As Chief Nurse and Director of Quality at Southern Derbyshire CCG I am responsible for quality and innovation. Acute Kidney Injury (AKI) has been on our radar for a while as a condition that is a really big challenge. It’s a challenge that is faced in secondary care, primary care as well as specialist and community settings, so we knew that if we could find some solutions we’d have a big impact on the lives of patients and their families.
We knew we needed to be innovative in our approach to the challenge and so when the National Programme for AKI swung into action last year we saw a great opportunity to drive and make some real changes – if we embraced innovation and worked with our partners collaboratively. This coincided with Royal Derby Hospital’s Renal team also articulating the need for us all to do something.
One of the key elements for driving real change through innovation is to make sure goals for innovation are clear. With AKI this was very much the case. We knew the stats, we knew the scale of the challenge facing us and the wide range of partners we needed to work with. It was relatively simple therefore to find some consensus around some shared and complementary goals which aligned with those of the national programme.
High level buy-in from all the partners involved was essential to help us break down barriers to change. We established a Steering Group , becoming the first CCG Pathfinder of the National Programme’s Implementation Workstream, which enabled us to bring a wide range of voices and expertise together, focused around our wonderful ‘expert patient’ Ruth. Ruth enabled us to tap into the patient view every step of the way.
To keep innovation moving we are adopting some real ‘step in- step- out’ working to keep up momentum. So we met regularly, kept records and trusted each other to get stuff done in the times between meetings – and boy have we covered some ground in our first year. We have been part of some truly innovative work and we are happy to share our learning.
Almost at the end of year one of our AKI CQUIN we are well on our way to achieving targets successfully. We have a Risk Assessment Tool, Discharge Summaries and AKI education in Royal Derby Hospital, we have agreed PC Guidance notes available for GPs and Sick Day Rules, a PC Education and Awareness Programme including peer review and case based discussions almost ready to launch in response to a large-scale GP survey of our 56 practices and we are just shaping up an approach to managing AKI in care homes. We have really tried to embrace pace in our work but we also understand this can be scary for some people – we are open to review and adapting as we go. It seems to be working.
Lynn Woods
Lynn’s role is Chief Nurse and Director of Quality for Southern Derbyshire Clinical Commissioning Group. Lynn qualifications are as registered nurse, midwife, health visitor as well as a Masters in Business Administration from Nottingham. She has a special interest in quality assurance and patient safety.
For the acute kidney injury national programme Lynn is Chair of Southern Derbyshire Pathfinder Steering Group.