Transcript Peer Reviewer Training

Peer Reviewer
Major Trauma
Network Training
Welcome and Introductions
Aims of the Training
• To promote understanding of the purpose and
implementation of the National Peer Review
Programme
• Enable the cascading of information to support
teams within the network
Learning Outcomes
By the end of the day you will:
• understand the principles of the National Peer Review
Programme
• be prepared for the forthcoming peer review and ensure
that all good practice is shared
• understand how to complete a self assessment
• be able to cascade details of the review to others.
Session 1
The National Peer Review
Programme
Our Key Principles
Consistency in
delivery of
programme
Clinically led
Driver for service
development and
quality improvement
Focus on
coordination within
and across
organisations networking
Quality assurance
process for clinical
services
Peer on Peer
User/carer
Involvement
Aims of Peer Review
To ensure services are as safe as possible
To improve the quality and effectiveness of care
To improve the patient and carer experience
To undertake independent, fair reviews of services
To provide development and learning for all involved
To encourage the dissemination of good practice
Organisation of the Programme
Ruth Bridgeman
National Director
Julia Hill
Deputy Director
Marie Cummins
Programme
Development
Manager
NVMU
Sally Edwards
South Region
Quality Director
Local Review
Units (LRU) x
4 QM & AQM
Clinical
Leads
Richard McMahon
North Region
Quality Director
Local Review
Units (LRU) x
3 QM & AQM
The Peer Review Programme
Validated
Self
Assessment
All teams
complete a self
assesment
validated by the
host
organisation
Pre visit
Review of
Evidence
All validated self
assessments
reviewed prior to
the visit by the
NPRP local
review unit
Peer
Review Visit
Comprehensive
visits to all major
trauma centres
and units
The Peer Review Schedule
Development of the Measures
National
Guidance
• Evidence based
using agreed
national guidance
and best practice
Expert
Group
• Development of measures is undertaken by
an expert group made up of each of key
disciplines, patient/carer representation
and representing a variety of organisations
involved in the pathway
Consultation
• General consultation to
gather feedback from the
wider community
Editing
• All comments from
consultation reviewed
by expert group
• Measures
reviewed on a
regular basis to
Publication take into account
changes in
national guidance
Major Trauma Measures
• Pre-Hospital
• Reception and Resuscitation (Adult, Children,Trauma
Units)
• Definitive Care (Adult, Children,Trauma Units)
• Rehabilitation (Adult, Children,Trauma Units)
• Network
Pre Hospital
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Clinical Governance
Triage Tool
Enhanced Care Teams
Pain Management
Administration of Tranexamic Acid
Pre Alert and Handover
Reception & Resuscitation
• Emergency Department (ED) staff
– Trauma Team Leader
– Training
• Radiology
– CT scanning
– Radiology reporting
– Interventional Radiology
• Surgery
– Access to theatre
– Access to specialist consultants
• ITU
• Transfusion
Definitive Care
• Major trauma leadership and staffing
• Major trauma pathways
• Specialist management pathways
Rehabilitation
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Rehabilitation leadership and staffing
Enhanced rehabilitation
Specialist rehabilitation pathways
Rehabilitation prescriptions
Repatriation
Psychological support
Network Organisation
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Network configuration of services
Network governance structure
Network protocols and guidelines
Trauma Audit and Research Network
Development of Clinical Indicators
• Clinical Indicators are developed in
consultation with national clinical groups
• Data is available from national sources
such as national audits - TARN
• TARN reports are used where available
Completing a Self Assessment
Completing a Self Assessment
Evidence
Documents
Report
Key
Themes
Quality
Measures
MTC and TU Evidence Documents
Operational Policy
Describing how the team
functions and how care is
delivered across the patient
pathway
Outlining policies/processes
that govern safe / high quality
care
Agreement to and
demonstration of the clinical
guidelines and treatment
protocols for the team.
Annual Report
Summary assessment of
achievements & challenges
Demonstration that the team is
using available information
(including data) to assess its own
service
Workload & Activity Data
TARN
Local Audits
Patient Feedback
Work Programme Update
Work Programme
How the team is planning to
address weaknesses and
further develop its service.
Outline of the team’s plans
for service improvement &
development over the
coming year
Actions resulting from audit
and from previous reviews
Network Evidence Documents
Operational Policy
Annual Report
The network’s constitution
and how it functions
Summary assessment of
achievements & challenges
Description of the
governance process
explaining how the network
links to individual services
Demonstration that the group is
using available information to
assess network services, including
TARN audit
Work Programme
How the group is
planning to address
weaknesses and further
develop network
services
Outline of the plans for
network wide service
The current clinical and
Summary update on implementation improvement &
referral guidelines agreed
of previous year’s work-programme development over the
by the network
(including progress on implementing coming year
actions from previous reviews)
The agreed configuration of
Should include
services across the network. Consideration and discussion of
addressing actions from
performance against clinical
previous peer reviews
indicators
where relevant
Demonstrating Agreement
• Where agreement to guidelines and
policies is required this should be stated
clearly in the relevant evidence document.
Self Assessment Report
• Compliance against the measures
• General commentary based on 4 key themes
• Identification of
– Good practice / significant achievements
– Immediate risks / serious concerns
– Concerns / Recommendations
Key Themes
The following themes should be considered when writing the
report
Categorising Review Findings
Good Practice/
Significant
Achievement
• Relates to the service and can be either innovative
or common practice undertaken very well
Immediate Risk
• An issue that is likely to result in significant harm
to patients or staff or have a direct serious
adverse impact on clinical outcomes and therefore
requires immediate action
Serious Concern
Concern
• An issue that whilst not presenting an immediate
risk to patient or staff safety is likely to seriously
compromise the quality of patient care, and
therefore requires urgent action to resolve
• An issue that is affecting the delivery or quality of
the service that does not require immediate action
but can be addressed through the work
programmes of the services
Self-Assessment – Key Tips
Be honest
Get the evidence
agreed in line
with the
measures
Ensure
agreements are
documented
Don’t let yourself
down with poor
evidence
Establish
process for any
data
requirements
Use annual
report to focus
on outcomes
Sell yourself
Using TQuINS
www.tquins.nhs.uk
 Secure web based database supporting each stage of
the peer review process
 Records assessments, compliance with the measures
and reports
 Provides information for national analysis and reporting
 Access to resources
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Measures
Handbook
Reports
Training slides
TQuINS Homepage
Navigate to
TQuINS
homepage
www.tquins.nhs.
uk
Enter your
registration
details
Pre-visit Review of Evidence
Desk top review of validated self-assessment
undertaken by the Peer Review Local Review Unit
Review accuracy of self-assessment
Identify areas/issues for clarification at the visit
Review shared with reviewers and services
The Peer Review Visit
Who are Reviewers?
Multidisciplinary teams of:
Service users, clinicians, AHPs, managers,
commissioners
“Peers are people who have been trained
and working in the same discipline as the
people they are reviewing”
Reviewers will not normally review teams
that are part of their own patient pathways
Review Team for MTC
• 2 consultants from different specialties
(ED, T&O, Intensivist.)
• Rehab specialist
• Either a trauma coordinator or a
paramedic
• Lay member of local MTC Trust Board
• National Peer Review team member.
Review Team for TU
• The network lead clinician
• The network manager
• A consultant from another TU in the
network
• A trauma co-ordinator / trauma nurse /
rehabilitation specialist from the MTC
• National Peer Review team member.
The Visit Day
MTC
TU
Review Team Arrival
Review Team Arrival
Review Team Evidence Review
Review Team Evidence Review
(1.5 hrs)
(1hr)
Review Team Tour of Facilities
Review Meeting
(45mins)
(1hr)
Review team meet with the team
NB presentations should be kept brief to allow for
discussion between reviewers and teams.
Presentations and Review Meeting
Reviewer Preparation of Feedback
(2hrs)
(15mins)
Review team meet with
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Network

Ambulance Services

MTC
Feedback to the Team
(20mins)
NB presentations should be kept brief to allow for
discussion between reviewers and teams.
Lunch
Report Writing
(1hr)
Reviewer Preparation of Feedback
(30mins)
Feedback to the Teams
(45mins)
Report Writing
(2hrs)
Logistics
• Rooms
– Suitable to enable discussion (not lecture theatre)
– Small breakout room for review team
• Refreshments / Lunch
• Information
– Car parking arrangements
– Map / directions
– Contact details
Resources Available
TQuINS www.tquins.nhs.uk
NPRP Handbook
Slides and packs from today
Local review units are able to offer support
Training
• Organisation training sessions supported
by local review units
• Reviewer training
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29th October: Thistle Marble Arch London
3rd November: Holiday Inn Bristol Filton
20th November: Cedar Court Huddersfield
26th November: Hilton Birmingham Bromsgrove
3rd December: London TBC
Any Questions?
Thank You