Search examples of implementation
The examples of practice included in this database aim to share learning among NHS and partner organisations. NICE has carried out a minimal quality assurance process on each project to ensure it meets basic criteria. Inclusion in this database does not constitute NICE endorsement of the approach, product or tool.
The examples in the database do not constitute NICE guidance. NICE has not assessed the projects to confirm that they accurately reflect or implement NICE guidance. If you have queries or concerns about the relationship between NICE guidance and any examples given, please refer to the original NICE guidance, which is the only definitive statement of the guidance.
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|Examples of Shared Learning|
Improving management of Patient Group Directions (PGDs) during organisation change
Description: The formation of PCT clusters in 2011, and subsequent CCGs in 2013 covering the whole of Devon, gave opportunity for the medicines optimisation teams to collaborate, produce, review and authorise PGDs for primary care covering a population of approximately 1.1million across an area of 2,500 square miles in Devon. The use of the NICE PGD Medicines Practice Guidelines (MPG) and the Medicines Practice Guidelines PGD Baseline Assessment Tool, has allowed us to benchmark the work that we do.
Organisation: New Devon and Torbay Clinical Commissioning Group (CCG)
Category of submission: - Date: 20 Jan 2014
Improving managing violence training - combining managing violence and life support
Description: Combining Managing Violence and Life Support training has created a safer response to violence by highlighting the importance of life support during restraint. Including the service user's views into the training has increased the staff understanding of the impact of restraint on the individual. We emphasise the importance of early intervention to prevent violence.
Organisation: Rotherham Doncaster and South Humber Mental Health NHS Foundation Trust
Guidance: CG25 - Violence: The short-term management of disturbed/violent behaviour in in-patient psychiatric settings and emergency departments
Category of submission: Clinical Date: 29 Sep 2008
Improving Outcomes through On-line Collaboration: The Teenager and Young Adults Cancer Services
Description: The Teenage and Young Adults Cancer Services (TYA) is a new and innovative service funded by the Teenage Cancer Trust. The IOG for Children and Young People with Cancer set out recommendations on how healthcare services for children and young people with cancer should be organised. Based on these guidelines a novel approach to multidisciplinary working with Teenagers and Young Adults (TYA) with cancer was developed in the South West region: a virtual Multi-Disciplinary advisory Team (MDaT). Using a new online collaboration tool the team members are able to contribute remotely, making geographical patient treatment and support easier.
Guidance: CSGCYP - Improving outcomes in children and young people with cancer: Improving Outcomes Guidance (IOG) 2005
Category of submission: 2010-11 Shared Learning examples Date: 05 Feb 2011
Improving Pressure ulceration documentation pathways
Description: The introduction of a primary care trust wide documentation system for the district nursing service to promote standardised assessment and management using best practice indicators for the management of pressure ulceration in community settings.
Organisation: Trafford Provider Services
Guidance: CG29 Pressure ulcers - The prevention and treatment of pressure ulcers
Category of submission: 2010-11 Shared Learning examples Date: 03 Feb 2011
Improving safety through a Therapeutic Chlordiazepoxide prescribing Detoxification Regime
Description: Tameside Hospital serves a population of 250.000 across Tameside. Figures show that about 22% of the population are binge drinkers (37,000 people). Admissions almost tripled over the last 10 years. In April 2013 the HALS (Hospital Alcohol Liaison Service) was established. The team consists of a Team Leader Specialist nurse, 2 Alcohol Specialist nurses, Data Administrator and Consultant Hepatologist. The team run a 7 day 8am-8pm service, offering a duty response to all inpatient and outpatient departments within the hospital, in addition to the response work the service also runs a 7/7 Ambulatory Detoxification clinic, based at the hospital which is flexible to patient's needs. The team are predominantly based in A&E as a frontline service. Almost immediately it proved a positive impact on the support offered to patients admitted for alcohol misuse, the team have been pivotal in launching and applying the principles of the NICE Alcohol withdrawal pathway.
Organisation: Tameside Foundation Trust
Category of submission: - Date: 29 Jan 2014
Improving services by focussing on what works: developing NICE learning in a Local Authority
Description: A ninety minute lunchtime learning seminar was organised to raise awareness about the use of NICE guidance and resources within a local authority setting. Through an interactive format of presentations and small discussion groups we aimed to engage with local authority colleagues and provide a wider understanding of NICE's role in supporting the local government agenda. The seminar included small discussion groups to encourage participants to think about and discuss how NICE guidance can be used in the local planning and commissioning processes, focussing on three specific pieces of relevant Public Health guidance.
Organisation: London Borough of Bromley
Category of submission: - Date: 23 Dec 2013
Improving the detection and response to patient deterioration
Description: NICE CG50 requires that all adult patients in hospital have (i) a clear written monitoring plan specifying which vital signs should be recorded (and at what frequency), (ii) their severity of illness measured using a physiological early warning score (EWS) and (iii) a graded response strategy. VitalPAC, a wireless, handheld computer-based system, provides a structured mechanism for clinical staff to record patient vital signs electronically at the bedside on general hospital wards, calculates patients' early warning scores and provides instruction to bedside staff (e.g., 'increase the observation frequency', 'obtain assistance'). Importantly, all the data collected by VitalPAC is integrated with the hospital's other clinical systems and provides staff elsewhere in the hospital with instantaneous, reliable access to the charts and data via the intranet.
Organisation: Portsmouth Hospitals NHS Trust
Guidance: CG50 - Acutely ill patients in hospital
Category of submission: 2010-11 Shared Learning examples Date: 07 Feb 2011
Improving the quality of care for children with epilepsy
Description: We targeted two major priorities in our care for children and young people with epilepsy.
(i) Referral time by primary care to a specialist in Paediatric Epilepsy.
(ii) Information shared and, in particular the very difficult subject of SUDEP.
Organisation: Musgrove Park Hospital
Guidance: NICECG137 - The epilepsies: the diagnosis & managemnet of epilepsies in adults & children in primary & secondary care
Category of submission: - Date: 23 Nov 2012
Improving the quality of care through implementing the NICE 'alcohol use disorders' guidelines
Description: To implement NICE guidance and develop an evidence-based streamlined pathway for service users with alcohol use disorders both within the organisation and with partner organisations.
To maximise all opportunities to deliver interventions relating to alcohol use disorders and to ensure high quality care across all services in particular during in-patient admission.
To design and deliver training solutions to support the above using a range of methods to ensure staff have the knowledge and practical competence to deliver the improvements detailed by NICE.
Organisation: Manchester Mental Health and Social Care Trust
Guidance: CG 115, 100, PH24 - Alcohol dependence and harmful alcohol use
Category of submission: 2011-12 Shared Learning Awards Date: 30 Jan 2012
Improving the standard of service provision for people with epilepsy and learning disability in Nottinghamshire.
Description: This example was originally submitted to demonstrate implementation of CG20 on Epilepsy. CG20 was replaced by CG137. The practice in this example remains consistent with the updated guidance.
Organisation: Nottinghamshire Healthcare NHS Trust
Guidance: CG137 - Epilepsy
Category of submission: Clinical Date: 03 Oct 2008
In the balance : Development of a model Occupational Health system based on the NICE Obesity Guidance (Clinical Guidance CG 43 ) for detecting , assessing and managing overweight and obesity in NHS staff in an Acute Hospital Trust.
Description: Pennine Acute Hospital NHS Trust, continuing the momentum set by Dame Carol Black and Dr Stephen Boorman in their recent reports, aims to reduce sickness absence from 18 to 8 days/employee/year and expects Occupational Health(OH) to play a key role by targeting obesity in staff thereby reducing disability, premature retirement, work stress and injury whilst improving work attendance and productivity. Current obesity management in OH is inconsistent with no set protocol and muddled care pathways, yet NICE has produced in CG43 a systematically developed framework to promote high quality evidence-based assessment and management of obesity. An audit was performed to identify deviations in OH practice from recommendations in CG43, design an action plan to correct deficiencies bringing clinical staff up-to-date with best practice, to ensure a consistent standard in diagnosis and management of obesity and also to dispel the current apathy in OH which surrounds the subject of obesity.
Organisation: Pennine Acute hospitals NHS Trust
Guidance: CG43 - Obesity
Category of submission: 2011-12 Shared Learning Awards Date: 05 Dec 2011
Increasing Healthy Start vitamin uptake
Description: We wanted to ensure that the Healthy Start vitamins (containing Folic Acid, Vitamins C and D) were available to everyone who needed them.
We set up a local scheme so that Healthy Start vitamins were available to buy or on voucher exchange (for those on the Healthy Start welfare programme) in all children centres across North East Lincolnshire (NEL).
In addition we offer a free 'starter' pack (2 months supply) of women's vitamins for all pregnant women through maternity services. We also are offering a free 'starter' bottle of children vitamin drops through health visiting teams.
Organisation: North East Lincolnshire Care Trust Plus
Guidance: PH11 - Maternal and child nutrition
Category of submission: - Date: 26 Oct 2012
Increasing NICE compliance through improved database monitoring and reporting
Description: We have developed, in-house, a bespoke Access database to enable monitoring and assurance of the Trust's status against NICE guidance. The database allows comprehensive and accurate reporting in numerous permutations at the touch of a button. The facilities for improved monitoring of progress and flagging when deadlines and next actions are due have enabled us to demonstrate an increase in compliance of more than 50% since the database was introduced in November 2011.
Organisation: University Hospitals Coventry & Warwickshire
Category of submission: - Date: 13 Jan 2014
Integrated care documents - a means of implementing NICE guidance
Organisation: Taunton & Somerset NHS Foundation Trust
Guidance: CG063 - Diabetes in Pregnancy
Category of submission: Clinical Date: 22 Aug 2008
Integrating men being treated for prostate cancer into exercise referral schemes
Description: We identified a low level of exercise and high level of obesity in men with Prostate Cancer, both risk factors for extra toxicity following ADT, particularly fatigue. Working with patients, health care commissioners and the government body- Skills Active, and a training provider we developed a national level 4 qualification in exercise rehabilitation which empowered local (and national) gym instructors to accept referrals for patients with cancer within the national exercise referral scheme. All men, with prostate cancer now receive exercise counselling, supported by a written information pack and are offered referral to a 12 week exercise programme which when later audited had a high uptake rate and satisfaction. This project is in line with recommendation 1.4.19 in CG175 which states: Offer men who are starting or having androgen deprivation therapy supervised resistance and aerobic exercise at least twice a week for 12 weeks to reduce fatigue and improve quality of life (new 2014).
Organisation: Bedford and Addenbrooke's Cambridge University Hospitals
Guidance: CG175 - Prostate cancer: diagnosis and treatment
Category of submission: - Date: 19 Dec 2013
Interactive simple telehealth for the management of blood pressure
Description: This innovative simple interactive telehealth system has demonstrated rapid improvement in historically difficult to treat hypertension using just a home blood pressure monitor and interactive SMS texting between clinician and patient with a mobile telephone. Patient satisfaction with the system was high. Pragmatic use of the system during has demonstrated that there may be a place for this technology in diagnosing, refuting a diagnosis of or managing a pre-existing diagnosis of hypertension.
Organisation: Stoke-on-Trent Clinical Commissioning Group
Guidance: CG127 - Hypertension
Category of submission: - Date: 29 Nov 2012
Introducing a Governance framework for New Interventions and Intervention Procedures Guidelines
Description: In response to the Healthcare Circular - HSC 2003/011, the University Hospitals of Leicester (UHL-NHS trust) and the Medical Director established an advisory body; the New Interventional Procedures Advisory Group (NIPAG) to oversee the process and to oversee the application of NICE issued IPGs. Since it was established, NIPAG has received 47 new applications and distributed 146 IPGs. This submission describes the challenges and key learning points.
Organisation: University Hospitals of Leicester
Category of submission: General Date: 29 Sep 2009
Introducing techniques and medical devices
Description: It is vital that the inauguration of any new technique or medical device takes into consideration not only costs, implication and benefits but also ensures any risks to patients, staff and the Trust are minimised.
The Royal Liverpool and Broadgreen University Hospital Trust (RLBUHT) established the Techniques and Medical Devices group (T&MDg) to formally assess any new technique/medical device and ensure governance arrangements are in place for its introduction.
Organisation: Royal Liverpool and Broadgreen University Hospital Trust
Category of submission: - Date: 30 Jan 2013
IPG404: Transoral incisionless fundoplication (TIF) in children
Description: Prospective audited cohort of 20 children showing efficacy (pH objective, QOL subjective, and drugs stopped) and safety of TIF, with a median follow up of 30 months.
Organisation: Sheffield Children's Hospital NHS Foundation Trust
Guidance: IPG404 - Endoscopic threatment for gastro-oesophageal reflux
Category of submission: 2011-12 Shared Learning Awards Date: 16 Dec 2011
Is Lithium Therapy Safe? A local Audit of Lithium Monitoring in Primary and Secondary Care of Patients in Regular Contact with Secondary Care
Description: Renal failure, hypothyroidism and fatal toxicity can all result from lithium therapy, a drug commonly used as a mood stabilizer for bipolar patients. As a result of the above regular monitoring is required as set out by the NICE guidelines for bipolar disorder (CG38). A retrospective audit was carried out in Osborn House CMHT (Community Mental Health Trust) in Birmingham in order to asses the concordance with these guidelines.
Organisation: University of Birmingham
Guidance: CG38 - Bipolar disorder; The management of bipolar disorder in adults, children and adolescents, in primary and secondary care
Category of submission: - Date: 28 Jan 2013
This page was last updated: 14 March 2014