Traditionally Trusts focused on HSMR, however when SHMI was introduced, Aintree was highlighted as having one of the highest SHMI scores in the country.
In response to this situation, Aintree Hospital Management Board approved a 12 month Project to focus on three key work streams; Acute Kidney Failure (AKI), Sepsis and Pneumonia as it is well documented that the implementation of time critical clinical interventions for these conditions can considerably reduce mortality.
The interventions are nationally known as Sepsis Six care bundle and AKI care bundle.
The Project commenced in October 2014, initially first three months working on recruiting suitably trained nurses to expand the existing Outreach/MET Team to undertake the Avoidable Mortality initiative. During this period a collaboration with Software Development/IT Team and Clinical Laboratories commenced to create a 'fit for purpose tool' in the form of a bespoke data base which identifies all patients in the Hospital (excluding ED and ITU) with key blood markers that highlight high risk patients with emerging AKI, Sepsis/Pneumonia.
From January 2015 The Outreach Support Nurse (OSN) review this data base at regular intervals during the day to 'pick up' high risk patients and commence a process of triage to archive patient details who do not require support (end of life situation or patients who have full care bundle in place already). The OSN will then clinically review those patients who are deemed still at risk and requiring initiation of care bundles by visiting wards and discussing with ward clinical teams/parent teams the management of the patient and deliver education and support also the importance of time critical interventions to ensure the ward team retain overall responsibility of patient care and management.
TRUST OVERALL MORTALITY The table below outlines improvements within each work stream PROGRESS TO DATE Given the increase in appropriate case management by the Outreach Team (see table below) , which runs in parallel with steady improvements in Trust mortality figures, it has been recommend that consideration is given to permanent funding of this Team. This will enable continuous education and empowerment of ward teams regarding the early implementation of care bundles and the benefits to patient recovery. SHMI, for the period April 2014 – March 2015, has been published by HSCIC and the Trust have experienced a reduction to 101.99 (-5.60). HSMR and SMR metrics relate to the period October 2014 – September 2015 and both measures remain below expected and are reported as 88.19 and 86.09 respectively. The crude in-hospital death rate for November 2015 is 3.17%. The work continues until March 2016. Project Lead; Shirley Brady 0151 529 2371 Project Assistants: Debbie Cowell, Sue Gallagher