Case Study: Wessex Trainee Consultant Practitioner Programme

Carl Adams is a currently studying on a three year Trainee Consultant Practitioner Programme with Health Education England, Wessex.  As part of Carl’s training he regularly participates in our Quality Improvement Workshops as well as benefiting from online QI training and one-to-one coaching clinics.

Our approach at the Quality Improvement Clinic is to help individuals make a sustained difference to patient care. We facilitate and nurture skills acquisition and this fosters confidence for learners to set new goals and realise improvement for their patients.
As part of Carl’s ongoing QI learning and development he undertook a Quality Improvement Project: ‘The Comfortable Position – Positioning of the Stroke Arm’. The project ultimately resulted in Carl winning first prize at the Bristol Patient Safety Conference for his poster that demonstrated ‘Best Practice in Positioning the Affected Arm’

The QI methods and tools Carl learnt and developed through the Quality Improvement Clinics gave him the structure and direction for his chosen QI project which was focussed on patient outcome as well as obtaining a very good measure to support and guide the project. Ultimately these QI methods help improve the chance of project success and long term improvement in patient care.

“My QI experience is making a sustained difference to patient care and I have new skills and confidence to apply to future patient improvement projects.”


Quality Improvement Project – The Comfortable Position

 The problem

The poor and inconsistent positioning of a patient’s arm who had suffered significant paralysis following a stroke. Approximately 70% of stroke patients suffer altered arm function (RCP 2012) and on almost of one third of stroke ward patients require good arm positioning. Carl’s QI project endeavoured to solve the problem of inconsistent positioning of the stroke arm whilst the patient is in bed.

The Solution

The problem was addressed through the development of a five-point, best practice guide. It provided Carl with a tool to measure the size of the problem, to education those caring for these patients and to measure the improvement.

The outcome

The two measureable outcomes to Carl’s QI project have been: an improvement in the positioning of the stroke arm and an improvement in patient comfort. From published evidence, the former is likely to reduce the risk of long term complications such as pain, contractures and pressure problems for patients.

‘Best Practice to Positioning the Affected Arm’ Poster

Carl produced a storyboard as a poster. This allowed him to showcase all the components of this QI project presenting it in a clear and concise manner. The poster delivers clear and effective communication of the project including the observed problem and solution to all stakeholders and wider audiences.


Winning first prize at the Bristol patient safety conference has been a highlight for Carl and a boost to his confidence. It was commended for QI methodology, as well as the process and the impact on patient care. “I was very proud to win this prize but also this was an opportunity to share my project with a wider audience.

See Carl talk about his poster here

“The Quality Improvement Clinic has taught me the skills of QI, but rather than just being taught I have been able to apply them to my project. They have provided me with a learning environment which is practical, approachable and promotes individual development through training days, coaching and feedback. Most importantly they gave me mentoring and confidence to develop my skills from my project journey.”

With thanks to Carl Adams and the Consultant Practitioner Development Programme, Wessex and Thames Valley