Transcript HSCP28214DrCrowley.p
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