29 April 2021

Case study

Implementing an Enhanced Care Unit at Medway
Article by Dr Svetka Tencheva & Diana Mhonda –Project Leads & Steve Houlihan- Quality Improvement Coach During the worst of the pandemic in January, the Acute Medical team were still […]

Article by Dr Svetka Tencheva & Diana Mhonda –Project Leads & Steve Houlihan- Quality Improvement Coach

During the worst of the pandemic in January, the Acute Medical team were still thinking of how to build and improve their service. Long-time advocates of innovation the team contacted the Institute to talk about creating an Enhanced Care Unit (ECU).

An Enhanced Care Unit provides high quality medical and nursing care to critically unwell patients using enhanced monitoring and the aim is to improve the outcome for patients who experience acute but reversible physiological deterioration. One of the key aims is to avoid admissions to ICU by providing effective and safe care in the ECU.

The Acute Medical Team approached the Medway Innovation Institute to discuss whether the Institute could help fund this vital development which would require investment in monitoring equipment to deliver a new Enhanced Care Unit.

A QI coach was linked to the project, in this case Steve Houlihan and he talked the team through the funding route, explained the type of questions the panel would ask and outlined the crucial need to demonstrate quality improvements as the outcome of this piece of work.

To be considered for funding and coaching support the Institute needs to be convinced that the project provides the opportunity to deliver quality improvement and so the first steps were to ask the Acute Medical team to pull together a proposal identifying the aims, costs and potential QI benefits.

Dr Tencheva noted that having a QI coach aligned to the project developed a sense of being in “partnership” with the Institute and enabled a clear proposal to be developed and presented.

Following presentation at the funding panel it was agreed that the Medway Innovation Institute would purchase the key equipment needed to create the ECU. The process took a matter of 6 weeks from initial submission to order for equipment – showing the pace that the Institute can deliver.

The equipment for the ECU should be delivered during May and the plan is to fully operationalise the unit by August 2021. This will enable clear pathways of care to be established, quality improvement metrics to be identified and tracked and staffing to be supported and trained in the new arrangements

Steve, Svetka and Diana meet regularly to discuss progress on the project. Steve Houlihan explained from his point of view he approaches the discussion as a coaching discussion, explaining that “identifying the goal is the first step, I work with the team to ensure that we have clear aims on what we are trying to achieve and from there we try and be creative in thinking about how to achieve that goal and finally detailed in building a plan for implementing”.

One of the key issues will be demonstrating Quality Improvement. Dr Diana Mhonda already has plans in place to realise the benefits with an expectation of decreased mortality and a  decrease in patients referred to ICU. Audits will be used pre and post change to objectively check for the anticipated benefits. It is also anticipated that the change will have a positive impact on staffing with additional training opportunities and career development made possible through the new unit.

We will be following the project closely and reporting on progress against the goals and realising the benefits with further updates planned for September, shortly after the Unit is planning to go live.

If you have an idea for funding, do contact the Medway Innovation Institute to discuss how we can help.