Issue - meetings

To consider the draft Quality Account 2011/12 of Mid Cheshire Hospitals NHS Foundation Trust.

Jayne Hartley and Julie Smith presented the draft Quality Account from Mid Cheshire Hospitals NHS Foundation Trust. 

The Quality Account covered the period April 2011 – March 2012.  The Trust was now in the third year of its 10 out of Ten programme which set out 10 priorities under four headings:

Safety –

·        Mortality – reduce mortality rates by 10 percentage points in patients groups where death is not expected;

·        Patient Safety – monitor and reduce the number of unnecessary patient moves during a patient’s stay in hospital

·        Harm caused – monitor and reduce the number of patients who experience avoidable harm by 10% annually

Effectiveness –

·        Readmissions – reduce the number of patients who are readmitted to hospital within 7 days of discharge;

·        Finance – reduce the percentage of the Trust’s budget that is spent on management costs

Experience –

·        Patients and staff – ensure that the ratio of doctors and nurses to each inpatient bed is appropriate for delivering safe high quality patient care;

·        Environment – monitor and eliminate mixed sex accommodation for all patients admitted to the Trust (unless based on clinical need)

Outcomes –

·        Cardiovascular – reduce the 30 day mortality rate in patients following an Acute Myocardial Infarction (AMI)

·        Cancer – reduce acute admissions and length of stay in hospital following early complications of diagnosis and/or treatment of cancer

·        Infections – reduce the rates of Healthcare Associated Infections (HCAI).

Jayne explained that the Trust had achieved 5 of the 10 priorities – mortality, patient safety, finance, Cardiovascular and infections.  In relation to the targets that had not been achieved:

Priority 3: Harm caused – the Trust had made considerable improvements in this area especially in reducing harm in the severe, major and moderate harm categories with levels being below all other small acute Trusts according to the most recent data available. 

Priority 4: Readmissions – the Quality Account listed a number of actions the Trust had taken to reduce the number of patients who were readmitted to hospital within 7 days, with a plan to reduce readmissions to 2% by 2014.  This had resulted in a reduction in readmission rates during 2011/12 and better performance than peer Trusts; however the target of 3% had not been achieved for this year.

Priority 6: patients and staff – the Quality Account listed various actions taken to ensure nurse staffing levels were based on evidence, for example in July 2010 the maternity unit had begun using the Birth Rate Acuity.  This system provided “real time” information on the numbers of midwives needed to match the needs of the women in the labour ward.  It measured the intensity of need arising from the number and clinical status of women and infants during labour, delivery and other women being cared for in the delivery suite against the number of midwives available to provide care.  During this year, eleven out of the fifteen wards reviewed were within range of their required establishment which equated to 73% against the target of 75%.  ...  view the full minutes text for item 84