ILUMIN: Improving Leg Ulcer Management in Community Nursing (and podiatry)
What are we trying to do?
The ILUMIN project aims to optimise the assessment and treatment of leg ulcers being cared for in the NHS community services, with a view to ultimately improving outcomes for patients.
Why is it important?
In 2015/16, in collaboration with our partner NHS organisations, we undertook a community-based survey of complex wounds and their care. The survey revealed a number of examples of good, evidence-based practice in community wound care, but also identified several opportunities to further optimise care for patients with complex wounds, in particular for those with leg ulcers (which the survey found to be the most common type of complex wound being treated in the community).
The ILUMIN project therefore aims to support teams to bring about improvements in leg ulcer management, with a focus on ensuring appropriate (and timely) Doppler assessment and use of suitable compression therapy, including compression hosiery.
How will we do it?
Over this 12 month project, staff will receive dedicated facilitation input and will be supported to:
- Design and implement a regular (e.g. monthly) and rapid ‘data collection and feedback’ approach to provide a snapshot of the quality of leg ulcer care being provided This snapshot will look several key quality markers for leg ulcer management, principally focused on (timely) doppler assessment and the use of suitable compression therapy.
Discussing (e.g. as part of safety huddles) the data on a monthly basis, will help teams to have a shared understanding of their performance in relation to these quality markers, and provide an opportunity to talk about why key assessments may not have been delivered in a timely manner and why compression therapy (including the most appropriate form of compression therapy) may not be being used. This, in turn, will help teams to recognise opportunities for improvement and identify potential changes that could be made (at an individual, team, service or directorate level).
- Continuously drive improvements in care by identifying where changes need to be made, developing new and innovative ideas for change, testing these out in practice, assessing their impact (i.e. did they result in an improvement and, if so, how much improvement?) and sustaining any improvements made.
At the end of the 12 month facilitated period, we hope to revisit teams a few months down the line to see how sustainable the systems and processes developed are in the absence of dedicated support, and to understand if/how they have evolved.
Who are we working with?
The partner NHS Trusts involved in the CLAHRC wound care programme are: East Lancashire Hospitals NHS Trust, Manchester University NHS Foundation Trust, Pennine Care NHS Foundation Trust and Salford Royal NHS Foundation Trust