“Quality is not an act, it is a habit”

RRV with blurred paramedic

We often talk about providing a service to patients of a ‘good clinical quality’ – but what does this actually mean? What does quality clinical care look like, how do we measure it, and what is our clinical focus over the next year?

Every NHS trust has to produce a Quality Account annually that addresses these questions, and a new one has just been published here at EEAST. Quality Accounts are an important way for NHS services to report on quality and show improvements in the services they deliver to local communities and stakeholders.

The quality of the services is measured by looking at patient safety, the effectiveness of treatments that patients receive and their experience and feedback about the care provided.

This year, we are focusing on seven key priorities and against each of these we’ve created a goal that we want to achieve in this financial year.

  1. Timely response: to improve the response times to patients for the most life-threatening call categories. Specifically, reaching 75% of Red1 and Red2 calls in eight minutes, getting an emergency ambulance to those calls in 19 minutes, 95% of the time, and reaching 75% for all our Green targets.
  2. Heart attack care: to achieve 95% PPCI within 150 minutes and 87% STEMI care bundle compliance (the baseline figure for STEMI 150 in March was 88.5% and the care bundle was 85.4%). Each care bundle is made up of a set of patient checks, observations and drug administrations to make sure the patient gets the best level of clinical care.
  3. Stroke care: to achieve continuous improvement in Stroke 60 (i.e getting patients who have suffered an STEMI to a specialist centre within 60 minutes) to reach 56% compliance, and to increase the percentage of stroke patients (assessed face-to-face) who receive an appropriate care bundle to 97% (we are currently reaching 96% for care bundle and 52.7% for Stroke 60).
  4. Friends and family: the friends and family test asks patients whether they would recommend our service to a friend or member of their family if they needed similar care or treatment. Once the national average is known, we want to maintain the friends and family score at the national level – across all our services. We also want to see an increase in the number of staff who would recommend the Trust as a place to work to someone else.
  5. Frequent callers: to increase the number of patients with a locally-agreed frequent callers procedure in place by working with the patient’s other health and social care providers. This will help ensure these people get the right care, which is often not through the 999 service.
  6. Cardiac arrest care: to improve outcomes from cardiac arrest and work towards an increase in return of spontaneous circulation (ROSC) and Survival to Discharge figures.
  7. Sepsis care: to increase the number of sepsis cases our clinicians recognise and record to 85% (currently at approximately 75%). 

Aristotle was once quoted as saying, “quality is not an act, it is a habit.” The challenge for us moving forward is to culturally change so that everyone is focused on high quality patient care, all the time. We want better clinical quality in every aspect of what we do, but these seven priorities, chosen with the help of staff and stakeholders, will help to improve patient care and experience if achieved.

Quality means doing it right even when no one is looking.

You can look at this year’s Quality Account, which also reflects on our 22 priorities from last year, on our website.

Published on 5th July

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