Safer Higher Quality Care for our Patients

HSCP Research Conference Friday 28 th February 2014

Dr. Philip Crowley, National Director QPS

Media coverage

€320k payout as hospital says sorry over death from dehydration

Healthcare System Failures

Where does improvement Happen?

National Group Ward

Quality Improvement of Patient care

Where Improvement Happens

Conditions

Leadership Patient involvement Clinical Governance Education & Learning: - Measurement - QI Methods National Group Ward

Quality Improvement of Patient care

A culture change – safety first

1.

Individual relationship between HSCP and patient 2.

Multidisciplinary Team / Ward 3.

Hospital / organisation

Patient and H+SCP

 Take ownership – accountable for the safety of care  Pivotal role in respecting and defending the dignity of every stage of life  Pivotal role in advocating for and on behalf of patients  What are the 3 biggest challenges that prevent me in delivering care – communicate out and up

MDT and Ward

 Leadership role in drawing others into supporting change  Engaging Patients and staff you manage  Safety Pause

MDT and Ward

 Understanding what safety and quality means for your ward  Safer Better Healthcare Standards  Multidisciplinary team prompts

MDT and Ward

 How well are you delivering Safe Quality Care  QA+I tool, clinical audit

Clinical audit guidelines

Hospital / Organisation

 Strong culture of Governance for Quality and Safety – be a champion for quality/question everything  Generate a culture of listening to your staff and patients  Quality and Safety Walkrounds  Transparency  Patients – open disclosure  Measurement – Quality Profile

Checklists

  Safe survey national policy and checklist Ward rounds principles for best practice and checklist

Open disclosure

 National Guidelines  National Policy  Guide for health and social care staff  Patient information leaflet  Staff support ‘assist me’ model

Quality Profile

Patient Experience Staff Experience Quality Improvement

+ Dashboard of Quality Indicators and Outcome Measures

2 1 0

Foreign Body left in Post Operatively

0 0 0 1 0 0 0 0 0 0 0 0 6 4 2 0

In hospital fracture

1 0 3 2 1 4 0 0 2 2 0 1 10 5 0

In hospitals falls

2 5 2 0 2 0 6 0 3 0 7 0 20 10 0

Accidental Puncture or Laceration

3 4 2 10 2 6 1 1 3 2 4 4 2 0 2

Transfusion Reaction

3 1 1 2 1.5

1 0.5

0

Iatrogenic Pneumothorax

1 4 2 0

Post Operative DVT / PE

3 2 1.5

1 0.5

0

Wound Dehiscence

1 4 2 0 1

Cardiac Arrest

3 2 1 1 2 1 0 4 2 0

Post Operative Hip #

2 1

Mortality Indicators

1.5

1 0.5

0

Time to Hip # surgery

1.5

1 0.5

0

Medication Management Pressure Ulcers

10 5 0 4 2 3 1 5 1 1 1 3 5 2 1

Post Operative Sepsis

10 5 0 2 6 6 3 4 1 1 5

Employees & Patients: Likelihood to Recommend Press Ganey Associates Patient Likelihood to Recommend 16

How can we support you?

Quality and Patient Safety Division Patients and Staff Engagement Improvement Supporting and Assuring Quality

Areas for focus by QPS

Listen to staff Foster development and growth Embrace Transparency through Measurement (Indicators/Clinical Audit) Listen to and empower patients Improve the Safety of Patients QI skills and knowledge

Patient central

 Patient Forums  National Healthcare Charter  Patient Safety Champions  Measuring experience  Surveys  Patient stories – from ward to board

Listening to Staff

 Staff experience – seek and value feedback/ideas for improvement  Patient Safety Culture Survey/ Walk-rounds  Prioritise staff welfare  ‘Walk in my shoes’

Elements of the National QI Programme Each parallel element targets a different level of healthcare professional, maximising penetration of QI capability across the hospital system

Measurement

 ASK FOR THE DATA    Data driven quality improvement Number of incidents plus trends  Ensuring preventable don’t keep reoccurring Quality Profile  New quality indicators  Patient experience and Staff experience  Complaints… Clinical audit Use data to generate light not heat

Berwick’s Challenge

      Abandon blame as a tool and trust the good will and good intentions of staff Reassert the primacy of working with patients and carers to achieve healthcare goals Use quantitative targets with caution – they should never displace the primary goal of better care Recognise that transparency is essential and expect and insist on it Give staff career-long help to learn, master and apply modern methods for quality improvement Make sure pride and joy in work, not fear, infuse the service

Thank You

Oh! The places you’ll go.....

And will you succeed? Yes! You will, indeed! (98 and ¾ percent guaranteed.) Kid, you’ll move mountains!

Today is your day!

Your mountain is waiting.

So…get on your way!

Dr. Seuss