The Health Foundation announces seventeen innovative projects to improve the quality of health care

The Health Foundation has selected seventeen projects to be part of its new £1.5m innovation programme, Innovating for Improvement.

Innovating for Improvement aims to improve health care delivery and/or the way people manage their own health care by testing and developing innovative ideas and approaches and putting them into practice.

The selected projects will be led by clinical teams and will develop their innovative ideas and approaches, put them into practice and gather evidence about how their innovation improves quality.

The programme will run for 15 months, including a recommended set up phase starting in May 2015. Each team will receive up to £75,000 of funding to support the implementation and measurement of their project.

The innovative ideas will be tested in health care settings around the around the UK including primary and secondary care, as well as organisations providing health and social care. The selection of these projects is currently subject to contracts being finalised with the lead organisation of each project.

The seventeen projects are:

Surviving major surgery: nurse-led pathways to meet individual need
Lead organisation: York Teaching Hospitals 
To improve perioperative outcomes for patients undergoing major surgery, this project involves introducing innovative ward-based and nurse-led protocols using advanced monitoring. These will guide and standardise post-operative care using treatments and technology normally only seen on intensive care units.

TRAK: online self-management for knee rehabilitation patients
Lead organisation: Cardiff and Vale University Health Board
Physiotherapy is recommended for the management of musculoskeletal conditions, but with rising demand for longer-term condition management, new approaches are needed. An online approach to support self-care, TRAK will provide knee patients with access to expert knowledge and advice to support recovery and help prevent the progression of chronic conditions.

The psychological management of medically unexplained symptoms: a needs-led approach to improving quality and outcomes
Lead organisation: Birmingham and Solihull Mental Health NHS Foundation Trust
An innovative approach to managing patients with severe medically unexplained symptoms (MUS), this project involves embedding specialist MUS expertise in the acute hospital setting and creating a new care pathway that is based on patient need. It will involve the use of evidence-based interventions in a systematic and patient-centred way.

SmartCareCF: improving the delivery and quality of care for people with cystic fibrosis
Lead organisation: Cystic Fibrosis Trust
SmartCareCF involves the use of smart technologies to provide safe, home-management of cystic fibrosis (CF). It will empower people with CF to manage their condition; provide a coordinated approach to care, support and treatment; and reduce the risk of patients acquiring lung infections when attending clinics.

Person-centred approach to health and social care integration
Lead organisation: NHS Ayrshire and Arran
This project seeks to improve the quality of care and experience of older people and those with long-term conditions by creating pathways that are seamless and delivered by high-performing teams. It will involve measuring integration from the patient’s perspective, assessing team interactions, and then delivering improvements using quality improvement methodologies.

Smart rehabilitation at home before and after lung surgery
Lead organisation: Heart of England NHS Foundation Trust
Enhanced recovery programmes, which include rehabilitation, improve patient experience and fitness, and can reduce the risk of complications after surgery. This project involves the use of a tailored at-home app-based rehabilitation programme for lung surgery patients, which will allow wider and more convenient access to care.

Stabilising sleep for patients admitted at acute crisis to psychiatric hospital: a pilot randomised controlled trial
Lead organisation: Oxford Health NHS Foundation Trust
Sleep disturbance is a contributory cause of poor mental health and low psychological wellbeing. However, in psychiatric practice it is often overlooked. This project will investigate the impact of using evidence-based techniques and technologies (cognitive behavioural therapy for insomnia, light therapy and sleep monitoring devices) on a psychiatric inpatient ward.

MISSION COPD: Modern Innovative SolutionS in Improving Outcomes iN COPD
Lead organisation: Portsmouth Hospitals NHS Trust
MISSION is a quality improvement project that identifies patients with high-risk or undiagnosed chronic obstructive pulmonary disease (COPD) from GP practices, with rapid evaluation in primary care, followed by comprehensive, specialist multi-disciplinary assessment in hospital. It will deliver interventions to NICE quality standards throughout the patient pathway.

Developing a model of recognition and rescue of the deteriorating patient across the community
Lead organisation: NHS Borders
This project involves the development of a reliable model for recognising the deteriorating patient in the community hospital and community out-of-hours service. It will involve designing an appropriate response to ‘rescue’ the patient, with the aim of reducing mortality, length of stay and undue distress to the patient and family.

Supporting patients and families after hospital discharge following critical illness: implementation and evaluation of a novel e-health resource
Lead organisation: NHS Lothian
Research demonstrates that patients and families can benefit from access to better information following critical illness. This project will test, develop and evaluate an e-health innovation that provides patients and families with information, advice, access to peer and professional support, and strategies for supported self-management post-hospital discharge.

Quality trauma discharge
Lead organisation: North Bristol NHS Trust
Analysis of patient feedback at North Bristol NHS Trust’s major trauma centre revealed that many problems attributed to rehabilitation were actually related to the discharge process. This project will involve introducing a discharge consultation with a trauma nurse, an individually tailored discharge pack, and assistance with forward planning for discharge.

AlcoChange: reducing alcohol use and admissions in patients with alcoholic liver disease
Lead organisation: Royal Free London NHS Foundation Trust
Ongoing alcohol use in patients with alcoholic liver disease (ALD) is the main cause of re-admission and death. This project involves providing ALD patients with a smartphone app and breathalyser that will enable them to accurately self-monitor alcohol intake, allow contact by alcohol workers and lead to sustained behaviour change.

Parkinson’s Advanced Symptom Unit (PASU)
Lead organisation: South Tees Hospitals NHS Trust
One in 500 people has Parkinson’s and hospital outpatient clinics struggle to meet the often complex needs of patients. The Parkinson’s Advanced Symptom Unit (PASU) will provide community-based specialist support to patients with falls, freezing episodes, hallucinations and dementia, thereby improving symptom control and quality of life, closer to home.

Developing and implementing nurse-led beds for end-of-life patients within a hospice inpatient unit
Lead organisation: St Gemma’s Hospice
Many end-of-life patients may prefer to die in a hospice but are unable to because they do not have specialist palliative care needs. This project will involve assigning some hospice beds as nurse-led; designated for the care of patients with a limited prognosis but without complex symptoms requiring medical input.

‘The Block Room’: developing a model to enhance the delivery of regional anaesthesia
Lead organisation: University College Hospital London
Regional anaesthesia, whereby local anaesthetic is given to a defined region of the body, is traditionally delivered within anaesthetic rooms. This project will involve the development of a dedicated ‘block room’ within the theatre complex where regional anaesthesia can be delivered in a more focused, specialised and therefore reliable environment.

Personalised long-term follow-up of patients with cochlear implants using remote care
Lead organisation: University of Southampton Auditory Implant Service
People with cochlear implants require lifetime follow up, carried out at specialist centres that may not be convenient for the patient. This project will involve the design and implementation of a follow-up pathway for cochlear implant patients using remote self-monitoring, self-adjustment of devices, and an online or smartphone intervention package.

Reducing inequalities in care for people with non-alcoholic fatty liver disease: implementation of an innovative community-based and specialist supported care pathway in East Yorkshire
Lead organisation: Hull and East Yorkshire Hospitals NHS Trust
Despite 25% of adults having non-alcoholic fatty liver disease (NAFLD), few defined management pathways exist, which can negatively impact diagnosis, optimal management and prevention of disease progression. This project brings together GPs and liver specialists through the implementation of an e-consult clinic; standardising the patient journey and improving outcomes.