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morning again, folks. It is Feels a bit like, uh it feels a bit like we're in a night club somewhere. I'll show my edge on the Golden Mile, Remember? Remember the golden mild? Um, so we're not because it's quarter to 12 on, uh, Wednesday morning. Um, so welcome to this session, this award ceremony, uh, your you're very lucky to be here, and this is the big session at this particular time. So I hope you're all comfortable. We're here for the annual HSC Q. I awards eight awards to present In all. I will talk you through them in a moment or two, but just by way of background to get the contact, what we're doing and why we're doing it and why it's important. I want to invite Doctor 18 kidney. Who is director of the H s. C. Q. I at the Public Health Agency to officially welcome you all and to explain how things are going to proceed today. So welcome. Thanks, Mark. Um, so Good morning, everyone. And welcome to the 2022 h s. C. Q I award celebration and showcasing event. It is great to see so many of you here today. As you know, this event is being livestreamed, so I also want to extend a special welcome to those joining US online. As many of you will know. Health and social care Quality improvement More commonly referred to as HSC Q. I is a network of people from across many parts of our health and social care system who are committed to using a quality improvement approach when leading change, so that from the ground up, we as a system can support the ongoing transformation of our health and social care system, as described in the 10 year strategy for transformation known as health and well being. 2026. Delivering together as the director of H. S. C. Q. I I feel very honored to stand here today to acknowledge the fantastic improvement work that teams have been leading on over the last 12 months. This is all the more remarkable given the fact that this improvement work has been happening despite the fact that we are living in a time when everything we do is still impacted by the ongoing challenges of coated 19 and the need to rebuild services during every interview and presentation within this awards process. It was evident to me that each team, through the application of a quality improvement approach, is committed to continuous improvement and that these teams always have the patient service user and carer at the forefront of their minds and at the center of their improvement work. The 2022 HS CQ I awards attracted a wide range of strong and innovative improvement projects across eight categories. Make no mistake, agreeing the various category winners was a really difficult process. The standard of the work submitted was exceptional. I have no doubt that members of the judging panels, some of whom are here today, will wholeheartedly concur with me when I say that deciding who the winning team was within each category often required much discussion and deliberation. Interestingly, in equal measure, when speaking to the judges afterwards and asking them to describe their experience of participating in this process, I noticed that many of them used words like uplifting, amazing, emotional and proud. To me, The fact that the judges used words like these reinforces what I know to be true, that is, that health and social care staff are truly committed and are passionate about improvement. This morning, the Minister for Health launched the first ever H. S E. Coli strategy moving forward, shaping the journey. Our vision for this strategy is that hs CQ. I will inspire and influence Northern Ireland's health and social care community to become a global leader in quality improvement and innovation by working together and focusing on person centered care. Now, as we all know, that can only be one winning team within each award category. However, I would like to take this opportunity to acknowledge all of the teams who reached the final stage of the awards process, because to me, the work of all of these teams is aligned to the vision set out within are newly launched H s E Q. I strategy. The future for health and social care is bright, so please join me now in giving all of the teams who reached the final stage of the awards process a well deserved round of applause. So I now I want to thank all the judging panel members who willingly gave their time to participate in the awards process. I would like to say a special word of welcome to some of them who are here in the room with us today. And they include a in Dawson, chief executive of the Public Health Agency Leanne Morgan, clinical Lead from Our Cute A. Andrew Dawson, director of quality regulation and improvement in the Department of Health, and Henderson Non executive director member of the board of the Public Health Agency. Lauren Swanberg, assistant national director at the National Quality and Patient Safety Directorate in the Health Service Executive in the Republic of Ireland. And Raymond Curran, assistant director of integrated care in the Strategic Planning and Performance Group in the Department of Health. I would also like to welcome Peter May are permanent secretary for health, and Andrew Dugal, chairman of the board of the Public Health Agency, who are here with us today. And I also know that we are joined by some other members of the board of the Public Health Agency and just to say welcome to them also, and to say that it is really, really lovely to see all of you here today with us. Lastly, I would like to extend a very warm welcome to Doctor Kathie Jack, chair of the HS CQ I Leadership Alliance and two, All the other alliance members who are here with us today. It is also so lovely to see you all with us. So let's move on now to the main event. Let's recognize and celebrate the winning teams. We will do this by presenting each team with the trophy and giving them an opportunity to briefly describe their improvement work and to Sharqi learning. In doing so. I hope that you, like many of the judges, will also feel inspired and proud and that you will be able to take away some pearls of wisdom that you can apply to improvement work going on within your own teams and within your organizations. So, without further ado, let me pass you over to mark our master of ceremonies who I have no doubt will expertly guide us through our celebration and showcasing event. Thank you 18. Thank you very much indeed. Very simple format as 18 says, I'm going to invite a VIP presenter to come up to make the announcement of the winners will get the winners to come up will be presented with their prize their award. Um, and I'll have a quick conversation with him. Just a couple of minutes about the project and about why I think it was successful and about where it might go from here. And then we'll move on to the next one. And at the very end, we'll gather everybody together for some photographs, um, an appropriate place, either down on the floor or up here, probably up here on the stage. So there are eight categories awards to be presented. Let me just run through the eight categories for you. Now here they are. The first one is using a Q. I approach to reduce health and social care equalities, then improving outcomes for patients with co vid 19 patient safety transformation staff, well being care homes and finally oh, delivering reliable care and then finally improving timely access. So those are the eight categories. We're going to focus on the first award, then is using a Q. I approach to reduce health and social care inequalities. And I want to invite aid in Dawson, the CEO of the Public Health Agency, up to the stage for his comments and then to present the award. Aiden. Okay. Thank you, Mark. And thank you again for those inspiring words to open the ceremony. I'm honored to be invited to present the award for the winning project in the using of cute I approach to reduce health and social care. Social Care inequalities category. This award recognizes teams who have used a Q I approach to reduce inequality and increase equity in service provision. In this category, teams will have used data Sorry, local data to evidence and monitor the impact of service change for targeted populations. I am delighted to confirm the winning project is Yeah. Okay, So the winner is reducing on a unallocated cases within our childhood and family Pigs carried out. Yeah. Thank you. Please welcome Jessica Anderson, Children's Improvement lead, and Jason Caldwell, interim assistant director for safeguarding and family support. Who will accept the award on behalf of their project team? Uh, thank you very much indeed. Are you both going to chat to me? Yes. Or I mean, I'm just gonna ask. Don't worry. Don't worry. I don't have that hat on today. I'm just going to ask nice questions like, Well, you're smiling. So obviously you're very delighted. Um, What do you think it was about this particular project that caught the attention of the judges. Oh, good question. To be honest, unallocated cases has been around for 10 plus years across the region. And whilst improvements have happened, nothing has been sustained. And I think our approach was just using our existing resources to just bring a collaborative approach to address the problem. And we had really good data, which was, I think, a really strong point of ours to be able to just evidence the improvements that we were making. And it's really simple. Project. We're a collaborative, unallocated process grip. And And I think that was just our strength, that it was a collaboration of the whole team coming together, and we were able to evidence that your data, I was just gonna ask what, in real terms, in simple terms, for the benefit of people who don't maybe no, about this particular project and what it is that you do. What what impact does it have on the ground? Okay, so really, the issue is families who need a social worker and don't have an allocated social worker, and they're waiting for a service. So, in essence, Mark, what we wanted to do was improved access to services to help families earlier. And to do that, we brought about an understanding of data and working as a team and a collaborative approach to that and what we were able to do over a period of a year was not only reduce the number of and allocated cases, we also improved the timeliness of access to services. So what does it mean? It means that families got help and they got help at the point of crisis and we were able to sustain that support and kind of just a big shout out to the rest of the team here, sitting over here who were integral in doing that. This is a new and innovative way mark in terms of thinking about how we manage on allocated social work cases and is there an application, then Jessica for this elsewhere? Do you think within the healthcare system, and can you develop this scheme to make it bigger and better in the years ahead 100%. So within our own trust, we've already managed to scale it out to our other locality teams. So it's across the Southeastern Trust and our Children's disability service. But in essence, what it is is a waiting list management system, and there's massive scope for that to be adopted. I know, Jason, you're working with our regional unallocated grip at looking at how we can roll it out to the other trusts mark Exciting news. Actually, as of last week, health and social care leadership for, um, deliver a leadership program called Protease. This project has been accepted as a regional scale and spread project, which will be the essence of what we're doing will be taken to address waiting list initiatives across health and social care. Not just only so short cases. It's a very exciting in terms of actually building on our success on how we scale and spread that in the region. So that is a real challenge. We've already been touching on that, and this is a tangible way of actually helping to make things better. I mean, you'd like the scheme not to be needed, really? Ultimately wouldn't you'd like to You'd like to actually improve the system so that it doesn't exist. But at the moment there are applications whereby people should benefit tangibly. Absolutely. Mark. I mean, I think in essence, what we're looking to do is get help and services to families earlier. And what we're able to do with a collaborative approach to that is actually look at what we can. We address that and meet the needs. Using the data helps us understand the themes and helps us then to redesign services to meet those needs quicker and where they're most needed. Right? Very good. Well, congratulations. You both. Thank you very much indeed. Enjoy the rest of the day. Thank you. Thank you to Jessica and Jason. And congratulations again, Um, to them and to the members of their team. Let's move on to the second award of the day. It's improving outcomes for patients with Cove in 19 and to make the presentation and Henderson non executive director at the Public Health Agency. Uh, thank you very much. This is the second category improving outcomes for patients with Cove in 19 honored and delighted to be able to award, uh, this one. The category recognizes teams who have used Q. I approach is to focus on driving continuous improvements, leading to better treatments and for patients with codeine. 19. I'm delighted to confirm the winning project is it's the X factor moment. Yeah, and It is the Nightingale Nutrition and Hydration Matters Project carried out in the Northern Trust. And I would like to welcome Heather Owen and Aaron O'Hagan, who are both advanced practitioner Dieticians, to collect the award on behalf of their team. Thank you. Right. Congratulations, folks. Here, both happy to chat. Yes, yes, yes, yes. Tell us why this is an outstanding project. Well, I think when When Nightingale the first opened its doors in November 2020 it was the very first unit of it's kind in Northern Ireland and the patients that had transferred over to Nightingale. They were profoundly weak. They had long hospital stays, some of them in. I see you and I had, you know, weight loss and really were malnourished. And we know that malnutrition really well weakens your whole immune system and really delays recovery. As dietitians and the whole multiple spring team. We want to make sure that the patients are getting the best care possible. And when we were carrying out assessments, we noted that patients weren't really getting enough nutrition and enough protein. And we know that nutrition, protein and hydration is really vital to help patients really achieve their best goals so they can live well. So the team are passionate, you know, and very adamant that we want to make a change to really help patients recovery. So we came together and, you know, just through how they will talk about, you know, through collaboration through education and sharing ideas, we brought about change to really help patients improve their nutrition and rehabilitation goals. And how did you actually promote that change? So this was a really interesting part of the project. We knew the change was needed. We were absolutely passionate about it. So what we did first was got the most important people in the room or the key. People don't want to say the most important, but the key people, which was catering managers, nursing managers, HPI managers and what we did was took the Qvar methodology and made a really, really clear pathway and process of how we were going to change how we were going to help nutrition and hydration on our ward. That was almost the easy part. The harder part was getting everybody else on board. So we needed everybody to help with this we needed, or domestics or catering our health care assistance. We needed nurses and HP es and we just got them all together and did really interactive training. So not education interactive when we got there ideas, what do they think might work? And we wanted them to see the scale of this problem of nutrition our in our ward through their own eyes. We wanted to see what would be the best that they would want for their families. So I think that approach was slightly different and the results have spoken for themselves. Are weight gain was better? Our intake was better, our fluid intake was better and nutritional supplements were all reduced. Sorry. Patient feedback has been outstanding as well. Like patients have said they've never been felt so well, which is a really great thing, you know, coming from the hospital. But it's it's been really rewarding and is there further application? Can you develop it? Do you think in the months and years ahead, and can you share your experience with others? Yeah, malnutrition is a big problem facing the NHS and thankfully, best nutritional care is on high level strategies both locally and regionally and even national. So our model of care has worked with are coated patients, but it also has worked in a fracture rehab model and our general rehab model. So we're absolutely confident that this can be rolled out. And we are doing our best to go in every platform to tell everybody about are brilliant project and all of the results. And I guess it's just about that, like, shining the light on. Really? You know the changes you can make. You know how good nutrition, good hydration can really help patients recovery Because, um, for fortunately, we all know someone being in the hospital on stage in our lives for being even at home and to know that that person is getting the best nourishment possible to help their recovery, you know, is really, really vital to us. So yeah, well, congratulations to both of you. Enjoy your success. And thank you very much for being with us today. Thank you. Well done, Heather. And 18. And the team, thanks to you for making a presentation. So the third category is patient safety and making the presentation. Andre Dawson, director of quality regulation and improvement of the Department of Health and thanks, Mark. I've never given out of prize before. So I'm honored to be invited to protect this award for the winning project. In the patient safety category, this award celebrates the use of acute. I approach to to push the boundaries of patients' safety and drive cultural change to minimize risk, enhanced quality of care and ultimately save lives. And I'm delighted to confirm that the winning project is suspense. Yeah, the, uh, arterial line safety project carried out in the Belfast Health Social care cost up to to receive the award. It's Dr have been purchased and consultant in intensive care medicine, uh, anesthesia and Mr Mark Echols, the senior nursing assistant to work on behalf of the project team. And thank you very much. Congratulations to both of you. Well done. Um, tell us a bit about the project and why you think it stood out for the judges. Okay, Well, myself and Mark work in the regional intensive care unit in the Royal Victoria Hospital in intensive care. Takes care of the sickest patients in the hospital, and their lives depend on us delivering safe care. So one of the first things we do when a critically ill patient arrives an issue with a life threatening illness is we placed an arterial line, and that is essentially a drip that goes into the patient's artery. And it allows us to continuously monitor their BP and also analyze the blood biochemistry to guide their treatment. And every single patient has one, and it's absolutely crucial that we get this set up that is correct. So the drip is attached to a pressurized, fluid flush system. That fluid must be a salt based fluid. If the sugar based fluid is used in error, then it can contaminate the biochemistry. It can lead staff to think that they've got a very high blood sugar, and then insulin can be administered in correctly and the patient can sustain irreversible harm. Now this has happened in the UK and Ireland, and here it is catastrophic. When it happens, it is rare, but it is a very profound problem, and so we want to try to make things safer for every single patient comes into intensive care and all the fluids look the same exactly the same. So when somebody Kristen critically ill and we're doing a 100 things to them to try and save their lives. There is a possibility that somebody can select the wrong fluid. So trust policy about this, about the use of adult arterial lines and how to get it right. But we wanted to make it practically easier for staph to know that risk and to know how to set up every single aren't line correctly every single time. So does it matter? Yes, it does. There's 1300 patients through I see you every year. Every one of them is an art line. 250 analysis a day. We've got to get it right every time it matters to the patients and their families and our team. Okay, so that's that's the problem identified and as a member of the public, I think it's something that you obviously want to get right, and now nobody wants a mistake made. What was the solution? So sorry. First of all, we got a very diverse multivision multidisciplinary team together, So that was from myself as a senior nurse, axillary right up to even as a consultant, and what we've done is we've condensed simplified the trust policy into our salt checks and our sugar checks. We also implemented what we call as a universal adult arterial pack. So it was a pack with the fluids, the transgender, the labels, all that was required to set up that pack safely. We also implemented education. So we put up posters in the unit. We also put a leaflet in the pack so that everybody was informed. We had, um what we call a trust, the arterial line champions. So we had champions there that if you needed a question, especially the senior staff, and I see you. So we made sure it was rolled out to those we come back. Also, we checked what we were doing. What? We're doing something right. We didn't obviously want to put anybody else more at risk. So we kept coming back and check and what we have done. And then before we moved on to the next step. And when your back is against the wall and a and e can you see the difference that it's making? Does it make your life easier? Well, I I found with the universal pick Now make up these packs, and quite a lot of them was probably thousands I've made up in the unit and I do find that, especially if we have a lot of staff over covered, especially we had a lot of new stuff that I've never seen the material line. They were 100% sure it was literally go to the store, grab this pack and everything was explaining what to do. Does it make your life easier? Absolutely. And I think, as Mark says, it's about giving the people to do things right every time. And it's kind of removing that potential risk for harm. No patient in this room or no person in this room or member of staff who comes to work has any intention other than helping patients. But, um, fortunately, we have multiple interventions, and there's risk and absolutely everything we do. If we can make it easier for staff to do the right thing instead of telling them there's a policy to look at, and then that is practically making life easier for me and for the staff involved in my team, just very quickly. Same question that I asked the others. Finally. Presumably there is an application that you can share with colleagues. Yeah, so our aim is that every single member of staff who uses an adult arterial line, knows that risk and that every arterial line in the Belfast trust will look identical and the set up according to those steps. So there's an application for theaters, the emergency department and the other intensive care units. Now we've already used educational tools and put them out into those areas to give them the ability to introduce this as well. And we produce any learning module as well. There's a real challenge for us, Mark. Go ahead. Because these are high acuity areas, they are under massive pressure. There's major staffing deficits. They have huge volume of patients forever. Therefore asking them to do quality improvement work on top of just being able to share day to day care is very, very difficult. And that's where our big challenges now, at this point in time. But we will try to equip them as best we can. And again, if you're giving them something that could make life easier in the long run, well, then hopefully it will be able to be implemented. But it has got potential cross high acute areas and each of the trust across the province. Okay, well, It's good news. Thank you very much indeed for explaining it and highlighting its significance. Congratulations to you and your colleagues and enjoy the rest of today. Thank you. So we're under the fourth category, which is transformation, And Andre Dawson is going to come back up from the Department of Health to make the presentation. So the first one was so well, they asked me to do it again. Um uh, this is the award for the winning project in the transformation category. Uh, this award celebrates teams who have used a Q I approach to improve quality, safety and effectiveness using new approaches or collaborative or cross boundary ways of working. Uh, and I'm delighted to confirm that the winning project is if you hold your suspense, the evaluation of a nurse lead multidisciplinary enhanced care response team into care homes from the Northern Health and Social Care Trust. Um, I'm delighted that Elizabeth Gram, assistant director of nursing innovation and development and Maria Lokeren Service improvement leaders are here to accept the world on behalf of the Project team. Congratulations. Um, and thank you very much indeed. Congratulations. Tell us a little bit about the project and why you imagine the judges pay particular attention to Thank you, Mark. It's of regional interest, the project that we undertook not only what we were able to sustain within Northern Trust, but it's applicable throughout Northern Ireland, with about 16,000 residents across Northern Ireland who live in nursing and residential homes. And unfortunately, the data shows us that they are very high. IgE attenders, um, emergency department attenders and as well as that. Some of those e d attendances are avoidable. So we looked at the data and we read the story behind those attendance is that e. D. And found that with the implementation of a team at an early stage in residence deterioration, that we could intervene early upstream and actually avoid that e d attendance for that individual. A lot of our residents are older people, and the last thing we want them to do is to attend an e. D unnecessarily. Now there will be those acute cases where they need any attention. But for those other examples, if we intervene early, they wouldn't have that distress and anguish. That ambulance journey that long wait an e d. So that's why it was important to us and for our residents and our population, but also for our emergency services are departments are beyond capacity. So this released capacity for E. D. E departments and also our ambulance service. So it was important. And I have to say it probably brought Bengo A and transforming your care and delivering together. It translated all of those messages into a system and a team where we delivered care in the community for the community. So everyone was a winner effectively, Yes, indeed, some of the suppose the key learning or the key successes Mark really was always having a clear sense of purpose and vision that everybody brought into with a lot of stakeholders. Between working in partnership with the care, homes and care, home staff, care, home managers, the residents GPS always maintain clinical governance. An oversight of the residents care. We had a true multi profess national multidisciplinary team going into the homes with a very high visible presence. We developed a residence wellness overview to that included frailty assessment. So we're able to detect residents in early deterioration. And then those referrals were all brought back to a weekly multidisciplinary team meeting where we discussed it with specialist nurses. HP es pharmacy staff clinical psychology staff were able to put together really truly person person centered, integrated care for the residents in the care homes. To avoid those in attendance is that Elizabeth referred to in terms of developing this project or rolling it out in other areas. Where do you think things might go from here? Well, during the course of this 15 month project and I know the data concentrates on three million care homes that lived with us throughout that journey. We also scale that up to another six homes within East Antrim and interestingly to a rural locality in mid Ulster with exactly the same outcomes. So we have evaluated this. We've used our data and we have a very strong evidence base blueprint which can be used right across other trusts. And actually, we have been contributing to some regional pieces of work. One is the chief nursing officer is coordinating and enhanced clinical care framework in to care homes. We've contributed to that with our knowledge and also other regional work that's looking at What does a good team look like actually going into care homes? So again we could contribute are profound information and knowledge into those. And more recently, a range of GPS across Northern Ireland are adopting an enhanced care service, which is connecting more into the care home environment. And actually, I can see that what we did here, Maria and myself and the team down there, what we have done is we can contribute to that conversation with our GP colleagues. We can contribute to their visit into that care home or their connection with that care home and actually, with our knowledge of the deteriorating resident, make that visit more efficient and effective and just finally, does it. Does it feel good to get this kind of recognition? Does that make a difference to you and the team? Um, it does. It's great to be valued, um, but I think it's What's really important is that we maintained, kept residents at the center of everything that we did were very much worked in partnership with the care homes and with the residents and their families, and it was very much a collaborative collective approach with a wide trust colleagues. HPI colleagues with nauseas with GP colleagues with Northern Ireland Hospice Because we had a specialist palliative care nurse within that team. So residents at the end of life care were able to be cared for in their own home, which is where they want to be and avoid the distress of the hospital admission or need the attendance where it's safe and appropriate for them to remain at home. And that, really, for all of us, is the most important things is fundamental and about delivering true, integrated, person centered care for frail older residents. And that's that's so important. It certainly is. Um, it's nice to get the recognition as well that you deserve. So congratulations to you and to the team. Thank you very much indeed. So, uh, we are now at award number five, which is for staff well being. And I want to invite Andrew Google, the chairman of the Public Health Agency, board up onto the platform to make the presentation. Andrew. Thank you, Mark. Ladies and gentlemen, I'm particularly pleased to be invited to present the award for the winning project in the category of staff. Well, being our greatest resource across the health and social care system is, of course, our staff. This award celebrates teams who have used Q I approaches to make measurable improvements in the well being of the workforce. I'm delighted to confirm the winning project is in the Southeastern. Trust. The cove in recovery and staff. Well, being project. Please. Please welcome Ruth Watson, clinical manager, and Karen Hole, lead nurse who will accept the award on behalf of the project team. Congratulations, Andrew. Thank you. Don't go too far away because you're going to do the next one. I think as well, aren't you? Yes, you can take my seat. Keep it warm. Congratulations to you can tell. And it is very comfortable on the stage. Can you, um congratulations. Um, tell us a little bit more about the project. Um, when you think back to the start of the pandemic, it was a hugely stressful time for everyone and particularly the respiratory awards. The dependency of the patient was much greater with many, many more aerosol generating procedures. It was very restricted. Visiting. Um, there were lots of fatalities, not necessarily within our respiratory wards, but regionally, etcetera. So it was a very, very anxious time, and we just kind of felt that there was a lot of wrap around services, particularly for I see you and lesser for the respiratory awards. So we put this program together to help support the team through what was a very difficult time. And can you give us a sense of of what the program looks like? What, what did you put in place to? To make things better and ease that pressure as best you could during a very difficult time. As we all know, I think what was really important was teamwork, Mark. And that was teamwork In the respiratory wars, they were dealing with the unknown. We were dealing with changes every day, even changes the legislation. And the staff were working extremely hard to look after those patients and in fact, so much enhanced care. And the respiratory awards prevented patients going to I saw you, which was quite frightening. And so what we had to do, really, with our well being colleagues in the trust was, Listen, um, speak to the staff and some of that was 1 to 1. Some was focus groups. We actually did questionnaires which we got a really good response from, and from that, then we were able to detail what what was the staff? What they would want and we had a range of programs over a period of time. Um, that range for mindfulness to space is for listening, which was actually supported by our senior um management team within the trustee, then came at the end of that session just to show the solidarity to the team. And also we had we had a bit of physical activity, would feel good Friday. So we had a bit of Chinese just to give the staff a sense of just a bit of space for themselves. But the one thing that really impacted was something quite simple. It was called Red and Green Day, so each of the wards took on a project of red and green balls. So they had a set of red ball's set of green balls, something very simple. And at the end of the day, they evaluated their day by simply placing a ball. Whether it was a red ball, today wasn't a good day or a green ball. Today was good, but what was more important was to hear why was it good and why that day was challenging and then we were able to take that detail away and work with the teams and see, and with some small winds out of that that we were able to develop very quickly. One ward needed a housekeeper just to keep all the ppd and and all that. And actually, then how do we know that that was working was from staff feedback and also a reduced in sickness and staff sickness. But actually, the highlight of it was that these teams were actually able to recruit through the pandemic to their awards. People wanted to come and work with them. Such was the team work and and the sense of involvement. Um, so, yeah, it was It's very interesting. I'm assuming. Am I right that as the project went on, you ended up with more green balls and fewer red bulls and very, very visual. So staff immediately knew at the end of each week, Um, you know, we could see the green Line accelerating that obvious. Could everybody see that happening? Yes. Yeah, very simple idea. Very simple idea, but very effective. And a very difficult time. There was a clear learning experience which can be used. And it was what this autumn and winter holds for any of us. But this is relevant to covert and coated management in the future, if we have to deal with that. But it's relevant, presumably across the board, you know, post the project we've reflected back and learned. And whilst we did put together a very comprehensive program, we were probably too ambitious. So this winter, now going in, we're going to offer talking therapy session where staff can come and openly have a chat with some of the experts. And we will do the red and green balls again. Well, you just picked up a very nice award. Presumably, today is a green ball day, Is it? Yes. Absolutely. You can go and celebrate. Thank you both very much indeed. Well done. Um, well done indeed to, uh, to Ruth and Karen. I can imagine that at next year's Nikon conference there will be a red bull and green ball exercise in some shape or form if weather has been listening to that. Okay, Andrew, you're you're up again. Um, we're going to give the award now for care homes, and you are going to make a presentation. Mark. The products and acclamation were such that I couldn't resist the on court. I'm really honored to be invited to present the award for the winning project in the car homes category. This award celebrates excellence and innovation in the car home sector Project is about and what made it outstanding. Yeah, well, as you can imagine, falls can be particularly devastating for the elderly, not just for the for themselves but for their carers and, uh, and and family. And with the co vid isolation, the nursing homes were particularly badly hit on the residents suffered from less activity and deconditioning, so there was increased risk of falls. The key thing is, though, that falls can be prevented. And it requires a targeted multi disciplinary approach. Looking at things like encouraging, say, for mobility with appropriate physio and strength and balance improving nutrition, addressing factors like lighting, footwear, reducing unnecessary medications, et cetera, et cetera. So using a Q I approach and involving fantastic input from our pilot nursing homes, we agreed a pathway to help, uh, the nursing home staff and healthcare professionals in the prevention and management of falls. And not only did this reduce falls, but it improves the quality of life of the residents because it increases their activity, it reduces their fear of falling. It also lead to a reduction in 999 calls and any attendances which are particularly traumatic for the elderly population. So it was a real win win. Yeah, which is similar to what we've been talking about already. One and I don't want to underplay it. But as you said yourself, you're relatively simple. Approach actually pays big dividends across the board. No, absolutely. And I think in terms of paying dividends, we have heard from Chris about the system savings and the system, you know, and pressures that were all under contributing to lessening that Eddie attendance. But what was so important about this project was it was about the resident and it was about their quality of life. And we used really innovative techniques and methodology to hear those voices that we don't normally here because when you're planning any quality improvement, service improvement, it has to be what that person needs and not what senior management around the table needs. So I think one of the things that was really key was the collective approach with the resident at the heart of it. That's very interesting. Did everybody buy into it straight away? Did everybody get it? I think there was a lot of collaboration and discussion, So the buying was fantastic, you know? And we had some specifically good examples of people who really embraced it. And we use those two because there is a little bit of work, and the more people use the tools, the quicker, easier it is to use. So so we use that and we shared those stories and I think the results themselves and using the methodology because the thing is you don't see the falls you prevent. So to show that you are preventing falls is the greatest motivation. And just finally, Karen, are there lessons that can be clearly? Lessons have been learned, but can those lessons be shared with others? Um, I suppose just from a firstly from a quality improvement perspective, I think the most important thing is having that collective stakeholder involvement from the get go. So we got everybody to decide with a blank page, what they wanted and what they needed. I would say that first of all is so important and learning to bring forward but also I think as well it's about making sure we talk about patients centrality and this morning and it's making sure that what we're doing is we're seeing outcomes for those residents and those very vulnerable people in our society. In terms of rule out, we were very ambitious, so we have 18 care homes involved in this project across Northern Ireland. So our next steps and we've got a We've got a sustainability spread plan to actually see about how we can make this custom and practice, which would be great. And it's lovely. You can't put a finger on it, of course, as you said Chris, but to think about the people who didn't have to go to hospital because they didn't fall, Yeah, we saw a reduction to think of about 30% which was fantastic, and as well as rolling it out, we want to. I mean, there is a big need to develop alternatives to A and B for are frail elderly patients. So we're working with the southern area in having a mobile screening, you know, so that you know whether it's a suspected fracture, they can have that done in the home and then go direct to a fracture, clinic or whatever be addressed. There was also some evidence that looked at the management of patients who were on blood thinners, anticoagulants that we're We've submitted to the nice guidance which we might hope, think might support more cautious, observed wait and see approach in very vulnerable patient. So there's a lot of positive spin offs from the project. Well, congratulations. Um, you want to? You can of course. I just want to say massive Thank you to the guys here, these two tables, Who without them keeping it going. And particularly our care. Home partners who, despite going through cove ID and the challenges the last 18 months, they stayed with the project, and it's to them that were indebted. Well, they can share in your in your pleasure and your excitement of winning today. Congratulations. Thank you very much indeed. Chris and Kira for being with us. Congratulations. Everybody else as well. So our penultimate award is delivering reliable care. And and Henderson did such a brilliant job the last time they were going to ask her to come back and make this presentation as well. Yeah. Thank you. Very much, Mark. Also my second time giving an award. Andrew, Um, I'm very honored to be invited to present this award. Um, and the category of delivering reliable care recognize is the use of acute. I approach to help reduce defects in care of or in care processes. Increase the consistency with which appropriate care is delivered and, of course, improve patient outcomes. So I am delighted to confirm that the winning project is, uh and is it going to come up? And it is the interest sickle opioid driving, surgical change project, um, was carried out in the Northern Health and Social Care Trust. And can I welcome Doctor Kira Mitchell, Consultant, anesthetist and doctor Lindsey Nelson, Physician associate. Uh, thank you very much indeed. And congratulations to both of you, Right. Talks to the project. So, in Causeway Hospital, a significant number of our patients were experiencing a delayed return of boil function after elective colorectal surgery or boil surgery, which was associate with the prolonged length of stay, which is bad for patients, staff and the organization. So the aim of our project was to encourage an earlier return of function and reduce the postoperative like this day. So the first thing we did was introduced intrathecal opiates, which is an injection into the lower part of the patients back into the fluid around the spine to provide excellent pain relief and reduced side effects compared to other forms of pain relief. We also created guidelines, delivered an extension, extensive teaching program and reduce postoperative morphine years. We collected our data presented on run charts and we had and impressive reduction on our median postoperative length of the day from 10.5 to 6 days, which is clear benefits for the patient. There's also an unintended reduction in staff, reported workload and improvement in morale. With an average cost saving of over 1500 lbs per patient, this multiplies up to over 165,000 lbs per year. There's clear benefit of the organization. That's very good. I felt like I was being pinched there, dragons down almost that same. You thought about that? Yeah, you know, very good. And again, what's interesting about that is it's it's the win win, isn't it? It's that the patient benefits, but the staff benefit as well. And the hospital benefits to Yeah, absolutely. Um, our patients really had a positive outcome. We did a number of kind of patient feedback following they following the project, and they were definitely happy. Um, certainly I had a number of other effects as well in terms of postoperative complications, Um, such as Post Operative Alias, where they needed to put into the stomach to gain and the fluid away. And and we I think it was 25% reduced. We reduce that by and it had been known from previous studies that that was one of the major things. That was a negative outcome of the admission. So we really improved their outcomes. So again, in terms of right pulling it out, sharing it with colleagues, you talked about this being a causeway, specifically, Is that right? So you can roll it out to others? Presumably. So this was in the elective surgical unit, the Causeway Hospital, and we proudly and clearly presented are, uh, successes on run charts on the board and and the success spread by word of mouth. So we have already scale this up across the site from the elective surgical unit to the emergency surgical unit and the gynecology unit, and we have shared our resources with the other site to facilitate trust Widespread. Obviously, if there's a regional approach to standardizing care and reducing variation for patients undergoing boil surgery, this would further improve.