The Continuous Improvement Team run Improvement Collaboratives where we use the Improvement Matters 6Ds approach to bring teams together to work on improvements around a focused topic.
Teams explore their own root causes and generate and test new ideas within their areas using improvement boards and huddles.
Collaborative Teams then report back progress so that we can learn from the changes and spread good practice and improvements across the Trust via the launch of an Improvement Change Package.
For more information on how you and your team can get involved, contact the Continuous Improvement Team for support, training or coaching: improvementmatters@mcht.nhs.uk
Antimicrobial Stewardship was identified as an area for improvement in June 2022 due to the IV to total antibiotics ratio at MCHFT remaining high and the Trust consistently performing 15% below its peers in the oral to total antibiotics ratio, with antibiotics also used as per formulary in only 87% of cases. This all impacts on nursing time and increased patient length of stay, potential for increased patient harm, Clostridium Difficile (C. Difficile) infections and poorer patient experience. In July 2022, Mid Cheshire Hospitals (NHS) Foundation Trust launched its first ever Breakthrough Series Collaborative (Institute for Healthcare Improvement) which aimed to improve the appropriate use of antibiotics.
The aim of the Antimicrobial Stewardship Improvement Collaborative was:
‘To increase the appropriate use of antibiotics on collaborative wards to more than 90% by April 2023’
An Improvement A3 was commenced and a Pareto Chart used to identify the top contributing wards which would be selected to become our Collaborative Wards. These were Wards 3, 6, 11 and 12.
The root causes around antimicrobial stewardship were explored with the Collaborative Wards as part of the diagnosis phase and Ward Level A3s developed that aligned to the overall Collaborative A3.
Change ideas were then generated by the Collaborative Wards and bi-monthly Learning Sessions and subsequent Action Periods commenced in October 2022 to test change ideas using Plan, Do, Study, Act (PDSA) cycles, whilst using Process Confirmation Boards and Huddles to track progress.
Collaborative Ward Teams have been working hard over the last 6 months on behalf of the Trust and our patients to design, test and reliably implement the ideas of staff with the aim of improving the appropriate use of antibiotics in their ward areas.'
