RCoA QI Study Day September 2024
The anaesthesia quality improvement study (QI) day at the RCoA was well attended on 10th September 2024. In a packed lecture theatre Dr Samantha Warnakulasuriya (RCoA QI Lead) gave a warm welcome to the anaesthetists of all grades and positions, as well as aspiring foundation level doctors, who wanted to increase their knowledge in QI.
Dr Ronan Hanratty (outgoing CR&I QI Fellow) opened the day’s talks with 'A National Survey of Implementation and Current practices of Airway management'. The results showed a promising uptake of current airway practice, training and governance in the context of the of NAP4 recommendations, more recent national initiatives and guidelines. The review has helped to raise questions of how we might be able to further implement national guidance at national and local levels.
Dr Gethin Pugh followed with 'The evolution of QI’s importance in postgraduate training over the past ten years'. How its presence in non-clinical training has influenced the 2021 curriculum, and what requirements are needed to evidence it in portfolios through each stage of training. He highlighted the importance is mainly attaining an understanding of core QI principles and not necessarily in project outcomes. Current guidance can be found via the RCoA website including the QI compendium, upcoming resources are in development.
After a short coffee break, as is vital in anaesthesia, the attendees broke off to QI based workshops.
Fun was had in the foundation workshop, as Mr Potato Head took a lead role in helping to explain the PDSA process. Dr Lesley Jordan and Dr Hanratty delivered a good introduction to QI and emphasised the importance to test, adapt, adopt or abandon. As well as to appreciate that measurement is fundamental to evaluate any change.
Dr Johnston, Dr Revill and Dr Warnakulasuriya led the more experienced group workshop in developing advanced measurement skills, the importance of co-design and engaging stakeholders; as well as insights into achieving behavioural change for QI.
After a very social lunch, the afternoon provided an exciting opportunity for anaesthetists in training to present recent QI work. Following oral presentations of the 4 shortlisted projects, the judges had their work cut out to award The best QI project award for 2024. It was a close decision with Dr Kaveri Chozhan’ s project 'Quiet Please: Enhancing operating theatre environment through on noise reduction strategies', coming out on top.
The afternoon talks resumed with Dr Warnakulasuriya discussing how (local and national) leadership and the QI network play their key roles in advancing the RCoA strategies. How to get involved in RCoA level QI initiatives and building future QI leaders by aiming to establish a Quality Network Career Development Programme.
Dr Johnston took a more clinical approach with her session entitled 'Improving Emergency Surgery Pathways', examining the ways that NELA has helped emergency laparotomy mortality rates fall over the past decade. By exploring how ongoing obstacles, particularly the complexity of a process with multiple stakeholders, each facing their own challenges, affects the outcome. And how observing best practice in other time-sensitive specialties can help deliver improvements through learning systems and adopting new approaches.
Dr Kevin Fong provided the penultimate talk of the day with 'Risk in Complex Systems', which tied in well with the previous session. Talking about how "work prescribed and work done are very different", he highlighted we work systems with lots of changing variables. He further emphasised the importance of the role that QI has in "making complex changes to improve complex systems" but also focus on how staff interact in these systems.
The last session of the day was 'An Update on Patient Safety' by Dr Matthew Fogarty, Deputy Director of Patient Safety (Policy and Strategy) for the NHS England Patient Safety Team. His talk focused on The Patient Safety Incident Response Framework (PSIRF), which is dedicated to learn from events. He highlighted the learning opportunities from even the lowest harm events, help in a culture of self-improvement.
Dr Daniel Nolan, CR&I QI Fellow