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Abstract

Patient safety is a major challenge and goal for NHS trusts. This paper describes the experiences of a district general hospital (DGH) intensive care unit (ICU) implementing change methodology under the auspices of the Safer Patients' Initiative (SPI). The team applied small tests of change (PDSA – Plan, Do, Study, Act) and, supported by education and measurement, introduced bundles of care, without the need for significant investment. Ventilator and central line bundles were applied, along with multidisciplinary ward rounds and daily goal sheets. Over a two year period, average length of stay fell from 6 to 2.7 days. The rate of ventilator-acquired pneumonia (VAP) decreased from 24.39 per 1,000 intubated days to 0. As a consequence, there was increased available capacity and admissions increased by one third. At the same time, overall drug costs fell. The application of the change methodology has made a significant difference to the performance of this DGH ICU.

Keywords

intensive care critical care patient safety

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