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Recognised for Developing the Most Innovative Idea

Recognised for Developing the Most Innovative Idea


We are extremely proud to report that Dartford and Gravesham NHS Trust have been recognised for developing the most innovative idea as part of the NHS Improvement Pressure Ulcers Collaborative; 120 day improvement Programme.

In September 2018 the Trust were invited by NHSI to participate in a 120 day improvement collaborative. The aim of the improvement collaborative was to deliver an improved experience for vulnerable patients across clinical and community settings whilst also seeking to measure and monitor care.


The collaborative approach was to support 25 Trusts in the delivery of their improvement programmes through opportunity to focus on improvement skills, share work and network with others undertaking work in relation to pressure ulcers.


The Trust Tissue Viability action plan identified the need for review of pressure ulcer prevention in the Emergency Department / Cypress unit and the Acute Medical Unit, with the aim to reduce Category 2 pressure ulcers within the first 7 days of admission.


From reviewing the patient pathway through the department the collaboration team were able to identify the problems staff encountered around preventing pressure ulcers.


The pressure ulcer collaborate members for this Trust are:


  • Deborah Everitt (Lead Tissue Viability Nurse)
  • Zoe Evans (Tissue Viability Clinical Nurse Specialist)
  • Nicole Feltham (Tissue Viability Nurse PA) 
  • Louise Cole (Emergency Department Matron)  
  • Rebecca Beck (Emergency care paramedic)
  • David Coombs (Practice Development Nurse)
  • Yvonne Davidson (AMU Nursing Assistant)
  • Selina Cooper-Thorne (Emergency Department Nurse)
  • Swapna Sukumaran (Cypress SSR)


The team were were also supported by Jennie Hall, (the Programme Director/ Strategic Nursing Adviser from NHS Improvement) who visited the Trust on the 1st March 2019. Jenny visited on ED/Cypress and AMU who showed her the changes in practice and discussed the on-going plan to manage patients ‘at-risk’ of pressure ulcers.


Changes implemented:


  • Adding in a quick screening tool to identify those patients needing support with pressure ulcer prevention
  • Having additional trolley toppers and foam boots available for patients identified as ‘at risk’ of pressure ulcers.
  • Having end of bed visual signs to identify (to staff) patients needing skin checks and repositioning.
  • The improved handover of the patient’s skin integrity and planning for equipment in advance to ward transfer.


Members of the team also travelled to London and Birmingham during this time to look at;


  • A model for improvement ACT-PLAN-DO-STUDY improvement methodology in practice
  • driver diagrams,
  • process mapping and
  • measuring improvement.


The 20th March was the final time the Collaborative group would meet. Team members travelled to London to present the work that had taken place over the 120 days.


We are so proud that Dartford and Gravesham NHST have been recognised for developing the most innovative idea as part of the NHS Improvement Pressure Ulcers Collaborative; 120 day improvement Programme.


We were the only Trust who attempted changes in the Emergency Department!