Paediatric Units Data and Meeting Booklet · 3 4! UK Donation by Level Level 1 Level 2 Level 3...

Paediatric Units Data and Meeting Booklet24 April 2017

2

3

Categorisation of Donation Activity by Level

Level 1 12 or more proceeding donors per year (averaged over two years) 33

Level 2 5-12 (> 5 to < 12) proceeding donors per year (averaged over two years) 45

Level 3 3-5 (≥ 3 to ≤ 5) proceeding donors per year (averaged over two years) 47

Level 4 < 3 proceeding donors per year (averaged over two years) 46

For clarity 12 donors = Level 1 5 donors = Level 3 3 donors = Level 3 An additional descriptor is applied to each hospital, as appropriate. N = Adult Neuro ICU (29) P = Paediatric ICU (25) T = Major Trauma Centre (21)

– currently only applies in England pending possible changes in Northern Ireland, Scotland and Wales

Examples Level 1 (NPT), is a hospital Trust / Board that has 12 or more proceeding donors per year and also has a Neuro ICU, is a Major Trauma Centre and has a Paediatric ICU. Level 3 (P), is a hospital Trust / Board that has ≥ 3 to ≤ 5 proceeding donors per year and has a Paediatric ICU.

Trusts or Boards

34!

UK Donation by Level

Level 1 Level 2 Level 3 Level 4

Potential DBD/Eligible DCD donors

Potential donors after brainstem death (DBD) are defined as patients who have neurological death suspected by meeting all of the following criteria: apnoea, coma from known aetiology and unresponsive, ventilated, fixed pupils. Excluding those for whom cardiac arrest occurred despite resuscitation, brain stem reflexes returned. Eligible donors after circulatory death (DCD) are defined as patients who had treatment withdrawn and death was anticipated within four hours, with no absolute medical contraindications to solid organ donation.

Actual Donors

1st October 2015 – 30th September 2016 !

1st October 2015 – 30th September 2016 !

Level 1Level 2Level 3Level 4

Level 1

Level 2

Level 3

Level 4

2674(46%)

1527(26%)

1103(19%)

552(9%)

749(54%)

343(25%)

213(15%)

83(6%)

(19%)

(6%)

(25%)

(49%) 1348(49%)

685(25%)

518(19%)

173(6%)

Potential DBD/Eligible DCD donors1st October 2015 – 30th September 2016

(17%)

(6%)

(21%)

(53%)

689(53%)275

(21%)

223(17%)

103(8%)

Actual donors1st October 2015 – 30th September 2016

Level 1 Level 2 Level 3 Level 4

Potential DBD/Eligible DCD donors

Actual donors

UK Donation by Level

4

UK actual deceased donors1st October 2006 – 30th September 2016

Oct 06 - Sep 07

Oct 07 - Sep 08

Oct 08 - Sep 09

Oct 09 - Sep 10

Oct 10 - Sep 11

Oct 11 - Sep 12

Oct 12 - Sep 13

Oct 13 - Sep 14

Oct 14 - Sep 15

Oct 15 - Sep 16

Year

0

200

400

600

800

1000

1200

1400

Num

ber

DCDDBD

607

174

616

238

601

312

637

355

659

402

647

485

765

534

790

499

763

527

785

603

Paediatric Group actual deceased donorsDonors

5

Paediatric Group actual deceased donorsDonors

6

Paediatric Group keyKey Trust/Board1 Alder Hey Children's NHS Foundation Trust

2 Barts Health NHS Trust

3 Belfast Health and Social Care Trust

4 Birmingham Children's Hospital NHS Foundation Trust

5 Cambridge University Hospitals NHS Foundation Trust

6 Cardiff And Vale Health Board

7 Central Manchester University Hospitals NHS Foundation Trust

8 Great Ormond Street Hospital For Children NHS Foundation Trust (including both PICU and cardio ICU)

9 Guy's and St Thomas' NHS Foundation Trust

10 Imperial College Healthcare NHS Trust

11 King's College Hospital NHS Foundation Trust

12 Leeds Teaching Hospitals NHS Trust

13 NHS Greater Glasgow & Clyde

14 NHS Lothian

15 Nottingham University Hospitals NHS Trust

16 Oxford University Hospitals NHS Trust

17 Royal Brompton & Harefield NHS Foundation Trust

18 Sheffield Children's NHS Foundation Trust

19 South Tees Hospitals NHS Foundation Trust

20 St George's Healthcare NHS Foundation Trust

21 The Newcastle Upon Tyne Hospitals NHS Foundation Trust

22 University Hospital Southampton NHS Foundation Trust

23 University Hospitals Bristol NHS Foundation Trust

24 University Hospitals Of Leicester NHS Trust

25 University Hospitals Of North Midlands NHS Trust

7

Paed

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roup

: mis

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PIC

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ot

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DD

CD

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ey C

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datio

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ust

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(6)

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s H

ealth

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Of N

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land

s N

HS

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t0

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0 (0

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Not

e th

at p

atie

nts

may

app

ear

in m

ore

than

one

gro

up

(N) =

the

num

ber

of

oppo

rtun

ities

8

Missed opportunities in Neurological Death TestingPICU data, 2016

Number that w ere testedNumber of patients not neurological death tested

Year

Num

ber

St George'sSouthamptonSouth TeesSheffieldRoyal B&H

OxfordNottinghamNorth MidlandsNewcastleLothian

LeicesterLeedsKing'sImperialGuy's & St Thomas'

Greater G&CGOSHCentral ManchesterCardiffCambridge

BristolBham Children'sBelfastBartsAlder Hey

20122013

20142015

20162012

20132014

20152016

20122013

20142015

20162012

20132014

20152016

20122013

20142015

2016

048

12

048

12

048

12

048

12

048

12

Missed opportunities in DBD referralPICU data, 2016

Number of DBD that w ere referredNumber of DBD patients not referred

Year

Num

ber






20122013

20142015

20162012

20132014

20152016

20122013

20142015

20162012

20132014

20152016

20122013

20142015

2016

048

12

048

12

048

12

048

12

048

12

Neurological Death Testing2012–2016

DBD referral2012–2016

9

Missed opportunities in DBD SNOD involvementPICU data, 2016

Number of approaches that did involve a SNOD (DBD)Number of approaches that did not involve a SNOD (DBD)

Year

Num

ber






20122013

20142015

20162012

20132014

20152016

20122013

20142015

20162012

20132014

20152016

20122013

20142015

2016

036

036

036

036

036

Missed opportunities in DBD consent/authorisationPICU data, 2016

Number of DBD that consented/authorisedNumber of families not consenting/authorising to DBD donation

Year

Num

ber






20122013

20142015

20162012

20132014

20152016

20122013

20142015

20162012

20132014

20152016

20122013

20142015

2016

0

4

8

0

4

8

0

4

8

0

4

8

0

4

8

DBD SNOD involvement2012–2016

DBD consent/authorisation2012–2016

10

Missed opportunities in DCD referralPICU data, 2016

Number of DCD that w ere referredNumber of DCD patients not referred

Year

Num

ber






20122013

20142015

20162012

20132014

20152016

20122013

20142015

20162012

20132014

20152016

20122013

20142015

2016

0

20

40

0

20

40

0

20

40

0

20

40

0

20

40

Missed opportunities in DCD referral (shorter axis to focus on recent data)PICU data, 2016

Number of DCD that w ere referredNumber of DCD patients not referred

Year

Num

ber






20122013

20142015

20162012

20132014

20152016

20122013

20142015

20162012

20132014

20152016

20122013

20142015

2016

0

10

20

0

10

20

0

10

20

0

10

20

0

10

20

DCD referral2012–2016

DCD referral (shorter axis to focus on recent data)

11

Missed opportunities in DCD SNOD involvementPICU data, 2016

Number of approaches that did involve a SNOD (DCD)Number of approaches that did not involve a SNOD (DCD)

Year

Num

ber






20122013

20142015

20162012

20132014

20152016

20122013

20142015

20162012

20132014

20152016

20122013

20142015

2016

048

048

048

048

048

Missed opportunities in DCD consent/authorisationPICU data, 2016

Number of DCD that consented/authorisedNumber of families not consenting/authorising to DCD donation

Year

Num

ber






20122013

20142015

20162012

20132014

20152016

20122013

20142015

20162012

20132014

20152016

20122013

20142015

2016

048

048

048

048

048

DCD SNOD involvement2012–2016

DCD consent/authorisation2012–2016

12

17

Applying Plan Do Study Act (PDSA) Methods

Why? Why?Why?

Cycle end date: Cycle start date:

Issue: Cycle number:

Why?

X

Guide to completing your PDSA cycle template

State here your main ‘why’ This should be your root causeNow question your main ‘why’

Explain what your next steps will be now that your first cycle has come to an end. If the cycle was successful: You will have achieved your primary goal. As no further cycles are required make sure you delete any blank slides.If the cycle was not successful: Copy your current cycle, paste the text onto the next template and adapt the plan and do sections accordingly.

What are you trying to achieve?

Explain what you are going to do and why. You will find an example on slide 3. which should help you complete this.

Explain what it is that you actually did. This may differ to what you had initially planned to do.

Note the lessons that you have learnt, addressing any problems that you found and summarising your result.You will find an example on slide 3. which should help you complete this.

What is the issue/problem?

dd/mm/yyyy dd/mm/yyyy

Why? Why?Why?


Issue: Cycle number:Hints & tips to help you complete your PDSA cycle

1. Plan: Be clear about the primary goal you aim to change, the questions that need to be answered and what is expected to happen. Plan how the PDSA cycle will be carried out, specifying who will be responsible for implementing the plan, where andwhen it will be tested, what will be done and what the expected outcomes might be.

Notes: when running PDSA cycles•Don’t think too big. Implement a small simple change as this is more likely to be successful.•Don’t be too vague or too detailed - some detail is needed but to a practical, not obsessive, level.•Make sure the results are acted on.•In practice more than one PDSA cycle can be run at a time as long as they are small and simple.

2. Do: Carry out the plan and record the agreed measures and outcomes carefully. Ensure that any problems or other unexpected events are also documented.

3. Study: Compare what the outcomes were to what you thought would happen. Ask those who were involved and study whatactually happened, noting problems and other unexpected events. Summarise the outcome of the pilot.

4. Act: As a team decide what should happen next? Should the same primary goal be kept but the cycle repeated, should the primary goal be adapted and the cycle run again or should the cycle be stopped. Make the decision based on what was learnt fromthe PDSA cycle. It is possible that a single PDSA cycle will show a primary goal that can be achieved and be applied more widely or even adopted into routine practice. However, remember that several cycles might have to be run before a primary goal of a PDSA cycle is successfully adopted into normal practice.

To Start: Identify issue to be addressed and drill down using 3 whys to create your primary goal.

Each primary goal should have at least 1 PDSA cycle. Each cycle has 4 sections which are listed below:

17

Applying PDSA methods

Why? Why?Why?


Issue: Cycle number:

Why?

X

Guide to completing your PDSA cycle template

State here your main ‘why’ This should be your root causeNow question your main ‘why’

Explain what your next steps will be now that your first cycle has come to an end. If the cycle was successful: You will have achieved your primary goal. As no further cycles are required make sure you delete any blank slides.If the cycle was not successful: Copy your current cycle, paste the text onto the next template and adapt the plan and do sections accordingly.

What are you trying to achieve?

Explain what you are going to do and why. You will find an example on slide 3. which should help you complete this.

Explain what it is that you actually did. This may differ to what you had initially planned to do.

Note the lessons that you have learnt, addressing any problems that you found and summarising your result.You will find an example on slide 3. which should help you complete this.

What is the issue/problem?

dd/mm/yyyy dd/mm/yyyy

Why? Why?Why?


Issue: Cycle number:Hints & tips to help you complete your PDSA cycle

1. Plan: Be clear about the primary goal you aim to change, the questions that need to be answered and what is expected to happen. Plan how the PDSA cycle will be carried out, specifying who will be responsible for implementing the plan, where and when it will be tested, what will be done and what the expected outcomes might be.

Notes: when running PDSA cycles•Don’t think too big. Implement a small simple change as this is more likely to be successful.•Don’t be too vague or too detailed - some detail is needed but to a practical, not obsessive, level.•Make sure the results are acted on.•In practice more than one PDSA cycle can be run at a time as long as they are small and simple.

2. Do: Carry out the plan and record the agreed measures and outcomes carefully. Ensure that any problems or other unexpected events are also documented.

3. Study: Compare what the outcomes were to what you thought would happen. Ask those who were involved and study what actually happened, noting problems and other unexpected events. Summarise the outcome of the pilot.

4. Act: As a team decide what should happen next? Should the same primary goal be kept but the cycle repeated, should the primary goal be adapted and the cycle run again or should the cycle be stopped. Make the decision based on what was learnt from the PDSA cycle. It is possible that a single PDSA cycle will show a primary goal that can be achieved and be applied more widely or even adopted into routine practice. However, remember that several cycles might have to be run before a primary goal of a PDSA cycle is successfully adopted into normal practice.

To Start: Identify issue to be addressed and drill down using 3 whys to create your primary goal.

Each primary goal should have at least 1 PDSA cycle. Each cycle has 4 sections which are listed below:

13

Exam

ple

of P

DSA

cyc

le

18

Why

?W

hy?

Why

?

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3

Paediatric Units Data and Meeting Booklet · 3 4! UK Donation by Level Level 1 Level 2 Level 3...

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Transcript of Paediatric Units Data and Meeting Booklet · 3 4! UK Donation by Level Level 1 Level 2 Level 3...