HCA Healthcare UK provides expert medical care across our network of hospitals, outpatient facilities and NHS partnerships in London and Manchester. HCA Healthcare UK includes The Princess Grace Hospital, The Portland Hospital, The Harley Street Clinic, The Lister Hospital, The Wellington Hospital, London Bridge Hospital, Roodlane Medical Ltd, and Blossoms Healthcare. HCA UK also partner with leading NHS Trusts to provide care at HCA UK at University College Hospital, The Christie Private Care and Private Care at Guy’s.
The Princess Grace Hospital has been recently named as an Exemplar Centre for our ongoing commitment to VTE (Venous Thromboembolism) prevention. We’re delighted at this achievement, and also being the first in our group of hospitals to achieve this. Our journey started in 2017 following a recent CQC inspection which highlighted a need to improve our VTE assessment.
A new VTE risk assessment was introduced as part of the paper drug chart. Data collection changed so an electronic code was needed to show assessments had been carried out, and a named VTE lead was introduced.
My name is Hilda Pingul, I am a Matron for Orthopaedic and Sports and Exercise Medicine, I’ve worked at Princess Grace Hospital for the past 25 years I have been its VTE lead for the last 2 years. This role was put in place to ensure NICE Guidance was being adhered too, and to reduce the amount of patients developing VTE whilst in hospital. Rather than appoint a single champion, a multidisciplinary approach was taken incorporating clinical and nursing leadership alongside input from pharmacy, quality improvement teams and the Hospital Chief Nursing Officer. Part of my role was exclusively devoted to ensuring patients received a VTE risk assessment on admission to hospital and implementing a network of champions that not only span my hospital but also filter into the group of hospitals we belong to.
One of the first things we did was established a VTE mission statement and strategy and formed a new Hospital Thrombosis committee. This enabled us to implement changes to practice and achieve national targets. Staff knowledge on VTE, data collection, and compliance in completing forms all needed to be improved. Senior medical directors became part of the thrombosis committee which disseminated its own policies across the group of hospitals, and risk assessment became mandatory for all patients.
Since January 2018 we have been auditing VTE risk assessment compliance. The beginning of PGH Exemplar journey in 2020, admission risk assessment had been audited on a weekly basis and regularly monitored. We wanted to further audit the quality of our risk assessment, information given to patients and prescription compliance. We used an additional 15 data questions set to drill down and track improvements.
Our Pre-Assessment team from Outpatients have played an important role in ensuring this is completed. If this is missed, Inpatient team complete when patient arrives in the ward. Any areas of non-compliance are flagged and escalated to sisters, ward managers and matrons.
In addition, in-house Pharmacists and Resident Doctors are actively involved in completing the admission risk assessment, particularly for patients undergoing major or complex surgery.
In 2020 we introduced our own VTE Root Cause Analysis (RCA) tool. During the first wave of the COVID-19 pandemic we worked in partnership with the NHS during these times we also noticed the complex time critical cancer surgery we were undertaking lead to an increase in VTE events. This RCA tool was a great addition.
We have noticed that our dedication by our clinical teams were central to all our improvements, we have achieved consistent VTE assessment of 100%.
We continue to develop our pathways of care for prevention, diagnosis and management of venous thromboembolic disease and work across the whole hospital group and are supporting our sister hospitals to become exemplar centres and are really please to be part of the exemplar network to share evidence of best practice and contribute to the evidence base.