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Safety Culture the journey in paediatrics – so far......

Safety Culture the journey in paediatrics – so far. Scottish Patient Safety Paediatric Programme. Success of SPSP – adopted work streams. SPSPP launched – June 2010 Inpatient paediatric care (all ages). Aims: paediatric evidence-base; ‘best in class’; linked to measurable outcomes.

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Safety Culture the journey in paediatrics – so far......

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  1. Safety Culture the journey in paediatrics – so far......

  2. Scottish Patient Safety Paediatric Programme • Success of SPSP – adopted work streams. • SPSPP launched – June 2010 • Inpatient paediatric care (all ages). • Aims: • paediatric evidence-base; • ‘best in class’; • linked to measurable outcomes. • Dynamic quality improvement programme. • Relevant to paediatric hospital care delivered in Scotland.

  3. SPSPP Key Aim: 30% reduction in adverse events by June 2013 “Harm” – anything done you wouldn’t like done to yourself

  4. Defining the problem

  5. Measuring Harm – Paediatric Trigger Tool

  6. What can we do with the data?

  7. Working with People Adapted from R Scoville, R Lloyd, IHI

  8. Subject Matter Experts Triggers not applicable to DGH care Liked the multi-disciplinary approach to reviews Culture shift – understanding of harm! Adverse Events ‘rare events’ – how to improve Many triggers addressed by SPSPP

  9. What are we trying to accomplish?

  10. The aim.....

  11. Testing / Change Concepts • Methodology • Review to follow admission • Identify what causes harm / common system failures • Long-term conditions • Child Protection

  12. What change can we make that will result in improvement? SPSPP Avoidable Harm - Structured Case Note Review

  13. How will we know a change is an improvement?

  14. Improvement Journey

  15. Cultural Shift – Adverse Events to Avoidable Harm

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