Join HandsFirst3

Recruitment for HandsFirst3 is now live and will close on 31 July. 

This national improvement collaborative supports trusts and health boards to reduce surgical site infections through evidence-based interventions and shared learning. There is a one-off cost of £7,500 (£9,000 including VAT) per participating site, and trusts are expected to cover any travel or expenses for in-person meetings. A named project lead and data lead should have dedicated time in their job plans to lead the work locally.

If your trust or health board is considering joining HandsFirst3, we encourage you to attend our informational webinar at 8am on 13 June. This session is designed for those interested in learning more about the collaborative, including what’s involved, our support and the benefits of participating. You’ll also hear directly from the clinical leads and have the opportunity to ask questions. To register or request further details, please email handsfirst@rcseng.ac.uk. 

What are the benefits?

Watch this YouTube short to see Mrs Sarah Tucker, Clinical Lead for HandsFirst explain the benefits of joining HandsFirst3

HandsFirst3 will build on the success of HandsFirst1 and HandsFirst2.

Sites that join HandsFirst3 QI collaborative will receive:

• Support from clinical and QI experts through coaching sessions, email support and teleconferences
• Access to a local data platform
• Peer collaboration with colleagues at participating sites
• Attendance at webinars and collaborative events
• Specially designed programmes to meet each trust or health board’s specific needs
• Participation in leading change masterclasses for site leads

The project team will work with participating sites to: 

• Improve theatre utilisation by identifying which cases can be managed in alternative facilities.
• Improve patient flow by utilising more efficient and agreed pathways, which will relieve pressure on emergency departments and assessment clinics.

If trusts/health boards implement these service changes, they will likely save money as there will be a reduction in the use of main theatre facilities (with more cases being managed in procedure rooms). There will also be fewer complications from delayed surgery. As a result of offering patients more timely surgery, we expect trusts/health boards will see a reduction in complaints received and reduce the risk of litigation.

Timeline

• Jan 25–Jun 25: Recruitment, payment and set-up 

• Dec 25–Mar 26: Set up and launch

• Apr 26–Nov 26: Testing ideas in practice

• Dec 26–Apr 27: Demonstrating sustained improvement 

• May 27: Collaborative close

• Jun 27–Nov 27: Evaluation and reporting

Read our HandsFirst Learning report.

Project goals

That 80% of hand injuries that present to any service on the day of injury and require surgical intervention should have their first operation within the timeframe given in the BSSH hand trauma standards.

 These are specifically:

• Category 1: Within 24 hours for open joints and open fractures
• Category 2: Within four days for all other open hand injuries (96 hours)
• Category 3: Within seven days for closed hand fractures (168 hours)

Limb-threatening injuries requiring more urgent intervention are excluded. For example:

• Where revascularisation is required;
• Compartment syndrome;
• Where there is an infection or risk of infection from e.g. bite wounds.

The timeframes for children up to 10 years of age from an injury to the first surgical intervention for patients presenting within 24 hours are:

• Open joints and open fractures within 24 hours
• Other open hand injuries within three days (72 hours)
• Closed fracture of the hand within four days (96 hours)

That 80% of hand injuries that present to any service on the day of the injury and require surgical intervention should have their first operation within the timeframe given in the BOA Standards for Trauma and Orthopaedics (BOASTs). These are specifically:

• within 72 hours for intra-articular distal radial fractures
• within seven days for extra-articular distal radial fractures

The timeframes for children up to 10 years of age that present to any service on the day of the injury and require surgical intervention should have their first operation in the following timeframes:

• Open joints and open fractures within 24 hours
• Other open hand injuries within three days (72 hours)
• Closed fracture of the hand within four days (96 hours)

Project approach

The project will use a healthcare collaborative approach, defined as a short-term learning approach that brings together a number of teams from hospitals to seek improvement in a focused topic area.¹

Combined with QI methodology, the use of a QI collaborative aims to close the gap between potential and actual performance by testing and implementing changes quickly across many groups.² Project teams from each hospital will look at the best examples of care. Sharing of learnings within the collaborative allows each group to benefit from the successes and failures of others, addressing similar issues, reducing duplication of effort and allowing solutions to be reached more rapidly.

QI involves implementing multiple, rapid cycles of change in response to a specific, predetermined problem and adapting the approach based on the results seen from each change. This is known as a PDSA (Plan, Do, Study, Act) cycle and has the benefit of allowing solutions to be tailored to the local environment, taking into account the context of the hospital they are being implemented in.

Support from clinical and QI experts was provided by RCS England through coaching sessions, online meetings, webinars, email support, and the facilitation of group collaborative meetings.

Project team

Clinical lead:                  Mrs Sarah Tucker
RCS Council Lead:        Professor Vivien Lees
QI Consultant:                Maureen McGeorge 
QI Consultant:                Ruth Colville
Programme Manager:     Sheena MacSween    

Contact details

For more information, email handsfirst@rcseng.ac.uk.

For more information on RCS England's QI collaboratives

References