Opportunities to PRevent Admissions (OPRA)

The Cardiovascular Strategic Clinical Network is delivering a project called Opportunities to PRevent Admissions (OPRA).

OPRA identifies potentially preventable emergency admissions under four headings:

  • Cardio-embolic stroke in a patient with Atrial Fibrillation (AF)
  • Readmission with heart failure
  • Diabetic foot amputation
  • Acute kidney injury

The OPRA audit tool provides a link back to Primary Care from Secondary Care to identify and support the learning from individual cases, as a means of improving practice and preventing admissions, across the whole patient pathway (primary care, secondary care etc). Each of these problem areas is being assessed in a different Clinical Commissioning Groups (CCG) area in the South West as part of a collaborative approach between Clinical Commissioning Groups, Cardiovascular Strategic Clinical Network and local Trusts as below:

  • Atrial Fibrillation – NEW Devon CCG (East Devon area) and Royal Devon & Exeter Hospital, Cornwall CCG and Royal Cornwall Hospital Trust
  • Diabetic foot amputation – Gloucestershire CCG and Gloucestershire Hospitals NHS Foundation Trust.
  • Heart Failure –Taunton & Somerset Trust +Somerset CCG
  • Acute Kidney Injury – Gloucestershire CCG and Gloucestershire Hospitals NHS Foundation Trust

The AKI project was the first to be completed and the results discussed at a joint

meeting in July 2014 with the CCG commissioners, Gloucestershire Hospitals NHS

Foundation Trust and GPs who had taken part in the audit, to draw out learning and

agree actions for improvement.

The audit tools developed for all these projects are available for CCGs across the

South West, for those who are interested in looking at any of these pathways in their area.

For further information about any of the above, please contact:

Rachel Levenson

Programme Manager

South West Cardiovascular Strategic Clinical Network