Improvers of the month!


Publication for IS4 alumni team

We are celebrating IS4Ac cohort three team, ERAS+, on their recent publication in the Journal of the Association of Anesthesia of Great Britain and Ireland. The article is titled Impact of a peri-operative quality improvement programme on postoperative pulmonary complications, and is available online.

That’s why we’re celebrating ERAS+ in our Improver of the Month series, here’s their story…


Team: ERAS+
| Central Manchester Foundation Trust
Domain | Cancer
Team members | Dr. John Moore, Consultant in Anaesthesia and Intensive Care Medicine
Mr. Thomas Satyadas, Consultant, Donna Cummings, Nurse, Sarah France, Enhanced Recovery Sister, Jo Hunt, Ward Matron, Nicola McGill, Critical Care and Surgery Physiotherapist and Nicola Larkam, Directorate P.A.

What was your IS4 project aim? Their project aim was to improve the five-year survival for Manchester cancer patients.

In a nutshell? There was a need to reduce the length of stay following major elective surgery at Central Manchester Foundation Trust: to address this, a multi-layered approach was developed which encompassed patient education and the creation and implementation of ICough UK. ICoughUK is a series of simple interventions which have shown to reduce lung complications in patients following surgery. These interventions were supported by a suite of resources and multimedia.

What changes were implemented? ICough UK was developed. Surgical patients were educated their upcoming surgery in preparation sessions led by multidisciplinary ERAS+ teams. These sessions were supported by ICOUGH UK information videos and other multimedia support. The ERAS+ICOUGH pathway was embedded within the critical care nursing and medical team structure.

What were the outcomes of your IS4 project?

  • Since September 2014, a 40% reduction in pulmonary complications has been achieved with the utilisation of ERAS+ in a surgical population of greater than 500 patients within a NHS teaching hospital. There was a reduction in number of tablets by
  • 30% Pathway innovation was supported by talking to patients and their relatives through sponsored listening sessions.
  • The team had developed a YouTube channel to promote their work.


Since completion of IS4, have their been any updates to your improvement project? Since completing the programme, ERAS+ plan to continue working on similar projects within the Trust and beyond, disseminating improvement skills and expertise both locally and nationally within the NHS.

The team won first place in Patient Safety Week Project 2016, were finalists in the 2016 QIC Oncology Awards for Patient Care Pathway and have been featured in NHS England Innovation Exchange (page10).

In November 2016, the team were also awarded one of eight prestigious NHS Innovation Accelerator (NIA) Fellowship to roll out the successful enhanced recovery surgery pathway ERAS+, also featured in this case study and on CMFT.

Finally, an article has been published in the Anesthesia Journal, read the article in full online, authors: J. A. Moore Consultant, D. H. Conway Consultant, N. Thomas Specialist Registrar, D. Cummings Sister and D. Atkinson Consultant. The paper acknowledges the support of Central Manchester University Hospitals NHS Foundation Trust Transformation Team and by the Manchester Academic Health Science Centre Partnership in collaboration with Haelo.

Find out how you and four colleagues could be joining the next IS4 cohort with your improvement project. Applications now open for cohort three, Improvement Science for Leaders (IS4L).

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