Ground breaking work by a team at Forth Valley Royal Hospital is saving lives. Figures just published show that the number of patients suffering cardiac arrest in the Acute Assessment Unit (AAU) at Forth Valley Royal Hospital has fallen dramatically, thanks to enhanced safety measures which have been implemented by staff. Now the new ways of working are being tested in other acute medical units across Scotland,and are being adopted as part of the innovative Scottish Patient Safety Programme.

The study, which has just been published by the journal BMJ Quality & Safety, shows that in a 17 month period to August 2012, the number of cardiac arrests per 1,000 admissions fell by 71%. There was a similar reduction in the number of calls made to the resuscitation team and an overall improvement in 30 day survival rates.

NHS Forth Valley Consultant in Acute Medicine, Dr Dan Beckett, clinical lead for the project said:

 The quality of medical care provided in the first 48 hours of admission is one of the most important factors in determining the outcome for a patient so we looked at a number of ways in which we could further improve the monitoring, care and treatment provided during this critical period.The outcome has been achieved with negligible cost and one of the great advantages is that these new ways of working can be easily tested worldwide.”

A number of initiatives were introduced by AAU to improve the quality and safety of patient care. These included the introduction of weekly safety meetings where medical staff, nurses, advanced nurse practitioners, pharmacists, allied health professionals and medical/nursing students were encouraged to voice any concerns and suggest potential solutions. The unit adopted twice-daily consultant led ward rounds. A new system was also developed to ensure reliable response to deteriorating patients and encourage team working between nursing and medical staff.

In addition, measures were put in place to improve end-of-life care and decision making including closer ties with the hospital palliative care team.

Progress updates in reducing the numbers of cardiac arrests were also displayed on a quality improvement dashboard in the relatives’ waiting room to increase awareness and support a culture of transparency.

The AAU at Forth Valley Royal Hospital is a 46-bed unit which admits on average 1500 patients per month. These can come from several areas including the Emergency Department, the Clinical Assessment Unit (which receives emergency admissions from general practitioners), and direct admissions from the community.