patients – The Newcastle upon Tyne Hospitals NHS Foundation Trust
Enterobacteriaceae are a group of bacteria which can cause potentially life-threatening infections. Although Carbapenems are broad spectrum antibiotics that are typically used for treating serious or life-threatening infections, Carbapenemase Producing Enterobacteriaceae (CPE) produce enzymes that allow them to destroy Carbapenem antibiotics. This is a major healthcare concern, because as well as expressing Carbapenem resistance, CPE are also frequently resistant to most other groups of antibiotics. The team are exploring the use of rapid testing techniques for CPE in order to reduce infections and improve the patient experience overall.
Prevention and Detection of Type 2 Diabetes in Primary Care – Derwentside Healthcare Ltd
Type 2 Diabetes is a widespread disease, contributing to high levels of morbidity and mortality, as well as leading to high healthcare costs. However, there is strong evidence to indicate that Type 2 Diabetes can be prevented or delayed with inexpensive and simple lifestyle interventions. There are guidelines to assist with the identification of Type 2 Diabetes, but these can be complex. The prevalence of the condition in Derwentside is high, and a general framework has been created, which allows healthcare organisations to integrate a new process into existing workflows, thereby facilitating the prevention and detection of Type 2 Diabetes.
Telemedicine Home Visiting Service to Ease GP Workload and Workforce Pressures – North Cumbria CCG
It is estimated that 10% of contact with GPs takes place in patients’ homes, and with growing proportions of older people, coupled with a rise in the prevalence of chronic diseases in the elderly population, the demand for home visits is projected to increase. There is therefore a need to make changes to the way that care is delivered, to ensure that precious resources are utilised in the best possible way. A new service has been developed, which facilitates a more efficient home visiting service for GP practices, allowing more patients to be seen, and at a lower cost than the current approaches available.
The KidzMed Project – Teaching Children to Swallow Tablet Medication – The Newcastle upon Tyne Hospitals NHS Foundation Trust
Families can become frustrated with liquid medicines, which often have short expiry dates, require refrigeration, are difficult to obtain from local pharmacies, can cause dental decay, and can be unpalatable. Moreover, liquid medications can be difficult to dose and can also vary in concentration. Tablet medications are safer, more convenient, and less expensive than liquid, yet children and young people (CYP) often remain on liquid medication due to habit and reluctance to convert. The aim of the Project is to teach CYP on long term medication how to take tablet medication as an alternative to liquid medication. An interactive training package has been developed, aiming to achieve a successful conversion rate and increase confidence.
Development of an Innovative Device or Technology
Sponsored by The Centre for Process Innovation
Improvements in Mandibular Reconstruction – The Newcastle upon Tyne Hospitals NHS Foundation Trust
Following radiotherapy for head and neck cancer, a small cohort of patients can develop osteoradionecrosis (ORN) in the mandible, which is a condition initiated by an injury to the bone. The current standard of care is symptom management, but in cases where the symptoms become unmanageable, the standard of care is mandibular resection and reconstruction. A new and collaborative approach has been developed, which aims to minimise surgical failure rate and to improve the process of mandibular reconstruction.
PED E-resuscitation Tool (PET) – South Tyneside and Sunderland NHS Foundation Trust
Critically unwell and injured children are brought to the Paediatric Emergency Department (PED) resuscitation room for life saving care, and although the staff are very highly trained, the PED resuscitation room is a high stress, time pressured, and very noisy, environment. This can make the performance of the clinical team more difficult by increasing their cognitive load, and by impairing communication between team members. The PED E-resuscitation Tool (PET) aims to optimise performance in the Paediatric Emergency Department (PED) resuscitation room, improving patient care and supporting healthcare professionals in the process.
AMBLor – Prognosis of Early Stage Cutaneous Melanoma – Newcastle University
Melanoma is the most deadly of all skin cancers. Globally, there are approximately 232,000 new cases of melanoma diagnosed annually, which places enormous pressure upon healthcare systems. Risk of disease progression is currently assessed based upon histological features of the tumour, however some tumours categorised as low risk will nevertheless go on to develop metastasis. The AMBLor test has been developed, which provides an accurate prognosis of disease progression. The test fits into the current diagnostic pathway for melanoma, and reduces the psychological burden on patients, as well as reducing costs associated with unnecessary patient surveillance.
Managing Unusual Sensory Experiences in Psychosis – Northumberland, Tyne and Wear NHS Foundation Trust
many ways, but it is common for sufferers to report having unusual experiences such as hallucinations, which can lead to distress and social isolation. Whilst treatments such as Cognitive Behavioural Therapy (CBT) can help, it can only be accessed by some psychosis sufferers on account of a lack of resources, for example. A new approach, MUSE (Managing Unusual Sensory Experiences), has been developed, which draws upon the latest understanding of hallucinations. The treatment is of shorter duration than CBT and it can be provided in an engaging way by a broad range of staff working in mental health settings.
Early Diagnosis and Precision Medicine Award
Sponsored by Diagnostics North East
The VARIANT Trial – Feasibility Trial of Personalised Treatment of Patients with Advanced Prostate Cancer – Newcastle University
Prostate cancer is the most common form of cancer in males, with 1 in 4 patients developing incurable metastatic disease. Initial treatment responses are transient and further management options include either additional chemotherapy and drug based internal radiotherapy, or further hormone therapy. Clinical choices in terms of deciding which of these treatment approaches to take, mean that management can be difficult in terms of patient experience, outcomes, and economic costs to the NHS. The VARIANT study aims to generate feasibility data confirming the clinical value of treatments in day-to day UK advanced prostate cancer clinical practice, to inform the design of a future definitive randomised controlled trial.
Measurement of Statin Concentrations – Northumbria Healthcare NHS Foundation Trust
Statins are one of the most widely prescribed medication groups in the UK, and in 2016, the annual associated prescription cost was £132.8 million. An ageing population means that the likely prescription rate of statins is set to increase. However, due to a combination of side effects and negative publicity, poor adherence to statin medication is common, resulting in increased NHS expenditure due to wasted prescriptions, expensive second line treatments, and consequent cardiovascular events. An analysis method has been developed, which ensures that patients are provided with optimal treatment prior to progression to more expensive second line treatments.
Improvements in Breast Imaging – The Newcastle upon Tyne Hospitals NHS Foundation Trust and Kromek
Breast screening programmes aim to detect cancers before they appear symptomatically. Despite this, every year, there are more than 55,000 new incidences of breast cancer in the UK. Breast screening using mammography was introduced in the UK almost thirty years ago, and it relies principally upon a difference between the density of the potential tumour and the surrounding normal breast tissue. In view of this, in women with a higher proportion of dense tissue in the breast, it can be more difficult to detect any abnormality using mammography. The new technique provides a more sensitive method of imaging women with dense breast tissue, improving prognosis and reducing treatment costs.
A Point of Care Device for Large Vessel Occlusion Diagnosis – POCKiT diagnostics LTD
Every year, around sixteen million patients worldwide suffer a stroke. The most dangerous type of stroke is a large vessel occlusion, which represents 95% of strokes causing permanent disability and 80% of strokes causing death. Currently, two types of stroke treatment centres exist, namely Primary Stroke Centres (PSCs) and Comprehensive Stroke Centres (CSCs), but treatment for large vessel occlusion only occurs at CSCs. A rapid point of care test has been developed for the detection of large vessel occlusion, which can be used to inform the decision regarding whether the patient should be directed to either the PSC or the CSC as appropriate.
Digital Innovation in Health and Social Care
Sponsored by Great North Care Record
Self Testing of Kidney Function – South Tees Hospitals NHS Foundation Trust
Patients are often required to attend Primary and Secondary healthcare services for assessment of their kidney function, when they are generally well and would not otherwise need to see a healthcare professional. Although such tests are clinically important, unnecessary clinic visits can impact negatively upon the patient experienc e, and they can also consume valuable healthcare resources. For example, avoidable clinic visits can impact upon the daily schedules of patients, disrupting employment and imposing a financial burden. The team are developing a model for patient self-testing of kidney function at home, which is safe, and which reliably replicates the key measurements that are assessed routinely in a clinic.
The Digital Doctors Surgery – Empowering Digital Patients – NHS Sunderland CCG
People in Sunderland are living longer, but they are at risk of spending their extended years in poor health as a result of high levels of poverty, deprivation and lack of opportunity, all of which influence behaviours such as poor diet, lack of exercise, smoking, and excessive alcohol use. The quality of general practice in the region is excellent, but pressures are increasing. The team have developed a new Programme, which aims to empower patients to take control of their own health and care, supported by secure and convenient digital channels. Patients in Sunderland will be able to choose how they interact with their GP Practice, whether it is using digital technology or via a traditional face to face method.
Capacity Tracker – NHS North of England Commissioning Support
Choosing a care home is one of the most important life decisions that any of us may have to make. The decision may not be out of choice, but it may be necessary when discharge from hospital to the patient’s own home is not possible. To facilitate a successful transition to a care home, it is essential that health and social care staff work together to achieve the best possible outcome. Developed
in partnership with NHS England North, Local Authority representatives and care home providers, the Capacity Tracker allows users to conveniently identify suitable care homes and ensure that they do not stay in hospital for any longer than is necessary.
Development of an Electronic Paediatric Emergency Department Asthma Assessment Tool (PEDAAT) – South Tyneside and Sunderland NHS Foundation Trust
The UK has the highest standardised asthma mortality rate in Europe for children up to 14 years old, and many of these deaths are avoidable. Key to addressing this issue is the identification of high risk children with asthma, and the identification of cases where clinical concerns exist, such as inadequate routine care and / or poor adherence to treatment. The team have developed an Electronic Paediatric Emergency Department Asthma Assessment Tool (PEDAAT), to provide high quality, patient focussed care, identifying high risk children and positively impacting upon asthma mortality rates.
Outstanding Research Collaboration with the NHS
Sponsored by NIHR Clinical Research Network North East and North Cumbria and MedCoNnecT North
Improved Treatment of Vascular Birthmarks – South Tees Hospitals NHS Foundation Trust
Vascular birthmarks are discolourations of the skin caused by abnormal growth or formation of blood vessels. The Trust are undertaking a study directed to the treatment of vascular birthmarks, with the aim of providing significant benefits to both patients and the NHS, with patients requiring fewer repeat treatments and achieving a faster treatment response.
SABR – A Radiotherapy Programme – South Tees Hospitals NHS Foundation Trust
Stereo-tactic Ablative Radiotherapy (SABR) is a state-of-the-art oncology treatment, which represents the current standard of care for early lung cancers. The Trust are looking into the application of the treatment to specific disease areas, with the aim of providing an alternative treatment option which presents a valuable opportunity to improve patient care.
Evaluation of a Point of Care Test for Respiratory Syncytial Virus in Infants and Young Children – Newcastle University
Respiratory viral infections (RVIs) in children impose a significant burden upon the children themselves, their families, and healthcare resources. RVIs are highly contagious, and in view of this, hospitalised children must be isolated to avoid cross-infection. The University are evaluating the diagnostic accuracy of a point of care test for Respiratory Syncytial Virus, which is a type of RVI, under real-life NHS conditions.
Innovation in Education Category
Sponsored by Health Education England North East
F|Docs – Innovative Training for Foundation Doctors – Medics.Academy
After completion of medical school in the UK, foundation doctors enter a two-year Foundation Programme, which consists of six placements in different specialties. The aim of the Foundation Programme is to provide foundation doctors with the skills to safely work within all areas, which they will take forward for the rest of their careers. Foundation Programme teaching is mainly delivered through classroom teaching, and as a result, foundation doctors can sometimes struggle to attend due to other clinical commitments. F|Docs is an online package of interactive teaching materials specifically designed to meet the educational needs of foundation doctors.
Simulation as Part of Shadowing to Increase Preparedness – County Durham and Darlington NHS Foundation Trust
Foundation doctors often feedback that they do not have sufficient opportunity to spend time on the wards during the shadowing period which forms a vital part of their training. The aim of the Project is to increase preparedness for ward work by simulation, ensuring immersion in the ward environment. Acute scenarios are developed, which enable the foundation doctors to simulate routine tasks and clinical care, but in a realistic way and in a realistic timeframe, introducing them to important tasks such as the procedures that they will typically use in day to day practice.
Paediatric Sepsis Podcasts – The Newcastle upon Tyne Hospitals NHS Foundation Trust
Despite being one of the most common causes of avoidable death and harm in children, sepsis can be difficult to recognise early, and a lack of associated educational materials for healthcare professionals was identified. In response to this, a series of Podcasts have been developed, exploring the condition from the point of view of infectious disease consultants, microbiologists, parents, neuro-disability consultants, allergists, intensivists, and district general consultants. As a result, healthcare professionals are more able to learn from the expertise of others, and also contribute their own knowledge to the learning of others.
Development of Integrated Competency Hubs – Cumbria Partnership NHS Foundation Trust
During clinical skills workshops, it became apparent that community-based staff were struggling with clinical skills training due to the geography and infrastructure of the Cumbria region, which often results in long journey times between community work bases and the two acute hospitals. In response to this, Integrated Competency Hubs have been developed, with Hub Co-coordinators matching the skills required by the community-based staff member with the relevant patient attending for treatment. In this way, staff have accessible provision for maintaining competency, which improves staff wellbeing and ultimately improves the patient experience.
An Online Programme of Interactive Allergy Education – Newcastle University
Allergic disorders are becoming increasingly prevalent and more complex. Whilst early recognition and management is key, there is a need to improve training in healthcare groups, particularly in view of the fact that a wide variety of healthcare professionals encounter patients with allergy in their day to day practice. A Programme of allergy education has been developed, which is designed to address the practice needs of specific clinical groups, facilitating direct interaction with experts in the field to discuss case management and improve patient care as a result.
Sponsored by Newcastle University
The Sensational Thinking Project – The Newcastle upon Tyne Hospitals NHS Foundation Trust
Sensory processing differences significantly affect participation in daily activities, including access to education, and they are prevalent in around 95% of children with Autism Spectrum Disorder (ASD). Alice Gair, a Paediatric Occupational Therapist, and the wider Children's Community Occupational Therapy Service, have nurtured the Sensational Thinking Project, which aims to improve the service provision for children affected by sensory processing differences, and their families.
Transition from Paediatric to Adult Care – A Co-produced Patient Experience Project – The Newcastle upon Tyne Hospitals NHS Foundation Trust
Neil Davidson, a Consultant Paediatrician, is the founder and medical lead of the Young Person's Advisory Group North England (YPAGne). The Group includes young people from the region, who meet each month at the Great North Children's Hospital and work together to improve research projects involving children and young people. They integrate the voice of young people into the research process, and their passion and drive are an inspiration to all.
The Acute Stroke Unit – Ward E58 Sunderland Royal Hospital – South Tyneside and Sunderland NHS Foundation Trust
As well as delivering care to patients who have suffered a stroke, Deborah Hindmarsh, Ward Manager, and the wider team at The Acute Stroke Unit at the Sunderland Royal Hospital, are integral in nurturing a culture of innovation and quality improvement within the Trust. Continually striving to improve patient care, Deborah and the team work hard to deliver the best possible care for every patient by ‘thinking outside the box’ in order to meet their needs.
Ian Dove – Business Development Manager – County Durham and Darlington NHS Foundation Trust
Ian has worked with the Trust since 2008, first as Service Transformation Lead Officer, and then later on as Business Development Manager. Throughout this time, he has championed digital health, provided mentorship and guidance to the wider Innovation Team, and has driven forward local Projects, working tirelessly in the development of innovation at the Trust. His experience and insight have been crucial to the successful implementation of innovation throughout the Trust.