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National recognition for quality improvement project

Dr Keith Pohl, a junior doctor at Torbay Hospital, is the winner of the Quality Improvement Project of the Year 2017 category in the National Clinical Audit Support Group.

The award is in recognition of Dr Pohl’s work around reducing the use of a drug called cyclizine, an anti-sickness drug prescribed to gastroenterology patients.

This work has helped to reduce the use of the drug by about 80 percent at Torbay Hospital, saving around £13,000 per year while maintaining the best possible outcome for patients. 

cyclizine, is an anti-emetic drug and is administered to relieve nausea, vomiting and dizziness. It is often given intravenously in hospital to combat the side effects of others drugs or after anaesthetic, but can occasionally have some other adverse side effects for patients.

It is one of three drugs that can be used, but is around 30 times more expensive than the other options available, which are just as effective for anyone suffering from sickness. 

By educating gastroenterology staff about the use, efficacy and cost of the drug, and removing it as an option on pre-printed drug charts and displaying posters on drug cabinets, there was a huge reduction in the use of cyclizine and change in attitude toward its use.  

Dr Pohl said: “The things we have done sound really simple but they have been about enabling a big culture change among clinical staff about the use and cost-effectiveness of this drug.

“There is still a place for the drug, and in some cases this will still be the best option for some patients, but it has really been around getting clinicians to give more consideration for the other drug options out there. 

“As part of the project we evaluated our programme of work and we have seen a drastic improvement in our clinical staff’s understanding and knowledge about administering anti-emetics and their cost-effectiveness, which is excellent. 

“It has taken a lot of work but we are really proud of the recognition this project has received and we hope that other departments may be able to benefit from our learning in the future.”

Mairead McAlinden, chief executive of Torbay and South Devon NHS Foundation Trust, said: “In today’s NHS we must make the very best use of funding, and Dr Pohl’s work has demonstrated that we can save money and still provide the best of care.  

“He has demonstrated real leadership in how he has changed the practice of our clinical staff through this project. He is a role model for the doctors of the future, encouraging us all to think about the limited resources of the NHS and think differently about how things can be done to improve care.

“Only by continuing to change and improve can we keep pace with the needs of our population and give them the care they need from us. Dr Pohl’s project shows that the smallest of changes can make a difference, but it takes leadership and initiative to bring an idea into a change in practice. Well done to Dr Pohl. 

“We are taking the learning from this project and looking at how else we can replicate this work across the Trust and NHS.” 

The Trust is now in the process of looking at other ways in which this work can be replicated and how cyclizine is considered as an option elsewhere.