Teamwork plays a critical and growing role in high quality cancer care. This award is given to an outstanding team who have made a significant contribution to patient care, treatment or cancer management.
SCIF – the Significant Clinical Incident Forum
Velindre Cancer Centre
The Significant Clinical Incident Forum (SCIF) is a novel multi-professional group that investigates clinical incidents and untoward clinical outcomes thoroughly and independently with the aim of fostering an open culture towards clinical incidents and disseminating learning from care episodes as widely as possible.
The multi-professional nature of the team enables it to work with all professional groups at the Cancer Centre. SCIF investigations have led to clear benefits in patient care/outcomes and also to specific inter-professional learning events that enable colleagues to learn from incidents and help reduce them in the future.
It has had a major impact on patient care and education practices in Velindre Cancer Centre and within the Cancer Network with measurable improvements in patient care.
SCIF has worked with colleagues in Primary and Secondary Care across the Cancer Network, developed links with local GPs regarding assessment of chemotherapy patients in the community and created local guidelines for GPs in this area.
It has organised an inter-disciplinary learning session on spinal cord compression, resulting in the writing of a specific educational workbook and the development of network wide referral guidelines.
eBooking – an electronic patient referral system in radiotherapy
Leeds Teaching Hospitals NHS Trust
The multi-disciplinary team in the radiotherapy department at St James’ Institute of Oncology in Leeds has pioneered an innovative project to ensure instantaneous receipt of patient referral forms from across the Yorkshire Cancer Network for radiotherapy treatment.
The team has worked collaboratively to project manage and sucessfully implement a fully integrated electronic referral system that has customised existing software and interfaces with other hospital systems.
This cost-neutral project has completely replaced paper-based referrals with a more robust, safe and efficient electronic system. The new system is more cost effective and will enable futher developments to increase efficiency and workflow modelling.
The project was designed and promoted using an iterative model of software development to analyse requirements, design functionality, implement solutions, evaluate and then repeat the cycle. Throughout, the team worked tirelessly with different hospitals and disciplines to deliver this project to a successful conclusion.
The work was shared with the wider radiotherapy community and the impact of this project is becoming widely recognised, with a number of centres requesting to come and see how the project was developed and implemented.
The huge success of the project is a direct result of the innovation, creativity and determination of the multi-disciplinary radiotherapy team at Leeds.
To provide and implement evidence-based clinical guidelines on appropriate post-operative enteral tube feeding routes following head and neck cancer surgery
The Oxford Head and Neck Cancer Multidisciplinary Team, Oxford University Hospitals (NHS) Trust
Nutritional support is essential during treatment for head and neck cancer (HNC) and requires proactive decisions within the multi-disciplinary team (MDT) regarding appropriate placement of enteral feeding tubes.
NICE guidelines state that gastrostomy feeding should be considered in people likely to need long-term enteral tube feeding for four weeks or more; and that there should be specific guidelines on the use, placement and management of gastrostomy tubes in HNC patients.
There was a lack of data related to length of tube feeding following HNC surgery and no clinical guidelines on appropriate feeding routes. This resulted in inconsistencies in practice, increased costs, risks and inefficiencies at the Trust, affecting patient care.
The team collected baseline data for 150 HNC patients tube fed post-operatively between April 1, 2006 and March 31, 2008. Data was entered on to an analytical database (Chiron), stringently verified and extensively analysed in order to recommend appropriate tube feeding routes following HNC surgery. The team then presented the findings, which were implemented by the MDT in Oxford. Data collection continued for a further two years from April 1, 2008 to March 31, 2010 (181 patients) to determine changes in clinical practice.
The second two-year data set showed a reduction in the number of patients tube fed via a nasogastric tube for more than four weeks from six to one; and the number of patients tube fed via a gastrostomy tube for less than four weeks reduced from 22 to 13, compared with the previous two-year period, demonstrating an improvement in clinical practice.
The clinical guidelines are compliant with NICE guidelines, improving quality of care for patients and contributing to NHS efficiency savings. The MDT is cohesive and collaborative and considers, discusses and agrees on appropriate nutritional support for each patient.