Quality Improvement in Surgical Teams: Anaemia and Infection Collaboratives

RUBIS.Qi is supporting a new and ambitious collaborative which will drive forward quality improvements for patients having joint replacement surgery.

The aim is to ‘scale up’ two new care bundles which have already been tested by Northumbria Healthcare NHS Foundation Trust and shown to improve care and outcomes for patients with mild anemia and to reduce MSSA infection rates. The overall ambition of the collaborative is to prove the case that these care bundles save lives and improve outcomes so that they become routine clinical practice across the NHS.

Patients with mild anemia are at a higher risk of needing a blood transfusion following surgery and of other post-operative complications. However evidence has shown that by using a care bundle – which includes interventions such as screening and treating those who need it with iron – has improved outcomes for patients.

These interventions have already been scaled up to 9,000 patients at Northumbria Healthcare resulting in huge benefits for patients such as reduced blood transfusions, critical care admissions, length of stay and readmissions. There are financial benefits too, with savings of £160 per patient which for an average sized trust equates to about £120,000 a year.

MSSA is a common cause of infection in joint replacement surgery. A Dutch study published in the New England Journal has shown that MSSA screening and de-colonisation can reduce the risk of infection by 60 per cent in some cases.

Northumbria Healthcare has adapted a MSSA care bundle to specifically meet the needs of patients having joint replacement surgery. Before and after data for the 9,000 patients cared for at Northumbria Healthcare shows that interventions such as screening are making a real difference.

The two projects are part of the Quality Improvement in Surgical Teams (QIST) collaborative which was established by Northumbria Healthcare NHS Trust in 2013. The two projects are a partnership between the Northumbria Healthcare, British Orthopaedic Association, University of York trials unit and NHS Improvement.

Find out more about QIST here www.QIST.co.uk or follow us on twitter @QISTanaemia @QISTinfection

Find out more about the project