Respiratory Governance Meeting

Specialty: Lung and Sleep Specialist **1.0** **Welcome and Introductions** "For minuting purposes, this meeting will be recorded" **2.0** **Apologies for Absence:** * Dr. Emily Thorne (Consultant Pulmonologist) * Nurse Manager Sarah Jenkins (Respiratory Ward) **3.0** **Declarations of Interest** Dr. David Lee declared an interest in Agenda Item 9.5 due to his involvement in the development of the new 'Asthma Exacerbation Management' guideline. No other interests were acquired since the previous meeting. **4.0** Minutes The minutes from the previous meeting on 1 November 2024 were reviewed and approved as an accurate record. There were no amendments or corrections required. The team acknowledged the progress made on the actions stemming from the last meeting. **4.5** Letter Review – Oldest Letter Date / Letter amount The oldest letter reviewed was dated 1 October 22, and a total of 12 letters were reviewed. The letters predominantly concerned patient follow-up requests and external referral clarifications. **5.0** Actions Schedule- 1 November 2024 * **Action:** Review and update Sleep Apnoea pathway. **Responsible Person:** Dr. Alex Chen. **Deadline:** 15 November 2024. **Status:** In progress. **Completion Notes:** Initial draft circulated to team for feedback. * **Action:** Finalise new PFT (Pulmonary Function Test) booking system. **Responsible Person:** Admin Lead, Ms. Green. **Deadline:** 8 November 2024. **Status:** Complete. **Completion Notes:** System successfully implemented and training provided to relevant staff. **7.0** **SAFE** **7.1** Incidents Overview A total of 3 minor incidents were reported this month. These included one medication error (incorrect inhaler dosage given), and two instances of delayed patient transfers from ED to the respiratory ward. The medication error was classified as low severity and a root cause analysis is underway. The delayed transfers are being investigated to identify systemic issues and prevent recurrence. **7.2** Risks overview One new risk was identified: potential for staff burnout due to increased patient demand during flu season. This has been added to the risk register with a rating of moderate. Mitigation strategies include increasing sessional availability for locum cover and reviewing current staff rotas. No changes to existing risk ratings were noted, and no risks were closed this period. **8.0** **Caring** **8.1** Patient Complaints and Concerns – Two patient complaints were received. One concerned a perceived lack of communication regarding treatment options for COPD, and the other related to waiting times for sleep study appointments. Both are currently under investigation. The themes identified are communication and access to services. Learning points will be shared upon completion of the investigations. **8.2** Patient Compliments Numerous patient compliments were received, predominantly highlighting the compassionate care provided by the nursing staff on Ward 6. Specific examples included praise for Nurse Thompson's explanation of nebuliser treatment and the overall supportive atmosphere created by the respiratory therapy team. Dr. Patel was also recognised for his thorough explanation of a lung cancer diagnosis. **8.3** Friends and Family Test Results and Action Plans The Friends and Family Test received a 75% response rate this month, with a 'likely to recommend' score of 85%. This indicates a positive trend. Key themes from feedback included satisfaction with clinical care but concerns regarding car parking facilities. An action plan has been initiated to liaise with hospital management regarding car park improvements and explore alternative transport options for patients. **9.0** **Effective** **9.1** Clinical Outcomes/ feedback from M&M meetings The recent Morbidity and Mortality meeting reviewed a case of post-operative respiratory distress following thoracic surgery. Key learning points included the importance of early recognition of deteriorating respiratory function and timely escalation. Actions identified included a refresher training session on early warning score (EWS) application for junior doctors and nursing staff. **9.2** Clinical Audits/Effectiveness/ NCEPOD The 'Asthma Inhaler Technique' audit showed a compliance rate of 78%, an improvement from the previous quarter. Findings highlighted a need for further patient education on correct inhaler usage. The NCEPOD report on 'Management of Community-Acquired Pneumonia' was reviewed, indicating general adherence to guidelines, with minor gaps identified in initial antibiotic prescribing for severe cases. Improvement actions include targeted prescribing audits. **9.3** NICE quality standards Three new NICE guidance documents were reviewed this period, focusing on interstitial lung disease diagnosis and management. The department's compliance status is currently 90%. Gaps identified relate to access to specific advanced diagnostic imaging. Implementation plans include a business case submission for new imaging equipment. **9.4** Research Ongoing research includes a trial on novel bronchodilator therapies for severe asthma, with 15 new patients recruited this quarter. Completed research on the effectiveness of pulmonary rehabilitation in post-COVID patients demonstrated significant improvements in lung function and quality of life. Future research plans include exploring AI applications in predicting COPD exacerbations. **9.5** Clinical Guidelines for ratification * 'Asthma Exacerbation Management' Guideline, authored by Dr. David Lee and Dr. Fiona Clark, review date 1 October 2024. Ratification decision: Approved. * 'Management of Pleural Effusion' SOP, authored by Respiratory Nurse Specialists, review date 15 September 2024. Ratification decision: Approved with minor amendments.