The Scottish Quality and Safety Fellowship produce project posters each year. These project posters have been identified as examples within primary care.
You can also browse the posters from the Scottish Improvement Leaders programme on their website. This includes projects from ALL sectors, including primary care.
Early, safe and reliable detection of sepsis in primary care
Aiming to improve the detection of sepsis among patients presenting to GP Out of Hours with acute illnesses via the introduction of an assessment bundle (observations and SIRS score), the use of which was then audited.
Multidisciplinary drug intervention (MDI) in a nursing home
The purpose of MDI is to ensure that adequate and correct medication is given to patients. Through this project it is aimed that all patients in a ward at Engen nursing home will go through MDI twice a year.
Appropriate management of stress and distress in Dementia in a nursing home
New assessment/review bundles implemented in a nursing home for use by nursing and medical staff assessing patients with dementia suffering from stress/distress. Both the use of this bundle and subsequent prescribing of antipsychotics were then then audited which observed 100% compliance with bundle and no new patients initiated on antipsychotic medication.
Recognizing severe sepsis in the pre hospital setting improves the timeliness of antibiotic administration
Aims to improve the number of septic patients receiving antibiotics within 1 hour of arriving in hospital by asking paramedics to send an advance notice “pre-alert” to the emergency department and subsequently recording whether this took place and whether this improved time to antibiotics.
Changing culture! involvement of junior doctors in QI work
Quality Improvement education programme, support and QI group set up to increase junior doctor involvement with QI in Emergency Departments in Norway.
Role of community pharmacy in reducing risk of gastro-intestinal bleeds in at-risk patients
Community pharmacist reviewed all patients in a GP practice who were aged over 75 and prescribed an oral NSAID, identifying those at high risk for GI bleeding and assessing need for gastro-protection. A new communication tool was used to refer these patients to their GP.
Sepsis in Primary Care: Recognition, response and referral using NEWS
A care bundle centred around recording NEWS score (assed by the NEWS app) and subsequent management of this implemented among a group of eight GPs working in out of hours, with aim to improve early recognition and appropriate management of sepsis.
Who is Frail? Identifying frail adults in a community hospital setting
A frailty screening tool was developed and implemented for patients aged over 65 admitted to a community hospital in the Outer Hebrides alongside a programme healthcare staff training on frailty in the elderly. Data was then collected regarding the use of this form and lengths of patient stay. The project increased local awareness of improvement methodology and of frailty and risk of unnecessary inpatient stay, and a reduction in length of stay was.
Acute Kidney Injury Prevention in Primary Care
General practice nurses prevent Acute Kidney Injury in patients with existing Chronic Kidney Disease through a package of patient education and patient empowerment.
Improving patient safety in primary care dentistry: an evidence based whole team approach
Aiming to improve the reliability of delivering safe care for diabetic patients and patients on high-risk medications, as per Scottish Dental Clinical Effectiveness Programme (SDCEPT) guidelines. Dental practices involved in the projected used PDSA cycles to improve compliance with a “high risk medication care bundle.”
Improving outcomes with medicines for homeless patients with multiple morbidities
Clinical pharmacists within the Homeless Practice used PDSA cycles to improve the number of patients attending clinic for review of their medications for long term conditions and gathered patient opinions on what mattered most to them about their medications.
Improving medicines safety in dispensing GP practices
Non-steroidal anti-inflammatory drugs (NSAIDs) have been shown to be associated with emergency hospital admissions and adverse drug reactions. This project aimed to improve the proportion of patients collecting their NSAIDs from 10 rural dispensing GP practices who receive appropriate medicines safety information with their medications. Practice staff were trained to provide medicines safety advice regarding NSAIDs and patient information cards developed. The project then observed whether this advice was given and whether patient understanding improved.
Making complaints matter
Project aimed to improve the response to complaints through promoting an investigative methodology and quality improvement approach, in order to gain meaningful information about the incident (about which the complaint) which would then be available for use in guiding improvement. This was done through the creation of a modified complaint response template.
Timely consultation and discharge at an out of hours primary care centre
A GP Out of hours service in Edinburgh tires to use PDSA cycles to improve patient waiting times for consultation and the percentage of nights where the centre is closed by the planned time of midnight
Bridging the gap: Paramedics providing palliative care at home
A Canadian project hopes to improve care experience and reduce unnecessary hospital admissions by training paramedics to deliver palliative at home. Evaluation will be by review tools which include force field analysis.
Medicine reconciliation after discharge from Hospital: Improving the system in a general practice
The majority of adverse events after discharge from hospital, and a significant proportion of readmissions, are as a result of medications. This practice therefore aims to use PDSA cycles to ensure that all patients have an effective medicines reconciliation by practice and pharmacy staff within 3 days of discharge