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A quality improvement project from two NHS 111 contact centre staff has led to the rollout of a CPR metronome to help provide life-saving support. 

In 2018 urgent care provider Integrated Care 24 (IC24) invested in the design and implementation of an innovative Quality Champions Programme (QCP). The QCP is designed to support and empower staff to improve quality in the workplace to ensure that quality and social value is at the heart of everything the organisation does. It supports students through a number of classroom based sessions prior to designing and presenting a quality improvement project of their choosing.

IC24 operates across four counties – Kent, Sussex, Norfolk and Essex – providing urgent care services such as NHS 111 and face to face urgent care services, often known as the ‘out of hours’ services, to a population of over six million people.

As a social enterprise, any surplus the organisation makes is reinvested back into the organisation for the benefit of patients and employees.

Tiffany Smith and Charlotte Mitchell, who work at IC24’s head office in Ashford, identified an opportunity to improve the quality of CPR advice offered. Although NHS 111 is a non-emergency service, sadly there are times when patients enter cardiac arrest during a call and health advisors need to provide CPR instructions over the telephone.

Tiffany and Charlotte researched the number of calls where this was the case and identified a year on year increase in the number of calls that needed CPR advice. Working with IT colleagues, a metronome was built into IC24’s clinical system (CLEO) to ensure all call handlers have immediate access to the metronome to help deliver the exact number of required beats per minute in every call.

The metronome is now available across IC24’s three contact centres, which serve a combined population of nearly three million people across Kent, Essex and Norfolk on a 24/7 basis.

Dr Andrew Catto, Chief Medical Officer at IC24 said: "The introduction of a metronome is great news for our patients and our people. It means that each time we need to support a caller in delivering CPR our health advisors will be able to do it to the exact number of beats per minute, every time, to give that patient the best possible chance of survival. We know that our front line colleagues have lots of skills, and the knowledge to help make our service better. The QCP is about empowering them to bring those skills to the fore with the support of other departments."

David Brown, Director of Digital Technology and Performance at IC24 said: "We are the only urgent care provider to have built our own clinical system (CLEO). The benefit of this is that we have agility to design and implement new and innovative features that directly meet the requirements our clinicians and service users. The idea for the metronome shows how we can collaborate and develop ideas with our front line teams. We plan to develop the project further by implementing an ‘emergency’ button within the system. This will help our health advisors bypass certain questions when it is clear that the call they have answered is an emergency rather than a routine 111 call."

In September 2019, the Quality Champions Programme was shortlisted in the employee engagement category of the UK Social Enterprise Awards.