Our level 2 Paediatric Critical Care Unit team has advanced Acute Paediatric Non-Invasive Ventilation (NIV). We have along the way radically changed the the way we think & work. This has included significantly improving the safety (e.g.  huddles, checklists & actively seeking parental inclusion) & so enabled us to push boundaries of practice in 13 different aspects of care which revolutionised the entire pathway for NIV in severe bronchiolitis. A 'gain' in improved quality and/or efficiency in each area led to a very significant overall large gain in patient care e.g. saving 60 infants from needing PICU in 3 years, reducing LOS by 48 hrs. The work has been recognised by coming 2nd in two national HSJ awards & 1st in regional KSSAHSN Quality award in 2016 & 2017.

The ripple effects have included other areas being improved, greater staff retention, improved recruitment. We will continue our journey, hungry to learn from others & to share our learning.