Advancing Patient Safety NHS Lanarkshire Diane Campbell Programme Manager (SPSP)

1. Advancing Patient SafetyNHS LanarkshireDiane Campbell Programme Manager (SPSP)

2. The Current Situation • Overwhelming agenda • Maintaining Financial Health • Same staff responsible for implementation • Cyclical approach • Parallel programmes and initiatives • Slightly different methodologies and ‘jargon’ • Competing imperatives

4. The Scope of Quality

5. Making good progress across all work streams within our acute Hospitals • Building capacity and capability right across the organisation • Active work stream teams with excellent executive and clinical leads • Data management • Data ownership • Listening and learning • Integration with other quality programmes • Embedding in organisational culture – Patient Safety is the way we do things! Hairmyres Monklands Wishaw

7. Peri Operative Measures % on time antibiotics - Hm % Hair removal all ownership % normothermia Hm % eligible pts with DVT prophylaxis - WGH % beta blockers - Mk

8. Briefings and Pause Pause excellent compliance Briefings WGH Briefings more challenging Briefings Hm Briefings Mk

9. Improvement Methodology? The issue raised “I am concerned that the Surgical Brief is being seen as a tick box process rather than it being used for the important purpose for which it was proposed. Whilst I appreciate everybody is busy it is extremely important if we say we are doing the Brief that we actually are. ….. are 90%+ fully compliant and ….. are about 75%+ at present. ….. was below 25% compliant” The responses • “the brief crystallises thought at the start of a list, and in my opinion advances the culture of safety. It is also useful at that point to let the theatre staff know which instruments and equipment you will, won’t or might need for cases, and, in urology anyway, can often prevent expensive disposables being opened unnecessarily” • “I think you’re right, and, although I thought this was daft at first, I’m now a convert. It just cuts time off the list “

10. Critical Care: Have made excellent progress. Average Length of Stay WGH Staph Aureus Bacteraemias Mk Reducing ALOS Nil since May 2008 % Blood sugar within range Central Line Infections Hm Similar picture with other process measures Nil since November 2008

11. Using data to drive improvement:- CRYSTAL Reports: Some actual examples, now demonstrating correlation between process and outcomes

12. Leadership Walk rounds Completed Walk round database with automatic functionality Automatically generated e-mails and action reminders, still hard to track!

13. Need for Data to Drive Improvement • SPSP widely spread and hence need to manage data differently • Ownership at clinical frontline • Staff input data and receive Crystal reports • Every ward and relevant department displaying progress via SPSP Quality Boards • Every ward and relevant department displaying run charts and Days between infection • Also used by work stream leads to drive improvement • Evolving system and web portal development • Integration of all quality activities – staff enter and receive data same way

14. Next Stage in Data Management: Our strategic Direction: Implementation of a Quality Web Portal

15. Lastly Integration: NHS Lanarkshire Strategic and operational priorities. Examples: • NHS Lanarkshire Quality strategy • Formal network / quality hub • Active participation and linking with LEAN, Productive Ward, CQIs, HAI, Better Together and so on…. • Charge Nurse objectives • Beginning to merge work streams • Joint ways of reporting at the clinical frontline • Strategic development of web portal to bring formally together