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The Scottish Patient Safety Paediatric Programme, General Ward Workstream. Jane Murkin, National Co-ordinator Annette Henderson PM NHS Lothian. Aims. Complexity and challenges Overview of SPSP general ward aims and drivers Share successes Learning to date
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The Scottish Patient Safety Paediatric Programme, General Ward Workstream Jane Murkin, National Co-ordinator Annette Henderson PM NHS Lothian
Aims • Complexity and challenges • Overview of SPSP general ward aims and drivers • Share successes • Learning to date • Overview of Paediatric General ward • A local board experience of implementing PEWS • Setting your first pdsa • What else?
Joke pic Ward 1 Ward 2
Challenges • complexity • Too Busy • Yet more work /audit • We don’t have a problem • Variation • Standardisation versus customisation • Tools to test • Tools to measure • Knowledge to test and measure • Motivation to change
Content areas • SBAR • Early recognition • Outreach teams / response system • Hand hygiene • Safety Briefings • PVC Bundle • Medicines reconciliation
Learning to date • Importance of linking process and outcome • Challenges in relation to testing and implementing response systems • Significant progress and successes • Achieving reliability prior to spread • Scale and challenge of spread • Importance of data at the frontline • Multidisciplinary engagement • Infrastructure of support
Percent trained in the use of SBAR within NHS Ayrshire & Arran Pilot Ward
In aviation 75% of accidents are caused by human factors… …what’s the figure in healthcare?
Percent compliance with EWS Assessment – Golden Jubilee National Hospital
Percent of observations identified as at risk that have appropriate interventions undertaken in terms of EWS – NHS Fife
Percent compliance with hand hygiene with general ward – NHS Grampian
Questions? Questions?
Using the lens of Profound Knowledge Appreciation of a system Theory of Knowledge Psychology Understanding Variation Aim or Values
simple tool for staff to use test out ideas that will improve healthcare systems and processes The Improvement Guide, API
Repeated Use of the Cycle A P S D D S P A A P S D A P S D Changes That Result in Improvement DATA Hunches Theories Ideas
Build on Small Scale Tests of Change • One patient • One doctor • One nurse • One day / shift Seek usefulness, not perfection
What will it take to improve safety? • Winning the hearts and minds of the staff • Focusing on improvement not targets • Leadership • Integration • Making it daily work • Creating infrastructure • Creating capability and capacity • Measurement that has meaning