Table 2 Background information for the QI initiative case studies

Initiative aim

To improve the physical health of people with severe mental illness that are admitted to a specific acute admissions ward

To improve delivery of specialist allergy services in a secondary care setting

To improve the health, quality of life, and experience of care for patients with acute heart failure

To undertake a structured medication review for patients ≥70 years who were potentially on inappropriate medicines

Intervention(s)

Physical health assessment form, training for staff on assessment and interventions, patient-held health record

Diagnosis and treatment training sessions; nurse-led asthma clinics, allergy network meetings, updated referral pathways

Admissions HF Care Bundle

Multidisciplinary team meetings, medication review tool, education and training of undergraduate pharmacists and junior doctors

Organisational setting

Acute Hospital

Site A- Integrated Care Trust

Site B- Acute hospital

Acute hospital

Acute hospital

Resource

Funded by a grant from a charitable organisation.

Site A - commissioned service.

Site B - funded by the Commissioning for Quality and Innovation (CQUIN) payment framework to reduce asthma admissions.

Funded by CLARHC NWL, staff time and resources were match funded by the host organisation.

Funded by CLARHC NWL, staff time and resources were match funded by the host organisation. Roll-out sites received additional funding for pharmacy time and participation.

Evidence of sustaining 1 year post-funding

Yes (Sustained adherence and delivery of physical health assessment. Integration of health assessment form on hospital’s IT system)

Yes (Maintenance of allergy proforma & child allergy booklet. Multidisciplinary team meetings continue. Adaptation including updating and adapting the review proforma)

Yes (Ongoing processes for bundle distribution and measurement. Sustained % of echocardiograms and specialist input within the recommended timeframes)

Yes (Medication reviews continued in multidisciplinary teams and mediation review tool continuing to be used)

Quality Improvement (QI) Support

CLAHRC NWL provided QI expertise, staff training, team coaching and facilitation, and evaluation support

Timeframe

All initiatives were funded from September 2015 to March 2017 with the follow-up period extending from April 2018 to September 2018.