Royal Free London NHS Foundation Trust - Freepress Clinical Strategy Special

12 Doris Ajayi, clinical nurse specialist, dementia care at BH Janadean McDonald, endoscopy unit manager at CFH Deepa Patel, diabetes clinical nurse specialist at RFH We get to know the person who is behind the dementia. Sometimes we can forget who the person is, that they’re someone who enjoys music, exercise, likes to have a cup of tea first thing in the morning. When we understand that person, we begin to tailor their care. We’re looking at early discharges, prevention and how we link with other agencies to continue with what we put in place. The big thing is preventative steps: eating Our endoscopy team are always looking at ways to improve outcomes for patients and reduce waiting times. We see anywhere from 40 to 70 patients a day and have introduced several innovations to enhance their care, including transnasal endoscopies which are faster and more comfortable than traditional gastroscopy as they go through the nose rather than the throat. We also offer general anaesthesia cases for patients who don’t want to be sedated, providing more comfortable procedures. Endobronchial ultrasound tests for respiratory diseases such as lung cancer, which enables more precise treatments. Data from the RFL diabetes clinical practice group (CPG) shows that approximately 25% of beds are occupied by patients who have diabetes every day. At the RFH, patients with chronic illness such as diabetes are managed by the acute medical teams with specialised diabetes teams providing an advisory service five days a week. We plan to implement a collaborative and completely digitalised CPG focused on inpatient diabetes care across all the RFL hospital sites. Our aim is to improve well, sleeping well and helping the people caring for them to reduce the risk of the person with dementia developing any other long-term conditions so they don’t have to return to hospital. Recently I referred a patient’s daughter to an Admiral nurse who provides support in the community. She was also connected to Barnet Carers which offers a range of services including information, counselling and practical assistance. When I met her again a few months later she was much happier and now has a network of other caregivers and support. We are piloting face to face preassessments to address all our patients’ concerns before their procedure. This helps reduce waiting times, avoid cancellations and unnecessary delays on the day of the procedure. Our exceptional service was awarded accreditation from the Joint Advisory Group on gastrointestinal endoscopy (JAG), an independent assessment scheme. This wouldn’t have been possible without my amazing colleagues, and I’m very proud that we’re contributing to CFH’s clinical vision. safety and reduce risk of harms caused to adult patients who have diabetes. We want to achieve this by working with patient care teams to identify patients with diabetes in EPR, targeting appropriate monitoring and care. Our digitalised pathway will present real time information to help with timely clinical decisionmaking. We hope to further develop working partnerships by providing live alerts to the diabetes team, providing real time data to enable clinical teams to monitor the quality of their care. We believe this data-driven and partnered approach is the way forward for diabetes care. Making our clinical vision a reality “ “ “ “ “ “

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