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North Wales Thromboprophylaxis team honoured for Quality Improvement project

A Quality Improvement project designed to tackle increased compliance in completing thromboprophylaxis and also decrease Preventable Hospital Thrombosis will receive a great honour this April.

The project teams behind the success of the initiative has been selected for presentation at the British Society for Haematology Annual Scientific Meeting to be held at Glasgow from April 1 to April 3.

Back in August 2017 five random patients on every adult in patient and admissions ward in Glan Clwyd hospital were audited ,showing only 34 per cent compliance in completing thromboprophylaxis risk assessment and 77% compliant in completing the drug card.

The Glan Clwyd team of Christine Welburn, Mr Amir Hanna and Haimon Chaudhry designed and introduced a new approach of starting a walk around to assess the compliance and give real time feedback and education

This was commenced in September 2017, once a week on the Acute Medical Unit (AMU) and the Surgical Assessment Unit (SAU). After several months of AMU and SAU sustaining their compliance at 80-100% the team spread the walk around to cover other wards which had low compliance on the audit.

Christine Welburn, Glan Clwyd Thromboprophylaxis Specialist Nurse explained: “Following ten months of walk around intervention in July 2018, we re-audited at Glan Clwyd hospital all the adult admission wards and units as before. The results from the re-audit showed that our compliance in completing the risk assessments had increased from 34% to 84%. Our compliance in completing the drug card had increased from 77% to 95%.”

“Due to this quality improvement project going so well, the team shared the idea and results to the other two main hospitals in North Wales. The spread to Wrexham Maelor through the team of Lisa Pemberton and Dr David Watson, has also yielded great results as prior to the thromboprophylaxis walk around their admission wards compliance was 0%, since commencing the walk around the compliance has increased to 80%.

“It has been a real strong team effort to move this quality improvement forward to help improve patient services in this area and everyone involved has worked really hard to make the thromboprophylaxis walk around an established feature of daily work and also a success.”

She added: “I want to thank all the team for their help and support throughout this project, they have made a big difference to patient care in this field and I am glad that they are all getting recognition of their work at the British Society for Haematology Annual Scientific Meeting.”

A secondary outcome of the quality improvement project was that as compliance in completing the risk assessments increased the number of preventable HATs decreased.

Prior to commencing the walk around, from January 2017 to August 2017 Glan Clwyd had nine Preventable Hospital Acquired Thrombosis which was reportable to the Welsh Government.

Since initiating the Thromboprophylaxis walk around from August 2017 to August 2018 the hospital has had one Preventable Hospital Acquired Thrombosis which was reportable to the Welsh Government.

Following the running of this quality improvement project, the admission wards on both sites have achieved 100% compliance and the health board now has the lowest percentage (4.1 %) of preventable HATS in all Wales according to the Welsh Government HAT report in January 2019.

This project has also been shortlisted for the Acute Service Redesign Award at the HSJ Value Awards 2019, for their improvements made since introducing the thromboprophylaxis walk around

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