Improving Care Bundle Implementation: Measurement and Reporting Requirements

Enhance care bundle implementation through effective data collection, reporting, and measurement strategies. From establishing baselines to monthly monitoring and yearly audits, this guide provides a comprehensive framework to track and demonstrate improvement in hospital care quality. Learn how to identify key outcome measures, optimize processes, and drive continuous improvement in your healthcare unit or facility.

• Care quality
• Data collection
• Reporting
• Measurement
• Healthcare improvement

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1. Data collection & reporting requirements AMBER care bundle 1

2. Measurement to support improvement Why measure? Support planning and implementation Minimum dataset: build collective evidence base Demonstrate improvement and impact within your hospital/unit You can t fatten a cow by weighing it You can t fatten a cow by weighing it (Palestinian proverb)

3. Baseline Baseline Baseline audit pre implementation Method: Method: Retrospective review of hospital notes Sample: Sample: 10 -15 consecutive patients who died in hospital Exclude: Exclude: Children and patients who were admitted to and died in HDU/ITU Audit: Audit: - Suitability for the AMBER care bundle - documented medical plan - documented escalation decision - evidence of MDT agreement - documented patient/carer discussion - readmission and interface with last days of life care

4. Monthly Monthly Monthly Use eMR reporting / Excel spreadsheet to collect: Number of patients where AMBER care bundle initiated Number of patients with last days of life care initiated Number of days patient on AMBER care bundle Any issues / key learning points A patient or staff story illustrating the impact

5. 12 months 12 months Annual More detailed information about patients who received care supported by the AMBER care bundle All data points via spreadsheet and/or the eMR AMBER care bundle quality audit similar to the baseline audit Patients who received care supported by the AMBER care bundle Any other evidence you may have collected

6. In your unit/facility Plan your measurement and identify: What do you need to demonstrate, and to whom? Outcome measures patients dying in preferred place of death readmission rates Decrease number of MET calls bereaved relatives views Process measure Appropriate patients identified compliance to the all four components of the care bundle What do you need to learn? What do you need to improve?

7. Be curious and look at multiple sources Patient demographics Rapid response data Readmissions GP experience Complaints Time spent with last days of life care plan Achievement of preferences for care Discharge letters Patient and carer experience

8. Patient, Relative, & Staff Feedback It was difficult to hear but I knew wasn t feeling better, I know now what's happening to me I didn t think the patient would deteriorate so quickly. I am glad I was able to talk to the relatives and prepare them for what may happen. Knowing that he may not recover (we just thought he would) earlier allowed us time to talk about what would happen to the house, and bank accounts. Which was important because at the end he couldn t talk to me anymore When I mention to a doctor that I think a patient is AMBER the doctor listens and revaluates the patients medical plan.

9. Contact Details Clinical Excellence Commission XXX LHD Cec-ambercare@health.nsw.gov.au Executive Sponsor Xxxx Clinical lead Medical Xxxxx Clinical Lead Nursing xxx The Clinical Excellence Commission wish to acknowledge the support of Guy s and St. Thomas Charity Modernisation Initiative and support from the King s College and South London and Maudsley Charitable Funds