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The implementation of the Surgical Patient Safety System (SURPASS) at UMCG

The implementation of the Surgical Patient Safety System (SURPASS) at UMCG Susan Wesselink , MSc . . Quality improvement in healthcare. M ore instruments to improve patient safety and quality

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The implementation of the Surgical Patient Safety System (SURPASS) at UMCG

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  1. The implementation of the SurgicalPatientSafety System (SURPASS) at UMCG Susan Wesselink, MSc.

  2. Qualityimprovement in healthcare • More instruments to improve patient safety and quality • Implementation of a quality instrumentSURPASS:- Multidisciplinary checklist to be used throughout the surgical trajectory • Crucial transfer moments in the trajectory

  3. STOP MOMENTSSurgicaltrajectory - SURPASS

  4. Safety is down to people: SURPASS Patient goes for surgery Stop moment 1 and 2 Pre-admission policlinic Stop moment 3a and 3b Stop moment 4 en 5 Pre-surgical phase and transfer department-holding en holding-surgery Time-out en sign-out op OK Transfer PACU or IC to holding Stop moment 6 Anesthesioloog And planning bureau Stop moment 7 Dismissal ward Surgeon and Anesthesiologist Patiënt Seriouslydamagedor Anesthesiologist orintensivist Ward doctor & nurse

  5. Implementationstrategies • Checklists aren’tpopularamongstmedicalspecialists (The checklist manifest – AtulGawande) • How to improveacceptation ?- pilot- ambassadors- access to information- feedback • Implementation research: anchor lessonslearnedforimplementations in the future

  6. Conceptual research model Team climate Implementationinterventions 1 Unfreeze2 Move 3 Refreeze + Use of SURPASS Readinessforchange + + • Research questions: • Does team climate have a moderating effect on the relationship between the ‘unfreezing’ implementation interventions and readiness for change? • Does readiness for change mediate the relation between the ‘unfreezing’ implementation interventions and the implementation outcome?

  7. Methods • Multi – level single case study:- individual level (self-rating) - department level (% usage of SURPASS) • Questionnaires (partlyvalidated) - 28,8% response rate

  8. Results • Interventions in unfreeze-fase (information, support) lead to a higher level of readinessfor change • Team climate is of positiveinfluenceon the readinessforchange, especially the intention to use the quality instrument • Emphasison the goal of the implementation, to improveacceptation • Direct relationbetweenexperiencewithintervention and adoption to change (department level result)

  9. Conclusion • Interventions in unfreeze-fase (information, involvement of key user groups) lead to a higher level of readinessfor change (all of the 3 dimensions) • Importance of team climate in the adoption to the change: - Participativesafety?- in-group vs. outgroup member? • Importance of implementationinterventionsunderlined; Improvepositiveexperienceswithimplementationinterventions

  10. Questions/discussion

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