Transcript Presentation to introduce the study to the Hospital Stakeholders ppt, 1.03Mb

User instructions
 This presentation is provided to assist with introducing the study to key
stakeholders of the health facility in which harmful incidents will be assessed
(facility managers, ethics council, etc.)
 The slides can be used to animate a face-to-face meeting (projected with a
beamer or used as talking points), serve as talking points for a telephone
conversation or, less ideally, be sent by email or distributed in hard-copy
 Deliver this introduction well in advance of the planned date of the study and
start preparing early (thoroughly read the slides, rehearse, etc.)
 Adapt the slides to local requirements and delete non-applicable slides
 Allow time to establish a relationship of trust with key stakeholders
 Clearly explain the need to tackle patient harm, but do not force anybody to
participate in the study
 Recommend a method, approach and time plan for the study, but be receptive
to input
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User instructions (continued)
 If you plan on using record review but are not sure whether the facility keeps
records, or if you are not very familiar with the quality of the facility’s records
and filing system (for retrospective record review), plan an alternative method
for if minimal criteria for record review are not met.
 Once at the facility, clarify whether the facility keeps records of current hospital
admissions (for record review of current in-patients) or whether the records of
last year’s hospital admissions are available (for retrospective record review).
If so, check a sample and, if records are sufficient, proceed with the
presentation. Otherwise, suggest the second most appropriate method and
proceed with the presentation of that.
 Provide further information if necessary and agree to a second meeting, or a
meeting with additional key stakeholders, if needed
 To allow thorough preparation, the study should be conducted no less than
two weeks after management have approved the initiative
 Ask for contact details and provide yours
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Why and how to study and improve patient
safety at your health facility
<insert your name, title and affiliation here>
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The need to tackle patient harm
 Every year tens of millions of patients throughout the world suffer disabling injuries
or death, due to unsafe medical care
 The consequences are millions of devastated lives and billions of dollars
unnecessarily spent on prolonged hospitalization, loss of income, disability and
litigation
 I am certain that you do all you can to ensure patient safety, but there is always
room for improvement
 I therefore wish to assist you in improving patient safety in your facility
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Be assured that...
 there is no risk in participating in the study
 you have the right to refuse participation (although
this would be a missed opportunity for improving
patient safety in your facility)
 you will not lose any state subsidies or other
benefits if you do not want to take part
 if you do participate in the study but later change
your mind, you can terminate the study at any time
 the objective is to evaluate practices and
challenges at the level of a ward, unit or facility
rather than to assess individuals: names of
individuals will not be recorded
 we keep patient data or other sensitive information
(availability of equipment, quality of practices,
medical records, etc.) strictly confidential
 investigators will be happy to answer any
questions you might have at any stage of the
process
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Objective of the study and recommended
method
 If you agree to participate in the study, I would like to assist you with
[delete objectives that do not apply]: counting patient harm, and/or
identifying causes of patient harm, and/or developing an action plan,
and/or monitoring & improving patient safety achievements
 I recommend employing [delete non-applicable method]: record review
of current in-patients and/or retrospective record review, and/or staff
interviews on current in-patients, and/or nominal group meetings,
and/or direct observation
 In the following I wish to give you a short overview of the
recommended method [delete non-applicable slides]
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Method overview:
record review of current in-patients
Method process
 reviewing medical
records of all patients
who are hospitalized on
the data collection day,
from all types of wards
and in-patient settings
Requires from you
 records of all current inpatients of x
departments of a health
facility on a given day, a
quiet room equipped
with a table
 availability for a couple
of hours of the doctor in
charge of the selected
wards to clarify
potential questions (if
available, not
necessarily required)
Results
 prevalence incidence of
harmful incidents
calculated
 contributing factors
identified
 preventability
determined, among
other results
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Method overview:
retrospective record review
Method process
 reviewing the facility’s
in-patient medical
records from the last
year, including all types
of wards and in-patient
settings
Requires from you
 facility’s in-patient
medical records from
the last year, a quiet
room equipped with a
table
Results
 incidence of harmful
incidents calculated
 contributing factors
identified
 preventability
determined, among
other results
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Method overview:
staff interview on current in-patients
Method process
 interviewing ward
nurse/nurse supervisor
and physician/doctor in
charge of in-patients
on day of data
collection (a given day)
Requires from you
 availability of the ward
nurse/nurse supervisor
(~ half a day) and the
physician/doctor in
charge of in-patients (~
half a day)
 a quiet room equipped
with a table and
records of current inpatients (if available,
not necessarily
required)
Results
 prevalence incidence
of harmful incidents
calculated
 contributing factors
identified
 preventability
determined, among
other results
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Method overview:
direct observation and interviews
Method process
 observation of facilities
and injection supply stock
 observation of injection
practices
 interviews with injection
providers
 interviews with
department supervisors of
injection providers
Requires from you
 availability of x
ward/outpatient nurses for
observation and
interviews
 availability of x
department
supervisors/ward
sisters/charge nurses for
interviews
 permission to observe
facilities and injection
supply (half a day for
data collection from five
wards/departments of a
district hospital)
Results
 causes of harmful
incidents occurring during
specific procedures as
well as problems relating
to injection
facilities/supply stock are
identified
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Method overview:
nominal group meeting
Method process
 one or several
brainstorming sessions
with staff representing all
hospital activities
 five to twelve staff from
this facility participate at
each session
Requires from you
 availability of staff for
approximately two hours
 a quiet meeting room
equipped with tables and
a blackboard/
 whiteboard/flipchart
Results
 causes of harmful
incidents are identified
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How you can contribute to the success of the
study
 be committed to the study and demonstrate to staff that you support it
 instruct participating staff to co-operate with investigators
 assist with providing the necessary materials and meeting the
requirements
 avoid controlling or obstructing the data collection process
 explain the study to the staff from your facility who will participate in it
(templates will be provided)
 reassure your staff that they will not be punished if the study reveals
shortcomings
 be available to be presented with the results at the end and to
communicate these to staff
 be willing to improve patient safety to the best of your ability
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The benefits for your health care facility
 The work in your facility will be thoroughly
assessed by trained and motivated investigators
 You will receive evidence-based external
recommendations to improve patient safety in
your health facility
 You will benefit from a constructive exchange of
experiences and good practices among
investigators, your staff and yourself
 Relationships that can be leveraged for future
initiatives will be established
 Your staff will be sensitized to patient safety
issues
[delete those of the following slides that do not apply]
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Your next steps for
record review of current in-patients
Preparation*
Conduct*
 we agree when the record review will
be held
 you introduce us to staff from selected
wards and medical records department, we
reassure them that the record review is
confidential and explain their role
 we select an appropriate sample, gather
these records and note missing records
 we screen and review medical records for
harmful incidents, contributing factors and
preventability and calculate the prevalence
of harmful incidents
 for monitoring and improvement only: we
discuss the results with the doctor in charge
to compare the results of the current study
to those of past studies
 we immediately present the results to you if
possible or, if not, do so at a later stage
 you arrange that a room equipped
with a table and the records will be
available
* more comprehensive guidance is provided in the method protocol
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Your next steps for
retrospective record review
Preparation*
Conduct*
 we agree when the record review will
be held
 you introduce us to the medical records
department, we reassure them that the
record review is confidential and explain
their role, the process and its objectives
 we select an appropriate sample, gather
these records and note missing records
 we screen and review medical records for
harmful incidents, contributing factors and
preventability and calculate the incidence of
harmful incidents
 for monitoring and improvement only: we
discuss the results with the doctor in charge
to compare results of the current study to
those of past studies
 we immediately present the results to you if
possible or, if not, do so at a later stage
 you arrange that a room equipped
with a table and the records will be
available
* more comprehensive guidance is provided in the method protocol
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Your next steps for
staff interviews on current in-patients
Preparation*
Conduct*
 we agree when the staff interviews
will be held and which wards will be
studied
 you arrange that a meeting room and
the medical records (if existing) will be
available
 you introduce us to the nurse and
doctor/physician and we explain their role
 we gather records (if available) and list names
of selected in-patients
 we determine for each patient whether harmful
incidents are present or not through
interviewing the nurse and consulting relevant
documents
 we study positively screened cases more in
depth through interviewing the doctor in charge
and consulting relevant documents
 for monitoring and improvement only: we
compare the results of the current study to
those of past studies through discussion with
the department supervisor
 we immediately present the results to you if
possible or, if not, do so at a later stage
* more comprehensive guidance is provided in the method protocol
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Your next steps for a
nominal group meeting
Preparation*
Conduct*
 we decide upon the number of
nominal group meetings and
agree when these will be held
 you select and invite
participants
 we conduct one or several
nominal group meetings
(depending on the size of the
facility) with 5 to 12 staff
members participating at each
 you arrange for a meeting room
equipped with tables and a
blackboard/whiteboard/flipchart
* more comprehensive guidance is provided in the method protocol
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Your next steps for
direct observation and related interviews
Preparation*
Conduct*
 we jointly select wards/units and agree
when the study will be conducted
 you ensure that ward/outpatient nurses
and department supervisors, ward sisters
or charge nurses will be available for
observation and related interviews
 we present the study to the matron and
explain his/her role in the data collection
 the matron introduces us to the charge
nurses/sisters of participating clinical
areas and informs them of the
observation and interviews
 we observe injection facilities/stock,
observe injection practices and conduct
interviews with injection providers and
department supervisors
 we immediately present the results to you
if possible or, if not, do so at a later stage
* more comprehensive guidance is provided in the method protocol
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Questions? Comments?
Thank you for participating!
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Further information
 For further information, questions or comments contact
<insert your name and telephone number or email>
 Visit the Patient Safety Programme (Research) website at:
http://www.who.int/patientsafety/research/en/
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