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SQUIPS at OUH

Welcome to the inaugural round of SQUIPS - Sustainability Quality Improvement Projects - at OUH! This is a collaboration between the QIP programme led Prof Helen Higham and the Sustainability Working Group chaired by Stuart Kinton.

Why SQUIPS?

Sustainability is vital for the delivery of healthcare, and as the future leaders of the health service this will come to a crunch point right in the peak of your careers. The SQUIP programme is a new subtheme of the QIP programme which has been successfully run by Prof Higham in recent years to advise and guide you through the QIP process to deliver your own QIP project. The SQUIP subtheme is specifically focussed on sustainability issues, and offers the same help available in the regular QIP process, but with a few key advantages:

  • Pre-packaged SQUIPS: Our oven-ready projects are based on the outcomes of the trust staff survey so they have inbuilt support across the trust. There are a number of different sustainability themes to choose from (see below). They can be adapted and badged for a number of clinical specialties for those thinking ahead in their careers, so a project can be an umbrella for many FYs working together, sharing resources and ideas to build a bigger more successful SQUIP. But if you have an idea for a project too, we can help you with that!
  • Additional support and mentorship: as well as the routine QIP programme support, you will have extra advice with the OUH Sustainability Working Group.
  • Bigger, better teams: become more effective and demonstrate greater leadership in a SQUIP with access to eager students and AHPs to make your project a success.
  • Business proposal training: for a QIP to make a difference you need to influence change, and that means speaking the language the trust understands best. Sessions later in the year will help supercharge your project!

How SQUIPS?

  1. Get in touch about a project you like the look of or a great idea you’ve had
  2. Register your project via Ulysses (making sure you highlight it’s a SQUIP)
  3. Save the world

Have a look at the ideas that came out of the Trust-wide sustainability survey to see if there is anything that interests you. Or if you have a better idea, that works too! Get in touch via this form https://forms.gle/NucZzx9NTxF5uwV27 so that we can help you prepare, then the rest of the process is exactly like a regular QIP with registration and the usual timelines as per Helen and Wendy.

Pre-packaged SQUIPS

Here is a list of our oven-ready projects. If you are interested, complete our survey so we can explore the projects further before registering formally with the QIP programme. There is plenty to go around and projects can be split (or merged) to accommodate interest.

Volatile anaesthetics: the dark cloud over healthcare

Concept

Modern anaesthetic gases such as desflurane and sevoflurane have a greenhouse gases effect thousands of times more potent than carbon dioxide. Nitrous oxide, though only hundreds of times more potent, is more widely used throughout the health system and depletes the ozone layer too. Overall, these gases are estimated to account for 5-7% of the NHS greenhouse gas emissions.

 

This SQUIP aims to:

  • Understand the use of environmentally impactful inhalational anaesthetics across specialties and sites
  • Identify opportunities to reduce use or switch agent where possible
  • Document progress so far in reducing or switching agents
  • Assess feasibility of gas scavenging

This is a broad project with plenty of scope for multiple specialties, sites, and objectives within the grander project to work synergistically to produce a far more impactful QIP than any one person tackling it alone.

Who might be interested?

Anaesthetics, ITU, Obs & Gyn, ED, and on a related theme, Respiratory due to a similar impact from inhalers

Theatre and endoscopy suite equipment use: from Refuse, to Reduce Reuse Recycle

Concept

The importance of preventing harm from healthcare associated infection, the risks from contaminated clinical waste, and the lucrativeness of the single-use business model conspire to generate an awful lot of waste. Contamination means that this must often be disposed as clinical waste: the most expensive for the Trust.

 

This SQUIP aims to:

  • Investigate ‘index’ procedures within each specialty
    • Record the lifecycle of equipment used to deliver a procedure
    • Identify reusable and disposable material use for that procedure
    • Identify opportunities to reduce, reuse or recycle
    • Calculate the environmental and economic impact of changes
  • Develop a toolkit 

    • Develop a toolkit to roll out across specialties and hospitals
    • Develop auditable standards for a given procedure
    • Gather data nationally to understand areas of improvement and opportunities for the future

This SQUIP has so many options and opportunities for multiple candidates to work together, plus the chance to not only reduce waste but save money at the same time.

Who might be interested?

All surgical and interventional medical specialties - orthopaedics, plastic, cardiology, gastroenterology, radiology - anyone who uses clean stuff once then bins it!

Remote working and telemedicine: a hidden impact of the pandemic

Concept

The pandemic has thrust many hospitals services into a newer, more digitally friendly way of delivering care, but as the lockdown eases and the novelty wears off, the risk of sliding back to the bad old days is present. What has worked and what hasn’t in remote working and virtual clinics? What are the risks and challenges? What has the impact been so far, and what best practice could we take forward?

 

This SQUIP aims to:

  • Calculate the cash and carbon savings associated with remote working and telemedicine
  • Identify specialty and condition specific barriers to effective telemedicine 

This could go a number of directions, including the perspective from the patients, from clinicians, and from telemedicine and heath tech point of view.

Who might be interested?

All specialties, and especially those of you with a health tech or innovation interest

Theatre masks and caps: get ahead of the pack

Concept

The #theatrecapchallenge took the simple step of writing your name on your theatre cap to enhance patient safety by improving communication and staff identification. But why do we bin our caps each day, yet we manage to launder scrubs?

 

This SQUIP aims to:

  • Understand waste and cost associated with disposable theatre caps and masks
  • Understand barriers to using reusable caps and masks  
  • Assess feasibility of a service to collect and clean reusable caps and masks as we have with scrubs

Who might be interested?

All surgical and interventional specialties

Paperless: dragging the NHS into the 20th century two decades into the 21st century

Concept

The caricature of the NHS form and fax is not without foundation, and though the Trust has a functioning electronic patient record, the role of paper is still there. The waste is twofold, as much of this must be kept as part of the record so cannot be recycled, but also inhibits the application of the data as useful clinical information unless it is transcribed into EPR.

 

This SQUIP aims to:

  • Identify the paper burden of a given form in a department or specialty
  • Identify the barriers and their solutions to making that process paperless

This project would suit not only anyone who has ever had the frustration of having to fill in a paper form (and worse still, fax it somewhere), but those with a health tech interest also. This project can be made rather small and discrete if you like, much accelerating the process of change.

Who might be interested?

Anyone who has every filled out a paper form about a patient and checked EPR to get their NHS number

Shuttle service: get from A-to-B to EV

Concept

The Headington sites spread services across a number of separate locations that are just on the upper limit of being walkable in the middle of a busy clinical day. We are well served by a shuttle minibus service, but these buses leave every 20 minutes and can often be seen idling with the engines running. Colleagues in Newcastle have just launched an electric vehicle shuttle service, and would be keen to help put together a business case and provide support to allow other trusts to emulate their success.

Who might be interested?

Those working at Churchill and NOC sites who also have JR commitments, and those who want a meatier project

 

Upstream Green: Supply side pressure

Concept

We can only work with what we have got, and many of our decisions are made for us by actions of our suppliers. As an organisation, taking responsibility for the impact our suppliers have on the environment is a powerful tool to both understand the whole cycle of the products we use, but also apply pressure. This project would initially involve contacting suppliers to the hospital to understand what actions they are taking to promote sustainability in their products and supply chain, then use this to understand how as a trust we can alter our environmental impact by changing our suppliers behaviour, or changing our supplier. Carrot and stick.

Who might be interested?

This one is very broad and has no specialty specific elements, but may suit someone with an interest in leadership and management due to the interactions required above the clinical level.